Wisdom teeth usually appear between 17 and 25; many visit the dentist during their summer break. While it is a common belief that wisdom teeth always need to be removed, dentists say that “wisdom teeth that come in straight and properly aligned generally do not need to be extracted.”
According to medical sources, wisdom teeth, also known as third molars, are the last to emerge in a person’s lifetime. Typically, there are four wisdom teeth—one on each side of the upper and lower jaws—but some people may never develop them, while others may have all four.
If wisdom teeth usually emerge and can be maintained cleanly, they can be kept and serve a useful purpose without extraction. However, depend-removal may be necessary depending on their position, shape, and size. Remoifically, suppose they are impacted or angled incorrectly. In that case, food can get trapped, leading to decay (where the tooth enamel is damaged, resulting in cavities) and gum disease, which can cause bad breath, tooth sensitivity, and pain.
Impacted wisdom teeth are categorized as either fully impacted (completely covered by gum and bone) or partially impacted (partially covered). Extraction is usually performed under local anesthesia, but sedation or general anesthesia may be used if needed.
Hong Seong Ok from the Oral and Maxillofacial Surgery Department at Kangdong Kyunghee University Hospital explains, “The difficulty of extracting lower jaw wisdom teeth depends on their angle of eruption. Teeth that emerge straight are easier to remove than those that are partially, fully, horizontally, or distally impacted.”
Hong also notes, “For upper jaw wisdom teeth, the difficulty of extraction depends on their proximity to the maxillary sinus (the hollow space within the upper jawbone). Wisdom teeth that are fully erupted and do not come into contact with the maxillary sinus are generally the easiest to remove.”
Medical professionals ensure that no one is affected when extracting wisdom teeth from the lower jaw. This is crucial because the trigeminal nerve, the fifth cranial nerve, runs close to the wisdom teeth. If the extraction inadvertently impacts branches of this nerve, such as the inferior alveolar or the lingual nerve, it can lead to sensory numbness.
The decision to extract wisdom teeth also considers factors like cardiovascular disease, diabetes management, corticosteroid use, pregnancy, liver and kidney conditions, and osteoporosis. Consulting with a dental specialist before the extraction is essential if these conditions are present.
If multiple teeth need to be extracted or the patient is particularly anxious, the dentist may opt for sedation or general anesthesia. Cysts or tumors can sometimes develop around wisdom teeth; if left untreated, these can increase the risk of jawbone damage or fractures, potentially requiring surgery under general anesthesia.
Extracting multiple wisdom teeth under general anesthesia can be advantageous in severe temporomandibular joint disorders. Kim Heon Young from Ewha Womans University Mokdong Hospital advises, “It’s essential to review the oral condition and any systemic diseases thoroughly and to develop a detailed pre-operative plan following a thorough consultation.”
After extraction, it is important to keep gauze or cotton in place for as long as possible and to bite down firmly. Avoid actions that create pressure differences, such as using a straw or smoking, as these can dislodge the blood clot that forms at the extraction site, potentially delaying recovery and increasing pain.
Additionally, activities that can raise body temperature, such as drinking alcohol, exercising, or using saunas, should be avoided as they can hinder healing. Pain may persist for up to two days after extraction, and applying ice packs can help reduce swelling and discomfort. Patients should consult their dentist if pain continues beyond three to five days.
Follow prescribed medications as directed by your doctor and stick to soft foods. Use mouthwash around the extraction site and continue brushing other teeth as usual, but avoid excessive rinsing and brushing, as this can cause dryness and inflammation by preventing the gum tissue from healing properly.
Kim Heon Young advises, “Wisdom tooth extraction can sometimes be a complex procedure and may cause patient anxiety. It is important to visit a specialist promptly and receive appropriate treatment early if needed.”