Wisdom teeth
Wisdom teeth can be very troublesome and commonly cause episodes of pain and infection.
Many people incorrectly assume the cause of wisdom tooth pain is the wisdom tooth erupting or growing. There is a common misconception that wisdom teeth cause so-called “over-crowding” of teeth.
Around 8% of people have no wisdom teeth, and not everyone with wisdom teeth will have problems.
Eruption timing of wisdom teeth
Wisdom teeth normally start to erupt at around age 18-25 but can erupt any time after this. They normally take a few months to a few years to fully erupt.
Impacted wisdom teeth
Wisdom teeth often get stuck bumping into the tooth in front. Sometimes they get stuck bumping into the gum or bone at the side or behind. When teeth are stuck and cannot fully erupt they are described as impacted.
Wisdom tooth pain
Most people tend to incorrectly attribute the cause of any wisdom tooth pain to the tooth erupting or growing. Instead the pain is usually caused by food and bacteria being left around the tooth or under the flap of gum that might cover some of the tooth. The bacteria then cause swelling and soreness of the gum around the tooth. Sometimes the bacteria can produce pus and this might cause more swelling and pain. The condition of swelling and soreness of the gum around a partially erupted tooth is called pericoronitis.
Treatment for pericoronitis at home
The first line of treatment for a sore wisdom tooth should always be to improve your oral hygiene and to use an antibacterial mouthwash. This means:
Treating pericoronitis with mouthwash
Chlorhexidine mouthwashes like Corsodyl are antibacterial, and should be used as a first line treatment for a sore wisdom tooth.
Usually the pain will improve over 2-3 days and resolve in 5-7 days. If the pain is getting better, you can continue to manage your wisdom tooth pain at home. If there is no improvement after 5 days then you should seek advice from a dentist.
Antibiotics are for treatment of whole-body, spreading and blood infections. Wisdom tooth pain is usually caused by bacteria located directly around the tooth. Antibiotics are therefore usually not appropriate for the treatment of wisdom tooth pain.
Misuse of antibiotics in humans is partly contributing to the global threat of antibiotic resistance. Antibiotics should not be used when they wont help or there is a more appropriate alternative.
If caught early enough, most episodes of wisdom tooth pain can be easily and successfully treated at home. The best treatment is to simply improve your oral hygiene and use an antibacterial mouthwash.
If left too long before starting treatment at home, or in circumstances where there are complicating factors (such as tooth decay or extremely difficult to clean impactions), then the bacteria around the tooth and gum can spread into your blood and around your body. At this point, antibiotic treatment may be advised by your dentist.
Pain control for pericoronitis
Wisdom tooth pain can usually be controlled with use of painkillers bought over the counter. Paracetamol and ibuprofentaken together or separately are very effective for most dental and oral pain.
If you are unsure if it is safe for you take ibuprofen or paracetamol (e.g. if you have an allergy, asthma sensitive to NSAIDs, stomach ulcers, gastrointestinal bleeding, heart failure, or you are pregnant) or you already know you are unable to use them, then ask your pharmacist for advice or visit the NHS 111 website.
When to get emergency or urgent advice from a dentist for wisdom tooth painYou should seek advice from a dentist as soon as possible if you:
Wisdom tooth extractions
Lower wisdom teeth are not preventatively extracted in the UK. This is because of the risk of damage to a nerve in your lower jaw bone during the extraction procedure. Nerve damage is thankfully a rare complication of lower wisdom tooth extraction, but can leave some patients feeling tingly or numb. Sometimes the numbness is temporary but it can be permanent.
All dentists in the UK (NHS and private) have to follow UK guidelines set by the National Institute for Health and Care Excellence (NICE). The guidelines state that your lower wisdom teeth should only usually be extracted if they are decayed, causing decay in the next tooth, or if you have been to your dentist with several episodes of wisdom tooth infection that were severe enough to need treatment with antibiotics.
Unfortunately, the guidelines have resulted in many patients having to suffer with their wisdom teeth problems for a few years before they meet the criteria for extraction. During the delay, the next tooth often starts to decay and then requires a filling, root canal treatment and a crown, or extraction.
The guidelines may be preventing a few cases of nerve damage, but in doing so, causing many more episodes of pain and suffering, and causing lots of tooth decay.
After much criticism by dentists and oral surgeons, the guidelines are currently under review and hopefully will be updated soon.
What to expect after a wisdom tooth extraction and aftercare at home
The Royal College of Surgeons have produced an excellent Get Well Soon guide to help you make a speedy recovery after wisdom teeth extractions.
Wisdom teeth and crowding
It used to be believed that wisdom teeth might cause “over-crowding” of teeth by pushing forwards from the back of the mouth. However the gradual crowding of teeth can be seen equally in people with no wisdom teeth. It is now understood to be a normal part of the ageing process. It is caused by a tendency for teeth to drift forwards toward the front of the mouth. Extraction of wisdom teeth unfortunately does not prevent tooth crowding.
Text and further advice from dentalchoices.org
Wisdom teeth can be very troublesome and commonly cause episodes of pain and infection.
Many people incorrectly assume the cause of wisdom tooth pain is the wisdom tooth erupting or growing. There is a common misconception that wisdom teeth cause so-called “over-crowding” of teeth.
Around 8% of people have no wisdom teeth, and not everyone with wisdom teeth will have problems.
Eruption timing of wisdom teeth
Wisdom teeth normally start to erupt at around age 18-25 but can erupt any time after this. They normally take a few months to a few years to fully erupt.
Impacted wisdom teeth
Wisdom teeth often get stuck bumping into the tooth in front. Sometimes they get stuck bumping into the gum or bone at the side or behind. When teeth are stuck and cannot fully erupt they are described as impacted.
Wisdom tooth pain
Most people tend to incorrectly attribute the cause of any wisdom tooth pain to the tooth erupting or growing. Instead the pain is usually caused by food and bacteria being left around the tooth or under the flap of gum that might cover some of the tooth. The bacteria then cause swelling and soreness of the gum around the tooth. Sometimes the bacteria can produce pus and this might cause more swelling and pain. The condition of swelling and soreness of the gum around a partially erupted tooth is called pericoronitis.
Treatment for pericoronitis at home
The first line of treatment for a sore wisdom tooth should always be to improve your oral hygiene and to use an antibacterial mouthwash. This means:
- Ideally use an electric toothbrush to reach and massage the gum as well as cleaning the tooth.
- Use dental floss to clean between all of your teeth.
- Use a chlorhexidine mouthwash like Corsodyl.
- Very hard-to-reach wisdom teeth which are only partially erupted can often be cleaned better with a single tufted toothbrush.
Treating pericoronitis with mouthwash
Chlorhexidine mouthwashes like Corsodyl are antibacterial, and should be used as a first line treatment for a sore wisdom tooth.
Usually the pain will improve over 2-3 days and resolve in 5-7 days. If the pain is getting better, you can continue to manage your wisdom tooth pain at home. If there is no improvement after 5 days then you should seek advice from a dentist.
- Brush your teeth at least twice daily, but wait around 45 minutes after brushing before you rinse with Corsodyl. Applying directly with a baby bud is preferable to avoid staining.
- Apply Corsodyl at least 4 times daily, ideally after eating.
- Time your application for 60 seconds using a clock or timer.
- Stop using a chlorhexidine mouthwash when your pain and swelling have resolved.
- Corsodyl is a popular brand of chlorhexidine mouthwash, but other brands are available. Corsodyl can stain teeth.
- An alternative to a chlorhexidine mouthwash is a peroxide mouthwash like Peroxyl, which can be used in the same way.
- A warm salty mouthwash may be of some benefit until you can obtain some chorlexidine or peroxide mouthwash to use. You should make the warm salty mouthwash using a teaspoon of salt in small a cup of warm water.
Antibiotics are for treatment of whole-body, spreading and blood infections. Wisdom tooth pain is usually caused by bacteria located directly around the tooth. Antibiotics are therefore usually not appropriate for the treatment of wisdom tooth pain.
Misuse of antibiotics in humans is partly contributing to the global threat of antibiotic resistance. Antibiotics should not be used when they wont help or there is a more appropriate alternative.
If caught early enough, most episodes of wisdom tooth pain can be easily and successfully treated at home. The best treatment is to simply improve your oral hygiene and use an antibacterial mouthwash.
If left too long before starting treatment at home, or in circumstances where there are complicating factors (such as tooth decay or extremely difficult to clean impactions), then the bacteria around the tooth and gum can spread into your blood and around your body. At this point, antibiotic treatment may be advised by your dentist.
Pain control for pericoronitis
Wisdom tooth pain can usually be controlled with use of painkillers bought over the counter. Paracetamol and ibuprofentaken together or separately are very effective for most dental and oral pain.
If you are unsure if it is safe for you take ibuprofen or paracetamol (e.g. if you have an allergy, asthma sensitive to NSAIDs, stomach ulcers, gastrointestinal bleeding, heart failure, or you are pregnant) or you already know you are unable to use them, then ask your pharmacist for advice or visit the NHS 111 website.
- Paracetamol is available to buy over the counter in supermarkets and pharmacies. Shop own brands are usually the best value. You can also buy paracetamol online from a pharmacist (or from Amazon: Panadol tablets).
- Ibuprofen is available to buy over the counter in supermarkets and pharmacies. Shop own brands are usually the best value. You can also buy ibuprofen online from a pharmacist (or from Amazon: Nurofen tablets).
When to get emergency or urgent advice from a dentist for wisdom tooth painYou should seek advice from a dentist as soon as possible if you:
- have severe facial or oral swelling
- cannot open your mouth fully or your tongue is swelling
- have swelling which is rapidly getting bigger
- feel unwell, excessively tired, or have a fever
- feel your glands (lymph nodes) in your neck are sore or swollen
- have been using an antibacterial mouthwash strictly (as detailed above) for 5 days with no improvement
Wisdom tooth extractions
Lower wisdom teeth are not preventatively extracted in the UK. This is because of the risk of damage to a nerve in your lower jaw bone during the extraction procedure. Nerve damage is thankfully a rare complication of lower wisdom tooth extraction, but can leave some patients feeling tingly or numb. Sometimes the numbness is temporary but it can be permanent.
All dentists in the UK (NHS and private) have to follow UK guidelines set by the National Institute for Health and Care Excellence (NICE). The guidelines state that your lower wisdom teeth should only usually be extracted if they are decayed, causing decay in the next tooth, or if you have been to your dentist with several episodes of wisdom tooth infection that were severe enough to need treatment with antibiotics.
Unfortunately, the guidelines have resulted in many patients having to suffer with their wisdom teeth problems for a few years before they meet the criteria for extraction. During the delay, the next tooth often starts to decay and then requires a filling, root canal treatment and a crown, or extraction.
The guidelines may be preventing a few cases of nerve damage, but in doing so, causing many more episodes of pain and suffering, and causing lots of tooth decay.
After much criticism by dentists and oral surgeons, the guidelines are currently under review and hopefully will be updated soon.
What to expect after a wisdom tooth extraction and aftercare at home
The Royal College of Surgeons have produced an excellent Get Well Soon guide to help you make a speedy recovery after wisdom teeth extractions.
Wisdom teeth and crowding
It used to be believed that wisdom teeth might cause “over-crowding” of teeth by pushing forwards from the back of the mouth. However the gradual crowding of teeth can be seen equally in people with no wisdom teeth. It is now understood to be a normal part of the ageing process. It is caused by a tendency for teeth to drift forwards toward the front of the mouth. Extraction of wisdom teeth unfortunately does not prevent tooth crowding.
Text and further advice from dentalchoices.org
Chat GPT advice.....after my input
Wisdom Teeth: Understanding Problems, Comfort Management, and Removal Options
Often referred to as third molars, wisdom teeth can lead to various dental issues if they don't erupt properly. Understanding the problems associated with these molars, how to reduce discomfort, and the options for their removal is essential for maintaining healthy oral health.
---
**Problems Associated with Wisdom Teeth**
Wisdom teeth typically emerge between the ages of 17 and 25, but many people experience complications due to limited space in the mouth. Common issues include:
1. **Impaction**: Wisdom teeth may become impacted, meaning they cannot fully emerge through the gums. This can create pressure against neighboring teeth and cause pain.
2. **Infection**: Partially erupted wisdom teeth can trap food and bacteria, leading to infections, characterized by swelling, pain, and bad breath.
3. **Crowding**: In some cases, wisdom teeth can push adjacent teeth out of alignment, leading to crowding and bite issues.
4. **Cysts**: Impacted wisdom teeth may lead to cyst formation, which can damage surrounding tooth structures and bone.
5. **Gum Disease**: Difficulty cleaning around impacted wisdom teeth can contribute to gum disease, causing inflammation and even tooth decay.
---
**Reducing Discomfort**
If you're experiencing discomfort due to wisdom teeth, there are several strategies to help manage pain and discomfort:
1. **Over-the-Counter Pain Relief**: Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen can help alleviate pain and reduce swelling.
2. **Warm Salt Water Rinses**: Rinsing your mouth with warm salt water can help soothe inflamed gums and wash away food particles.
3. **Cold Compress**: Applying a cold compress to the outside of your jaw can help reduce swelling and numb pain.
4. **Maintaining Oral Hygiene**: Good oral hygiene, including regular brushing and flossing, can prevent additional irritation or infection.
5. **Diet Modifications**: Eating soft foods and avoiding chewing on the side with the impacted tooth can help minimize discomfort while you manage symptoms.
---
**Removal of Wisdom Teeth**
If the problems associated with your wisdom teeth persist or worsen, removal may be necessary. There are two main approaches for the extraction of wisdom teeth:
1. **General Dental Practice**:
- Many general dentists can perform wisdom tooth extractions, especially for teeth that are fully erupted or easily accessible.
- The procedure typically involves local anesthesia to numb the area and may be done in-office. Recovery is generally straightforward, with post-operative care instructions provided.
2. **Specialist Oral Surgery**:
- For more complex cases, such as impacted wisdom teeth or those with deeper roots, referral to an oral and maxillofacial surgeon may be recommended.
- Specialists have the expertise and equipment to handle more challenging extractions (e.g., IV sedation for anxiety, advanced imaging techniques).
- This surgical approach may involve a short recovery period, and patients will receive detailed aftercare instructions to ensure a smooth healing process.
---
**Conclusion**
Wisdom teeth can present various challenges, but understanding these problems, adopting pain management strategies, and knowing your options for extraction can alleviate concerns. Regular dental check-ups are crucial for monitoring the development of wisdom teeth and ensuring timely intervention when necessary. If you have questions or want to schedule a consultation regarding your wisdom teeth, please contact us today. Let's work together to safeguard your oral health for a brighter, pain-free smile!
Wisdom Teeth: Understanding Problems, Comfort Management, and Removal Options
Often referred to as third molars, wisdom teeth can lead to various dental issues if they don't erupt properly. Understanding the problems associated with these molars, how to reduce discomfort, and the options for their removal is essential for maintaining healthy oral health.
---
**Problems Associated with Wisdom Teeth**
Wisdom teeth typically emerge between the ages of 17 and 25, but many people experience complications due to limited space in the mouth. Common issues include:
1. **Impaction**: Wisdom teeth may become impacted, meaning they cannot fully emerge through the gums. This can create pressure against neighboring teeth and cause pain.
2. **Infection**: Partially erupted wisdom teeth can trap food and bacteria, leading to infections, characterized by swelling, pain, and bad breath.
3. **Crowding**: In some cases, wisdom teeth can push adjacent teeth out of alignment, leading to crowding and bite issues.
4. **Cysts**: Impacted wisdom teeth may lead to cyst formation, which can damage surrounding tooth structures and bone.
5. **Gum Disease**: Difficulty cleaning around impacted wisdom teeth can contribute to gum disease, causing inflammation and even tooth decay.
---
**Reducing Discomfort**
If you're experiencing discomfort due to wisdom teeth, there are several strategies to help manage pain and discomfort:
1. **Over-the-Counter Pain Relief**: Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen can help alleviate pain and reduce swelling.
2. **Warm Salt Water Rinses**: Rinsing your mouth with warm salt water can help soothe inflamed gums and wash away food particles.
3. **Cold Compress**: Applying a cold compress to the outside of your jaw can help reduce swelling and numb pain.
4. **Maintaining Oral Hygiene**: Good oral hygiene, including regular brushing and flossing, can prevent additional irritation or infection.
5. **Diet Modifications**: Eating soft foods and avoiding chewing on the side with the impacted tooth can help minimize discomfort while you manage symptoms.
---
**Removal of Wisdom Teeth**
If the problems associated with your wisdom teeth persist or worsen, removal may be necessary. There are two main approaches for the extraction of wisdom teeth:
1. **General Dental Practice**:
- Many general dentists can perform wisdom tooth extractions, especially for teeth that are fully erupted or easily accessible.
- The procedure typically involves local anesthesia to numb the area and may be done in-office. Recovery is generally straightforward, with post-operative care instructions provided.
2. **Specialist Oral Surgery**:
- For more complex cases, such as impacted wisdom teeth or those with deeper roots, referral to an oral and maxillofacial surgeon may be recommended.
- Specialists have the expertise and equipment to handle more challenging extractions (e.g., IV sedation for anxiety, advanced imaging techniques).
- This surgical approach may involve a short recovery period, and patients will receive detailed aftercare instructions to ensure a smooth healing process.
---
**Conclusion**
Wisdom teeth can present various challenges, but understanding these problems, adopting pain management strategies, and knowing your options for extraction can alleviate concerns. Regular dental check-ups are crucial for monitoring the development of wisdom teeth and ensuring timely intervention when necessary. If you have questions or want to schedule a consultation regarding your wisdom teeth, please contact us today. Let's work together to safeguard your oral health for a brighter, pain-free smile!
