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Wisdom teeth pain: What is causing it?

The majority of people will have two sets of teeth over the span of their life: baby teeth (more correctly known as primary teeth), of which there are 20; followed by adult teeth (or permanent teeth), of which there are 32.

When teeth first push through the gums we call this eruption, with the first molars (located towards the back of the mouth) being some of the first permanent teeth to erupt, usually around the age of 6 or 7 years.

The molars do not actually replace any of the baby teeth, so they account for the increase from 20 teeth in children to 32 teeth in adults. With no other teeth in their way, the first and second molars (which arrive between 11 and 13 years) have plenty of room to break through.

Your third molars, also known as the wisdom teeth, are the last of the adult teeth to erupt, generally arriving when you are between 17 and 21 years of age. (It is assumed that one will be ‘older and wiser’ than when any of the other teeth appeared, hence the name wisdom teeth.) Sometimes referred to as the ‘eights’, each wisdom tooth is the eighth and final tooth in each of the four corners of the mouth.

By the time these teeth arrive, all of the other adult teeth are well and truly out, which can cause problems. Firstly, because the wisdom teeth are so far back in the mouth, they generally prove very difficult to keep clean (less than 2% of adults aged 65 years of age maintain their third molars free from cavities or gum disease). Secondly, there is often insufficient room for the eights, which can result in complications.

As an aside, given the trouble they cause, it is perhaps ironic that wisdom teeth are generally considered completely unnecessary from a functional perspective (for chewing and speaking). In fact, the third molars are thought to be a remnant from a time when humans had larger jaws and required an extra molar in each corner of the mouth so they could break down tough plant food, thereby aiding digestion.

Why the wisdom teeth pain?

The most common wisdom tooth problem is known as impaction, which refers to a tooth that is ‘coming in sideways’ because it has insufficient space to erupt. On the other hand, wisdom teeth can also over erupt.

Unless the teeth are removed, either of the following painful conditions might arise:

  • Development of gum disease, which tends to result from food building up around the teeth because access for cleaning is so restricted.
  • Inflammation and bacterial accumulation affecting the soft tissue (both gum and dental follicle) around the partially erupted tooth.

Over eruption can also cause bad bite and trauma to surrounding teeth because the erupted teeth can be quite sharp.

What does removal involve?

Given their location at the very back of the mouth, wisdom teeth are relatively complicated to remove. Also, they are situated close to the inferior alveolar nerve or lingual nerve.

However, with dentistry having become more sophisticated and patient-friendly over time, removal of wisdom teeth is today a far safer and more comfortable process than it once was and the end result is relief from wisdom tooth pain.

In rare instances, complications can still arise, including excessive haemorrhaging (blood loss), postoperative oedema (swelling) and/or infection, bruising and dry socket, most of which are only temporary.

Damage to either of to the nerves mentioned above can result in temporary or permanent paraesthesia (pins and needles) or anaesthesia (numbness) to the area these nerves supply (that is, the lip, cheek, gum and tongue of the corresponding side of the face). These permanent side-effects are very rare.

Any extraction also has the potential to cause damage to the adjacent teeth, which may then require restoration with treatments such as crowns, onlays and fillings.

At Core Dental, we aim to minimise the risk of such complications by referring our wisdom teeth patients to registered specialists, such as oral & maxillofacial surgeons, whose training includes 4 to 5 years of general dentistry plus 4 to 6 years spent completing a degree in Medicine (the same degree as a medical general practitioner).

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