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Updated: December 16, 2012 16:36 IST

When wisdom spells trouble

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WISDOM? It can be painful
WISDOM? It can be painful

Timely orthodontic care can relieve many teenagers and young adults of the acute pain caused by impacted wisdom teeth

It’s technically the third molar, but everybody knows it by its ‘other’ name — wisdom tooth. Girls tend to get wiser earlier than boys, with their third molars appearing between the ages of 16 and 18, while boys typically wait till they’re at least 19. But unfortunately for many, the coming of this wisdom can spell trouble. “The incidence of impacted wisdom teeth is increasing,” says Dr. Aparna Chitharanjan, American Board Certified Orthodontist. An impacted tooth, she explains, is when there is no space for the tooth to erupt, and so it remains within the bone or partially erupts. And that is when the problems begin. “When the tooth lies fully within the bone, it can form a cyst; clinically, you see it is as a bony enlargement. When it partially erupts, it can develop caries or gum diseases, causing swelling and pain.” What is especially interesting is the cause for this impaction — Dr. Aparna says it is because human diet has changed considerably during the course of evolution. “Early man had a greater need to chew, and his jaws accommodated the third molars comfortably. But as the diet changed, the lower jaws became smaller, and now there is no space for the third molars.”


Typically, an x-ray taken when the individual is 18 years old should give an indication if the wisdom teeth are likely to get impacted. “At that point we advise the patient if he is likely to have trouble ahead,” says Dr. Aparna. “We recommend removing the tooth if there is acute pain while it erupts or if a condition called pericoronitis develops. In pericoronitis, the gum forms a flap over the tooth, and it can get inflamed/infected. Occasionally, a bony cyst can form, but this is a rarer condition.”


“It is better to wait till the tooth erupts, so that the tip is visible, before you attempt to remove it,” says Dr. Aparna. “If it is removed when it is still inside the bone, it is a more invasive procedure, and there is more guttering of the bone.” Wisdom teeth are generally removed under local anaesthesia, which completely numbs the area. “You don’t feel pain, only the pressure of the tooth being removed.” After the surgery, don’t spit out the blood, Dr. Aparna advises. “Swallow it. Also, do not use a straw, don’t brush the area vigorously, and do not drink anything hot. The blood that clots will reorganise to form bone. Using a straw or spitting can dislodge the clot, and can form what is called as a ‘dry socket’, which impairs healing,” she cautions. With ice compresses, antibiotics and painkillers, you should be comfortable very soon, concludes Dr. Aparna.


* Wisdom teeth do not cause the lower front teeth to get bunched up.

* Typically, orthodontists diagnose impacted tooth and oral surgeons remove them.

* It is better to wait till the tip of the tooth appears before you remove it.

* Tell your doctor if you are diabetic or suffer from high blood pressure.

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