Permanent dentition comprises four types of teeth in different numbers. The innermost type is the molar. While most teeth would come out (erupt) before you enter adulthood, the last set (on each jaw) in the dental arch prefers to bid its time. The common name for this set is “wisdom teeth”: but in clinical speak; they are the “third molars.”
Ideally, you should have FOUR (4) wisdom teeth, one on each side of both jaws, emerging sometime between the ages of 17 and 25. But like most medical phenomena, nature often has other plans. And sometimes, it could be grounds for wisdom teeth extraction surgery in Carrollton, Texas.
There are a few deviations from the ideal. Some individuals do not develop any wisdom teeth (third molar agenesis). Others have fewer than or more than (hyperdontia) four wisdom teeth. Yet, there are others who have or are predicted to have issues with one, some, or all of their wisdom teeth.
Most people fall into the latter group, which explains why wisdom teeth extraction is almost a rite of passage for young adults.
But what exactly are these issues?
Wisdom Teeth Complications in Carrollton, TX
For some, erupting wisdom teeth can be painful. But because several things and conditions can cause pain in the mouth, you’d want to have some degree of certainty that the pain you experience is related to developing wisdom teeth. Signs to note include:
- Pain localized from behind your existing molars, near the back of your mouth
- Feeling or seeing the enamel of the wisdom teeth pushing through your gumline
- The part of the dental arch where wisdom teeth should be is becoming swollen, tender, and red
That said, in certain cases,
- you may not notice any visible symptoms related to wisdom tooth pain
- you may only experience wisdom tooth pain when you eat or touch the gum area
- you may only experience wisdom tooth pain constantly
Regardless, it’s crucial to have that pain checked out to ascertain the cause and figure out the next course of action.
Sometimes, wisdom teeth may not be aligned properly with the second molars. Misalignment may be classified as a form of impaction. They may be:
- oriented horizontally (also called horizontal or traverse impactions)
- angled toward (mesial impaction) or away (distal impaction) from the second molars
- angled inward or outward relative to the second molars
Misaligned or poorly aligned wisdom teeth can damage or crowd neighboring teeth, the jawbone, and/or nerves.
Tooth impaction is a term to describe a tooth failing to grow out fully within the expected developmental window. The most common cause of wisdom tooth impaction is inadequate arch length and space. However, it may also not erupt due to adjacent teeth, excessive soft tissue, overlying bone, or a genetic abnormality.
Third molars of the lower jaw are more likely to be impacted than those of the upper jaw. Impacted wisdom teeth are almost always removed.
Types of impaction
- Soft tissue impaction. Crown of the tooth emerges from the bone, but the gum still covers a portion of the tooth.
- Partial bony impaction. The tooth erupts partially, but a part of the tooth remains in the jawbone.
- Complete or full bony impaction. The entire tooth is within the jawbone.
You may or may not experience symptoms if you have an impacted wisdom tooth. Meaning, you may not be aware you have impacted teeth until a routine dental examination or it is implicated in the diagnosis of a dental condition in Carrollton, TX. If you do, you may experience:
- Swelling of the gum on top of the tooth; which is the commonest symptom
- Bleeding gum
- Jaw ache
- Headache, bad breath, and/or pain
- Unpleasant taste when eating
- Swollen neck lymph nodes or jaw stiffness; non-regular symptoms in some people
If impacted wisdom teeth are left untreated, they may lead to or be a factor in the development of harrowing dental complications such as:
- Teeth shifting; causing adjacent teeth to shift which may be painful or be associated with bite irregularities
- Irritation of gum tissue
- Dental cavities and periodontal disease
- Cysts and tumors; impacted wisdom teeth may play a part in the formation of cysts or tumors that destroy the bone and surrounding gum tissue
- Jaw expansion and bone loss
- Negatively affect orthodontics (treatment of teeth and jaw irregularities) and use of dentures
Wisdom teeth infection often affects partially erupted or impacted tooth.
Partially erupted tooth have a soft tissue covering called an operculum. The operculum can be difficult to access and so it often creates an area where food particles and plaque accumulate, technically called a “plaque stagnation area.”
This area is every mouth-resident pathogenic bacterium’s dream. And as the bacteria have a jolly time, a full-blown infection develops that leads to inflammatory responses in the operculum and surrounding tissues.
Inflammation of the operculum is known as operculitis. When the inflammation progresses to other soft tissues around the operculum, including the gums and dental follicle, it is called pericoronitis. Pericoronitis and operculitis are sometimes used interchangeably.
Unfortunately, the infection can spread to the cheeks, orbits and periorbits (eyes), other parts of the face and neck, and sometimes even lead to an airway compromise (called Ludwig’s angina) that’d require emergency hospital treatment.
Other causative factors include:
- Inadequate cleaning of the operculum space
- An opposing tooth biting into the operculum
- Over-eruption of the opposing tooth
- Presence of extra teeth
- Red, swollen, and painful gum tissue around the wisdom tooth and last visible molar
- Bad smell and taste
- Swollen lymph nodes
- Intense earache caused by the swelling placing pressure on adjacent structures which can radiate to the ear
- Fever or chills
- Jaw muscle spasms
- Pus may ooze or drain from the area; an occasional symptom
Wisdom Tooth Removal: Making A Choice
With the frequency of wisdom tooth extraction, you may get the impression that it is always necessary to maintain oral health. This is inaccurate.
Some wisdom teeth erupt cleanly and pose no problems at all. And as long as an individual cares for well-developed wisdom teeth as they do other permanent teeth, extraction is not an option you should consider.
That said, the number of complications has been steadily increasing (theories often point to changing diet and evolution as reasons). In addition, waiting for poor development of a wisdom tooth to run its course would only mean a more complex, harder, costlier, and substantially more painful procedure in the future.
This is because the risk of surgical complications increases with age, as the tooth grows, fuses with bone, and becomes tougher to remove. And this is besides the risk of developing an infection, dental cavities, or some other dental condition that jeopardizes the health of adjacent teeth (especially the second molar which is more critical) and by extension your health as well.
For this reason, the American Dental Association recommends that individuals have their mouth checked before age 20 to evaluate the condition of their wisdom teeth. Even if things look good initially, occasional re-evaluations are vital to make certain eruption is on track.
As at when a complication is noticed, such as impaction, decay, or acute pericoronitis, and it is determined that the complication would likely not resolve on its own; you’d need to have the implicated wisdom tooth removed in Carrollton, Texas.
Now, let’s discuss the infamous wisdom tooth extraction.
What is Wisdom Tooth Extraction?
As the name suggests, it is a surgical procedure to remove a wisdom tooth. It is a common oral surgery. And it is an outpatient procedure, meaning you can go home on the same day that you have the procedure.
Wisdom tooth extraction can range in complexity.
- If it has fully erupted through the gumline, then removing it is relatively
- If it is below the gumline and embedded in the jawbone, then it’d require more effort as incision and some degree of bone excision (the bone portion that lies over the tooth) is necessary.
Sometimes, tooth in this situation may need to be extracted in bits than in one piece. This is to reduce the amount of bone that’d have to be removed to get the tooth out.
- Furthermore, it is easier to perform an extraction when the roots are not full formed.
Wisdom Teeth Surgery in Carrollton, Texas
Consultation is necessary to go over the process, preparation, and discuss other pertinent information. You’d want to share:
- any health conditions you have
- any drugs you take regularly
- any questions you may have concerning surgery
You’d also have to undertake a pre-extraction exam, which would amongst several things, help in the formulation of a treatment plan; ascertain what preparation, surgery, and recovery would entail; as well as cost.
Furthermore, you would discuss the type of anesthesia you’ll have and get recommendations on how to plan time off work or school after surgery.
It may not sound like much, but proper preparation can make the recovery process smoother. You’d want to:
- Clean up properly. Brush, floss, and tongue-scrape thoroughly to make your mouth squeaky clean. And also because it may be a few days before you’d be able to get back to your regular oral hygiene routine after surgery.
- Plan your post-op recovery period. You may need to sort out childcare, pet care, and/or a ride home especially if you’re having a sedative or general anesthesia.
- Probably have a recovery area set up. You’d appreciate having a recovery room or station with water, elevated pillows, a sleeping area with TV and streaming (yes, you get an excuse to binge watch that series on Netflix you’ve been pushing back) or DVD, music; when you return from surgery.
- Prepare a batch of pre-made food. Heading to the kitchen to cook hours after surgery may not be something you want to do (or even possible, if you had sedation or general anesthesia). There are lots of wisdom teeth recipes online to check out.
The wisdom teeth removal procedure begins with anesthesia to make it painless. You’d be recommended to have one of three types of anesthesia depending on your comfort level and complexity of the process.
- Local anesthesia. You’d be awake during the procedure but you wouldn’t feel any pain. You may feel some pressure though. This is because only the surgical site is numbed.
- Sedation anesthesia. Unlike the local anesthesia that is administered using one or more injections near the surgical site, sedation anesthesia is administered through an IV (intravenous) line in your arm.
The effects include not feeling any pain, suppressing your consciousness (you’d only have limited memory of the procedure), and feeling drowsy or falling asleep. Sedation anesthesia may be used in conjunction with local anesthesia to numb your gums.
- General anesthesia. Occasionally, it may be necessary to have general anesthesia. Administering is through an IV line in your arm, medication through your nose, or both.
The effects are not feeling any pain and going unconscious (you’d have no memory of the procedure). An anesthesiologist will closely monitor your vitals (breathing, blood pressure, temperature…). Local anesthesia may also be administered to help with postop discomfort.
- Incision is made to expose the tooth and bone
- Bone may be removed if it blocks access to the tooth
- If necessary, the tooth is drilled into multiple pieces for easier removal
- Tooth is removed
- Debris is cleared from the surgical site
- Suturing is done (closed stitches)
- Gauze is used to pack the empty tooth socket to control bleeding and promote formation of blood clot
Recovery, Pain Management, and Aftercare
Relates to measures you should take within the first 24 hours following surgery.
You may bleed for several hours after the procedure. Tips to control the bleeding include:
- Place a piece of clean, moist gauze over the empty tooth socket and apply pressure. You may apply pressure by placing your fingers over or biting down on the gauze pad consistently for about 45 minutes.
- Alternatively, use a moistened tea bag. Tea contains tannic acid that helps in the formation of blood clots.
You can use over-the-counter (such as ibuprofen or acetaminophen) or prescribed analgesics to combat the pain. Additionally, antibiotics may be prescribed.
Facial swelling near the surgical site is possible. To get the swelling down as well limit discomfort, use an ice pack or warm, moist compresses depending on instructions received.
You’d typically have to apply ice packs to the outside of your mouth intermittently (you leave it on for 20 minutes and remove it for 20 minutes.
Food and beverages
- Take only liquids until the numbness from anesthesia wears off
- Afterwards, stay on a soft food diet
- Avoid drinking carbonated beverages and eating foods such as peanuts, popcorn, and pasta that may leave particles in your socket. This is to avoid dislodging the blood clot.
- Do not engage in any “sucking” action—say using a straw
- Avoid hot liquids
- Avoid alcohol if you’re also on narcotic pain medication
You may be instructed not to brush, floss, rinse, or spit for the first 24 hours. Follow received instructions strictly.
Refers to tips you should take after 24 hours.
You’d almost always have to use warm, moist compresses (say a moist warm towel) following the same routine as before (20 minutes on and 20 minutes off your mouth) if swelling persists.
Maintain a soft food diet.
You may resume brushing, but likely not on teeth adjacent to the surgical site. You may also be instructed to rinse with warm salt water. Follow received instructions strictly.
- You may have to make a visit to have stitches removed, if the stitches used are not self-dissolving
- Avoid smoking or using tobacco products
- Core recovery takes up to one week
- Complete healing of the gums takes up to four weeks
- If the jaw is damaged, recovery can take up to six months
Also called alveolar osteitis, it refers to a complication where blood clot is dislodged prematurely or fails to form in the extracted tooth socket. The lack of proper clot formation delays healing.
The exposed bone along the extraction socket can become inflamed and painful. Other symptoms include
- bad smell or taste
- constant throbbing pain
- swollen lymph nodes in the neck area
- low-grade fever
It can be fixed fairly easily with a packing medication or stimulation of a new blood clot.
Cost of Wisdom Teeth Removal
The price of wisdom teeth extraction in Carrollton, Texas varies widely from as low as $100 to $600 per tooth. The wide variance in price depends on complexity of the procedure, type of anesthesia used, examination done, proximity to surrounding teeth and nerves, type of complication, prescriptions, amongst others.
You should check with your insurance provider, as some policies cover a portion of the cost for a wisdom tooth extraction procedure.