DEFINITION: Wisdom Teeth is the common term used to refer to the third molars. The Wisdom Teeth are the very last molars in each quarter of the mouth.

DESCRIPTION

There are usually eight teeth in each quarter of the mouth. There are four wisdom teeth which are the very last molars in each quarter. Many people do not have a complete set of wisdom teeth. Some people may have only two or three and others have no Wisdom Teeth. Having all, none, or some Wisdom Teeth is considered normal. Wisdom Teeth erupt (come up, into the mouth) behind the second (12 year old) molar and do not replace any baby (primary) teeth. Wisdom Teeth usually erupt when a person is between 15 to 20 years of age, however this is extremely variable. Occasionally Wisdom Teeth may erupt much later in life. This is particularly likely if other molars are removed as this may allow a previously trapped (impacted) Wisdom Tooth to erupt.

ust as small children may experience discomfort (teething) when teeth erupt, so, too, can young adults. The discomfort is usually a niggling, annoying pain sometimes felt as pressure. This discomfort does not generally last for very long and is usually easily controlled with analgesics (pain relievers). Ask your Pharmacist for advice.

Sometimes as Wisdom Teeth erupt a small infection can occur in the gum immediately surrounding the erupting tooth. This is particularly the case when the tooth is only partially up. This infection is called 'pericoronitis' and is a result of plaque bacteria becoming trapped between the erupting tooth and the surrounding gum.

Pericoronitis can be mild to very painful, and may cause swelling which results in limited opening of the jaw. The bacteria need to be removed and a Dentist can assist with this. Occasionally, in severe cases, antibiotics may be prescribed. Mouthwashes of warm salty water may help to flush out the area, and help it to heal. With treatment, pericoronitis usually gets better over a period of between 3 to 4 days, but can occur on more than one occasion. Prevention of pericoronitis consists of ensuring that the gum around the erupting tooth is kept clean, even when it is a little sore to brush. Smoking may increase the risk of periocoronitis.

MUST WISDOM TEETH COME OUT?

Not all wisdom teeth need to be removed. Wisdom teeth are often removed for one or more of the following reasons:

1) Impacted Wisdom Teeth. These are teeth that due to the position in the bone and the position of the other teeth, may not be able to erupt, or be only partially able to erupt. These teeth may develop cysts, be impossible to clean completely and are prone to decay. Occasionally, wisdom teeth may erupt into a position which is in direct contact with the other teeth. This may make these teeth more difficult to clean and more susceptible to decay.

2) Multiple bouts of pericoronitis. Some Wisdom Teeth are prone to multiple cases of this infection and removal of the teeth may be the only long term solution to the problem.

3)Position. Some Wisdom Teeth may erupt into unusual positions that make opening, talking, cleaning etc., difficult. This is often seen with Wisdom Teeth in the upper jaw which may erupt out towards the cheek.

4) No function. Often, if one wisdom tooth is removed, the other wisdom tooth above or below it, which would normally have bitten against the removed tooth, will have no function. It may be advisable to have these teeth removed (particularly if a general anaesthetic is planned), due to the difficulty which is sometimes experienced with cleaning.

WHEN SHOULD WISDOM TEETH COME OUT?

If Wisdom Teeth do need to be removed it is usually best done at a younger age. Obviously the teeth must be old enough to have formed properly before being removed. Once a problem has been identified, most dentists suggest removing Wisdom Teeth while the patient is young. Younger patients have a faster healing capacity, and softer bone, allowing for easier removal. Younger patients are also usually medically fit and healthy, and able to cope easily with minor operations. This is not to say that Wisdom Teeth cannot be removed much later in life, but there is an increased risk of complications.

HOW ARE WISDOM TEETH REMOVED?

The technique used for extraction of Wisdom Teeth depends greatly on the situation for each particular tooth. Some teeth can be simply removed under local anaesthesia like any other extraction. Impacted (trapped) teeth will often require minor surgical procedures to cut the tooth out of the surrounding bone and gum. Surgery may be performed under local anaesthesia or general anaesthesia. Sometimes patients may be referred to an Oral Surgeon to arrange for the extraction. A Dentist can best explain the nature of a particular problem and its treatment.

TREATMENT OPTIONS

As with all dental conditions your Dentist should be consulted. Your Dentist will diagnose and treat your particular problem. Ask your Dentist about how to brush and floss your teeth, and how often you should return to be checked by your Dentist. Your Dentist can answer any queries you may have regarding your Wisdom Teeth.

PHARMACIST'S ADVICE

Ask your Pharmacist for advice

1) It may take some time for the pain associated with pericoronitis or extraction to settle down. If pain relief is required, ask your Pharmacist to recommend the most suitable type. There are certain pain relievers, anaesthetics and other medications which should not be used in combination so it is important for your Dentist to know what kind of pain relieving medication you are taking.

2) As pericoronitis is caused by plaque, practising good dental hygiene is the best prevention.

3) Your Pharmacy stocks a wide range of toothbrushes.

4) Brushes can only clean some surfaces of the teeth. To clean between teeth, it is important to use floss. There are many brands and types of dental floss. Ask your Pharmacist for a type that has been recommended for you by your Dentist.

5) It is advisable to brush after meals whenever possible and to avoid snacking between meals to help prevent the growth of bacteria which can cause decay.

6) Make sure that you clean your teeth before going to sleep. Going to bed without brushing allows plaque to grow on teeth and gums during the night.

REFERENCE SOURCES

All information has been compiled in collaboration with leading Dental Practitioners and Researchers.

ORGANISATIONS and SUPPORT GROUPS

See the Australian Dental Association topic on the Healthpoint.