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Wisdom Teeth

“I have a wisdom tooth that is coming through with an exposed nerve that is causing me a great deal of pain.

Do I have to have something done now, what would the cause of action be and how much would it cost? I’m also pregnant so what does that mean?”

– Question from Sonya of Chermside, Brisbane

Dr David Kerr replies:

When most people think wisdom teeth they think that they are going to have to be removed but in actual fact, in about 30% per cent of cases patients can have wisdom teeth that don’t need to be removed.

The reason why many people have to have their wisdom teeth removed is due to the fact that their jaw is mismatched to their teeth. Therefore when their wisdom teeth try to come through they simply cannot fit and become impacted against the teeth in front of them. This can result in a number of things:

  • Cavity in the adjoining tooth: impacted wisdom teeth can often come so close to the tooth in front of them to cause a cavity in them. This is a shame as it can lead to the patient loosing more teeth than just their wisdom teeth.
  • A cyst develops around the wisdom tooth: if a cyst develops then it can eat away at the jaw bone causing damage, pain and naturally more dental work to remedy the situation
  • Looser gums around wisdom teeth: The way that the gum attaches around the wisdom teeth is not as tight as it is to the other teeth This sets up the perfect situation for bacteria to breed and then the tooth and gum to become infected. Patients who are experiencing this report swollen gums, exposed nerves or the sensation like the “tooth is moving up and down”. This isn’t actually the case it just feels like it because of the problems with the surrounding gum.
  • Pain: When wisdom teeth start to cause pain the problems listed above are already well underway. I have been asked what would happen if someone did nothing about their wisdom teeth? The answer is that if your wisdom teeth become impacted the pain and infection would eventually become so great that you would not be able to stand the pain any longer. If you wait this long then it is likely that other teeth next to your wisdom teeth are beyond saving as well – there are cases where we have had to remove 8 teeth rather than 4 had the procedure simply been carried out earlier.

What about the cavemen?

So what would have happened back in the day of the caveman? Well they would have eventually died from the infection, though this wouldn’t have happened as much back then as it would do now if we didn’t have dentists – and we can thank evolution for that.

We have evolved to have smaller mouths than early man. The genes that control teeth and jaw size are on different chromosomes so they have not shrunk over time proportionately.

Communication with your dentist is a two way street and so important to get to the bottom of your dental pain.Wisdom teeth that break up

By virtue of the shape and placement of wisdom teeth, in addition to the fact that they often have only partially erupted, I have found that it is nearly impossible to keep clean and bacteria free. By the time patients report their wisdom teeth are ‘breaking up’ then the decay is so great that the tooth is literally falling apart. It is important to get these teeth treated by a dentist as soon as possible.

What ages are wisdom teeth a problem?

It is common for us to deal with wisdom teeth with patients in their late teens although this can be as late at 25 years of age.

My colleagues and I have seen an interesting trend recently towards more patients requiring treatment for wisdom teeth earlier, say between 13-15 years old.

As with all dental care and dental problems it is important to identify the ‘right time’ to treat your wisdom teeth as this will give you a number of benefits:

  • Lowest cost: wisdom teeth that are removed at the right time means the least complicated treatment, recovery time and most importantly cost!
  • Less pain: caught at the right time wisdom teeth can be treated with minimal pain.

We identify the ‘right time’ for wisdom teeth by monitoring them at our patients’ active maintenance visits.

Will I need to see a specialist for my wisdom teeth?

This all depends on your particular situation, how badly the wisdom teeth are impacted and how advanced any subsequent problems have advanced. Your dentist will be able to assess all of these aspects and recommend the best course of action in your case, and if cost is an issue then there are payment plans as an option.

Wisdom teeth and pregnancy

Ideally we would like to reduce any dental treatment if you are pregnant which is why I always recommend a trip to your dentist if you are thinking about a family.

Otherwise there are always ways to treat a pregnant patient and the best time for this is in the second trimester, as it is often too uncomfortable for a patient in their third trimester to sit in the dental chair for a long period.

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