So you’ve chosen to keep your wisdom teeth.

Alright, now the work really begins. In one of my other articles, I discussed the needs of considering how difficult it would be to retain your wisdom teeth and keep them clean. So now let’s go ahead and address what it is going to take to keep them clean and functioning well for years to come.

We talked about how wisdom teeth will sometimes crowd the inside of the mouth towards the back and make it difficult for you to get a toothbrush anywhere close to them. So let’s assume that’s the case right now.

With upper wisdom teeth you can often make enough room alongside them during brushing and flossing by moving your lower jaw to the side that you’re working on. So if you’re working on the right side you move your lower jaw to the right. And if you’re working on the left side you move your lower jaw to the left. That’s pretty simple. It still doesn’t make it easy, but it makes it possible in most cases with a little effort.

X-ray of crowded teeth due to wisdom teeth not being removed

Wisdom teeth causing crowded jaw.
(image courtesy of

One of the other things you can do in a situation like this is to  selected toothbrushes having an appropriate size for getting back in those difficult to reach places. So if you have tight quarters and have difficulty reaching those places, you need to select a small head style toothbrush. Manual toothbrushes, the old-fashioned type, come in all sorts of shapes and sizes. And even though they’re not as modern as the new electric brushes they may be just the ticket for cleaning wisdom teeth.  As the dental products market continues to respond to requests by consumers, we see a growing range of  electric toothbrush sizes emerging.

Small brushes get into tight corners very easily. If you have limited room a small brush will be best of course. With electric brushes, letting the brush do the stroke work is best. So positioning of the electric brush at the correct angle is key. With a manual brush, small circular or back and forth brush strokes are best.

The most critical areas to clean on wisdom teeth are the sides of the wisdom teeth, especially where it leans up close to either the cheek or jawbone. And the area where most cavities occur is right where the wisdom tooth meets the gum line. This is the place where moss tends to collect. Now it’s not really moss, of course, but it reminds me of the soft, slippery stuff you find on rocks in a stream. The technical term is dental plaque. But it too is a soft and slippery material consisting of leftover food with bacteria growing all over it.  If you’ve ever seen a petri dish in a science with little round bacteria colonies growing on the bottom of the dish the concept should be familiar. Instead of growing on a dish, they are growing on the sides of your tooth and in nooks and crannies throughout you mouth.

Everyone’s mouth is loaded with bacteria. So if you leave any food behind for bacteria to feed on they will grow like gangbusters. They are out to destroy your teeth. They will show no mercy. So you have to take on a similar mindset and show no mercy as you remove the residual food that they are using for meals. Your toothbrush will be one useful tool to help you remove that food. And in your efforts to remove the food [BONUS] you will also be removing the bacteria themselves. Yes!

In order for a toothbrush to do its job, the bristles need to come in contact with the food and bacteria on the side of your teeth as you are using it. You may have had a dentist tell you before that it’s best to use short scrubbing motions or short strokes to remove food and bacteria. I agree 100%. But what I found over the years in practice is that stiff bristles on your toothbrush don’t bend or flex enough to effectively remove food and bacteria hiding underneath the gum edge. And this is a critical area. So search for a very soft brush.

So we find now that with wisdom teeth that are hard to reach the next step is figuring out how are going to clean between the teeth. This is where dental floss comes to the rescue. It’s super narrow, its flexible and it will adapt to the curved shape of the  teeth. Now we just have to figure out how were going to get the dental floss behind the wisdom  tooth and between the wisdom tooth and the next tooth in front. Now if you have slender fingers, are coordinated, or willing to learn, you can have great success keeping wisdom teeth clean. I’ve seen it countless times. So don’t get discouraged. Give it a really good effort.

Yes, I said you have to clean behind the wisdom tooth as well. The moss, pardon me, the plaque is going to grow there too. If you’re having difficulty because your fingers are not quite so slender or you can’t extend them back far enough there is a solution. New products have come onto the market that will hold the dental floss for you and allow you to use a toothbrush-like handle to help position it and sweep it up and down between and behind teeth.

Now I do have some patients, that refuse to floss, but still want to have clean teeth. So I suggest they consider using what I refer to as a dental irrigator. It’s like a Rain Bird sprinkler for your mouth. It has a reservoir for warm water and a plastic tip with a nozzle on it powered by an electric pump. It shoots a series of water pulses along the gum line and in between the teeth. It’s similar to a pressure washer used by a painter to clean the exterior of your house before he paints it. The dental product manufacturers tone it down a little bit so the pressure does not cause damage in most cases. And each irrigator comes with a dial to control pressure for comfort and effectiveness.

It takes a little while to get used to using it. And one of the key tips I frequently have to remind my patients of is to keep their mouth closed when the water is flowing. This will help ensure that the bathroom stays dry, the mirror stays clean, and they will not need a rain slicker while caring  for their teeth. Now remember this is a “closed course and you are the professional driver” situation.  Do not let your children attempt this at home.

Gum tissue around healthy teeth is usually firm and quite tough. But on lower wisdom teeth especially on the tongue side there is a tendency for the gum tissue to be much softer. The softer gum tissue allows for more food to collect. And when you brush on the tongue side of lower wisdom teeth the gum tissue will become sore more frequently with stiff bristle brushes. Again, a soft bristle brush is my recommendation in most cases. It can also cause the least damage if used improperly. Your dentist, or one of his staff members can coach you on techniques of brushing, flossing and all of the other methods of caring for your teeth and gums.

In the next article in the series- Questions You Must Ask Your Dentist Before Having Your Wisdom Teeth Removed, I’ll cover the often asked question: Why Am I Getting Cavities In My Wisdom Teeth?