A wisdom tooth refers to the third molar in each quadrant of the mouth. Wisdom teeth tend to erupt later in life when a person is in their late teens to early ’20s, not always in correct alignment, and often causing more harm than good. Wisdom teeth were named as such because they make their appearance when a person has matured, and in theory, has gained more wisdom in life. Some would say this is not an accurate view of a 17-20-year-old, but it makes for a great name for a tooth nonetheless.
A wisdom tooth would have to be the most unreliable and unpredictable tooth that forms in humans. Some people might grow all four and they come through perfectly, as they are expected to do – although this is rarely the case. Others may have only one, or two, or three wisdom teeth and be missing the other/s for no reason whatsoever. And some fortunate people may never develop them at all!
Most people are not even aware they have wisdom teeth until they visit the dentist and have a full mouth x-ray called an OPG (Orthopantomogram). This diagnostic 2D radiograph shows the internal facial features from the chin to the bottom of the sinus and of course every tooth in a person’s jaw, including any wisdom teeth that might be buried below the gumline out of sight. For the more unfortunate, the discovery of wisdom teeth is when they develop pain towards the back of the mouth, often brought on by rot (dental decay) inside the wisdom tooth due to difficulty in reaching the area to clean, or the soft tissue around the wisdom tooth becomes infected with gum disease – again due to inability to maintain the cleanliness of the tooth and surrounding gum.
This is a question dentists are often asked by patients who have been told they have wisdom teeth. Wisdom teeth certainly do have a bad reputation for causing severe amounts of pain both when they become infected and after surgical removal, while the area heals. However, it’s important to note that not all wisdom teeth become infected, come through misaligned or become a long drawn out painful experience to have removed.
Several factors will determine if a person’s wisdom teeth are deemed good or bad, such as;
Have you been told you have wisdom teeth and advised to have them removed?
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The cost of wisdom tooth removal will depend on who performs the treatment ie: general dentist or maxillofacial surgeon, the complexity of the process needed to remove the wisdom tooth safely and any additional sedatives you may like to assist in your comfort and anxiety levels.
As a rough guide, a straightforward wisdom tooth extraction will cost between $170 – $300. A wisdom tooth which requires surgical removal of soft tissue and/or bone in order to gain access to the tooth will cost a few hundred dollars more to extract per tooth. If you decide to have I.V. sedation or a general anesthetic, this, of course, will add to the overall cost of wisdom teeth removal treatment.
When a wisdom tooth is unable to complete it’s a transition into the mouth successfully because there is not enough room on the jawline for it to fit, or it’s growing on an angle forcing it to head in the wrong direction, we class this tooth as being an impacted wisdom tooth. Often, removal of an impacted wisdom tooth is the only treatment option to prevent an emergency situation in the future and damage to the adjacent teeth.
Many people have lived through a week of sleepless nights with severe dental pain from an infected wisdom tooth and have managed to live to tell the torturous tale. So yes, the pain may go away on its own, if you can withstand the intense throbbing and swelling pain while the body attempts to fight the infection without medical intervention, however, most often the infection becomes so bad and makes the person extremely unwell – and in severe cases, will require hospitalisation to prevent it from becoming fatal. Therefore, waiting out the pain is of course not our suggestion! If you are experiencing wisdom tooth pain and infection, you are wise to seek medical assistance from your local GP or Dentist as soon as possible.
Have a good hearty meal prior to the appointment, or starting to fast if you are going under general anaesthetic, since you won’t feel like eating much afterwards.
Find out what post-operative care instructions your dentist will be recommending and have them ready at home. For example, most recommend warm salty rinses a few times a day for up to a week.
Prepare a few day’s worth of yummy, healthy meals that can be heated up easily. Soft meals are recommended as your jaw and gums will be tender for a few days post-treatment.
Have cold packs ready in the freezer to put on the side of your face to help reduce any swelling after wisdom teeth removal.
Make sure you have filled any prescriptions prior to your visit, if possible.
Have enough painkillers at home to last you up to a week.
Take enough time off work for recovery. Your dentist will suggest an appropriate amount of time-based on your treatment and expected recovery period.
Plan to avoid any physical activities for a few days post-treatment.
If the extraction procedure involved surgical removal of some soft tissue and bone surrounding the tooth before the wisdom tooth could be pulled out successfully, healing will take longer and you may be in more discomfort than if it had been a more straightforward and basic extraction. The dentist will prescribe antibiotics and painkillers only when needed and will recommend their preferred method of pain relief which may involve taking paracetamol and/or ibuprofen for a few days and the use of cold packs to help reduce swelling and bruising.
Your jaw will most likely be tender for a few days post-treatment and you may find it difficult to open wide and chew hard foods during this time.
After a week of rest and healing, you should be ready to return to work and exercise as normal and begin to introduce harder foods back into your diet. Continue to take it easy and rest when needed to give your body time to heal.
You may have stitches (sutures) in place to help close the socket and repair any damaged gum and soft tissue. Check with your dentist if these need manual removal, which normally occurs 7 days after the extraction, or are this resorbable in which case they may take around four weeks to dissolve.
A dry socket is the name given to a secondary infection in the gum socket after a wisdom tooth has been extracted. Patients sometimes describe the pain of a dry socket infection as being more painful than the tooth pain they were experiencing prior to having the tooth removed. Pain, swelling, pus and a hot face are all common symptoms of a dry socket. A dry socket normally occurs 2 – 3 days after a tooth is removed. Those at higher risk of developing a dry socket are smokers, those who drink alcohol and medical conditions and medications that slow the blood flow to the area needed to clot and close off the open socket.
If you are experiencing pain 2 – 3 days after having a tooth removed it’s likely you have a dry socket. This can become very painful and very dangerous to your health if left untreated. This secondary infection must be treated by a dentist or GP (if a dentist is unavailable) by flushing out the area with a medicated solution to clean out the socket, placing a medicated gel (which doesn’t taste very nice!) of butamben and eugenol which eases the pain and iodoform which helps to kill any micro-organisms that are present. The dentist will then prescribe you with antibiotics to fight the active infection. You should start to feel better within 24 – 48 hours of taking the first lot of antibiotics.
Keep the area clean by gently rinsing with warm salty water 2 – 3 times per day for five days post-extraction.
The day after your tooth extraction begin brushing the area lightly with a manual toothbrush to remove any food and debris trapped in the open socket. Continue to increase bushing to the area until you feel comfortable brushing as normal.
Do not smoke for at least three days post-extraction.
Avoid alcohol for 48 hours
Eat a diet of soft foods until the socket clots fully – this is normally around 3-4 days.
If you begin to feel unwell, develop swelling or pain around the extraction site, contact your dentist immediately.
Take time to rest and heal at home. Avoid strenuous work and exercise for 3-4 days.