Wisdom Teeth…What A Pain!

The purpose of this article, and all of the articles in the wisdom teeth series,  is to help you with conversations with your doctor about wisdom teeth.  You will have some basics down that will help you to not be intimidated during those discussions.

Image of A Man With Wisdom Tooth Pain Holding His Face

Wisdom teeth can cause serious pain.

Wisdom teeth, also known as third molars, are the third set of molar teeth to erupt or come into the mouth. If you were smart, you might be thinking, you probably would never have chosen to have wisdom teeth. The suffering they often bring and the necessary treatment is almost a right of passage here in the United States.  Part of that suffering is the pain and discomfort that comes with the eruption of wisdom teeth through the gums. Another part of that pain is from wisdom teeth trying to come into the mouth, but getting stuck or colliding with other teeth. This is the variety called impacted wisdom teeth. And a third part is caused by the removal of wisdom teeth and the recovery process. Some teens, being a bit more precocious, may begin to experience wisdom tooth related symptoms early in their teens and others of us much later in life.

You may remember your own experience, or seen a teenager or two, or a friend that went through the removal of wisdom teeth.  You might still have a vivid picture in your mind of the puffy face look, and it’s comparison to the facial features of a chipmunk. The puffy face, the inability to open much, and difficulty in eating comfortably are not uncommon following wisdom teeth removal.  After a few days the puffiness disappears and gradually the ability to open fully returns and life is good again.

My personal experience consisted of the removal the single wisdom tooth I developed.  I found out about the presence of my wisdom tooth during my dental school education and training.  The dental x-rays revealed that I had a single solitary wisdom tooth located in the bottom right side.  I could see it was one of the stuck variety, not pointing parallel to the other molar teeth but at 90 degrees to the last tooth and down deep.

Great, I thought. I’ll wait until I can have a real dentist remove the tooth and not a dental student.  So after graduation, but during a dental residency training program, my wisdom tooth started to act up.  Deep throbbing pain, on and off for two or three days and then several weeks of relief.  Then it was back again.  I had finally had enough pain. It was beginning to interfere with my residency training schedule.  I spoke with the oral surgeon in our hospital clinic an I had it removed.  I had sedation using intravenous medication and local anesthetic.  Which means that I had medication put into a needle in a vein, and the normal numbing that makes your face feel like it’s swollen up three times the normal size.   I had some of the same problems after my surgery that are common to many patient’s I found out later as my practice experience grew over time.

The symptoms most often described are twinges or deep jaw pain mimicking toothache pain.  So if jaw pain or swelling occurs, it’s probably wise to consult your dentist to determine the cause.  If it is caused by cavities, then appropriate treatment will be recommended to relieve the pain.  If it is wisdom tooth related, it often hurts deeply for a few days and then disappears for a few weeks before returning again, and again.  Exactly what I experienced.

My patients often laugh when I now suggest that the pain as probably similar to what an infant experiences when cutting a tooth, and that they, too, are teething. If, after an evaluation by your dentist, she believes enough room exists to allow the wisdom teeth to erupt, you may decide to put up with mild discomfort until they come in completely.

Depending on the size of your jaw and the size of your teeth your dentist may suggest that your fully erupted wisdom teeth be removed even when they appear cavity free.  This is often based on your dentist knowing you are likely to have a very difficult time maintaining your wisdom teeth because a toothbrush won’t fit anywhere near them. And keeping them clean is essential, if you want to use them for lifetime. It is your choice of course, and you will have to live with your decision either way.  Even if you put off removing wisdom teeth immediately, you may eventually agree with your dentist that taking care of them has proven near impossible and change your mind later.

Addressing wisdom tooth removal as you age also changes the landscape a bit. As years slip by after the initial removal recommendation, the roots of the wisdom teeth continue to grow fully and increase their grip on the jaw bone.  And what might have been an easier removal procedure at age sixteen may turn into a much more difficult procedure at thirty or forty with vastly increased risk for complications at age 50 or more.

Balancing all of this out requires that you understand the process used by your dentist to arrive at his conclusion. So start the conversation and ask the right questions so you fully understand the situation for you or a family member.

The next series of articles will help you ask the right questions of your dentist before you have to face wisdom teeth removal.  Look for: Questions You Must Ask Your Dentist Before Having Your Wisdom Teeth Removed