Wisdom Teeth: Symptoms, Complications, Treatment

Wisdom teeth are the last set to emerge between 17 and 25. Some people have no trouble with their wisdom teeth, but others experience pain, infection, and wisdom teeth getting stuck. The issues necessitate medical intervention, ranging from medication to surgical extraction. Understanding the symptoms, treatment options, causes, and research surrounding wisdom teeth helps manage and prevent complications effectively.

Symptoms of wisdom teeth problems vary widely but include pain and jaw stiffness near an impacted tooth. Other symptoms involve pain or irritation from a tooth coming in at an awkward angle, swelling around the jaw, tenderness, bleeding gums, and a bad taste in the mouth. Additional issues include crowding of other teeth, tooth decay or gum disease due to improper cleaning, difficulty opening the mouth or completing routine tasks like chewing, dark or white spots on the wisdom teeth, and persistent bad breath.

Treatment for wisdom teeth problems involves several approaches. Extraction, either through simple extraction or surgical removal, is recommended for impacted or problematic teeth. Medications like over-the-counter pain relievers and antibiotics manage pain and infection. Home care remedies such as saltwater rinses, cold compresses, and good oral hygiene temporarily relieve pain. Regular dental checkups are crucial for monitoring wisdom teeth development and deciding on necessary interventions. Orthodontic treatments and laser therapy are potential options for managing alignment and pain.

The causes of wisdom teeth problems include genetics, which determines the presence and alignment of these molars. Smaller jaw sizes, standard in modern humans, lack the space for wisdom teeth to emerge properly, leading to impaction. Environmental factors, diet, and chewing function help develop wisdom teeth. Diseases and trauma during the early formation stages disrupt their growth, resulting in various dental issues.

Similar conditions to wisdom teeth problems include ingrown hairs, which cause pain, inflammation, and infection, much like impacted wisdom teeth. Folliculitis involves inflammation of hair follicles and is comparable to diseases caused by erupted wisdom teeth. Sebaceous cysts are non-cancerous lumps filled with sebum, similar to cysts that form around impacted wisdom teeth. Alopecia areata, an autoimmune condition causing hair loss, and trichotillomania, a compulsive urge to pull out hair, involve chronic conditions requiring professional treatment, analogous to persistent wisdom teeth issues.

Research on wisdom teeth encompasses various studies to understand and manage these molars. Significant studies include "Estimated Cumulative Incidence of Wisdom Tooth Extractions in Privately Insured US Patients," which analysed US dental insurance data to find regional variations in extraction rates. "The Wisdom Behind the Third Molars Removal: A Prospective Study," study "Age of Patients at the Extraction of the Third Molar" investigated the common age for extractions, while "Evidenced-Based Decision Making: The Third Molar" provided guidelines for extractions. "A Prospective Study of Clinical Outcomes Related to Third Molar" compared outcomes of removal versus retention in young adults. Tara Renton and Nairn H F Wilson's article "Problems with Erupting Wisdom Teeth: Signs, Symptoms, and Management," published in the British Journal of General Practice, focused on managing painful and infected erupting wisdom teeth, emphasising early extraction to prevent severe infections.

What are the Common Issues Associated with Having a Wisdom Tooth?

The common issues associated with having a Wisdom Tooth are listed below.

Difficulty in Brushing: Brushing is difficult when dealing with impacted or misplaced wisdom teeth, which increases the risk of dental disorders.
Impaction: Some wisdom teeth become impacted, which means they do not fully emerge from the gum line, causing pain, oedema, and infection.
Overcrowding: Wisdom teeth produce overcrowding in the mouth, leading to tooth misalignment and orthodontic difficulties.
Decay and Infection: Wisdom teeth are difficult to clean correctly, which leads to decay, gum infections, and pericoronitis.
Discomfort and Pain: Wisdom teeth cause pain, discomfort while chewing, and difficulties with oral hygiene.
Ulcers and Cheek Rubbing: Crowded wisdom teeth slant sideways and rub on the cheek, resulting in sores and discomfort.
Bad Breath: Infections and decay connected with wisdom teeth cause bad breath.
Potential Complications: Infections produced by wisdom teeth complications lead to more severe health problems in people with weakened immunity.

What are the Symptoms of Wisdom Teeth Problems?

The symptoms of Wisdom Teeth problems are listed below.

Pain or Irritation from a Tooth Coming in at an Awkward Angle: Discomfort due to a wisdom tooth emerging in an abnormal position.
Swelling Around the Jaw: Inflammation and puffiness in the jaw area.
Tenderness, Bleeding Gums, and Bad Taste in the Mouth: Sensitivity, bleeding in the gums, and an unpleasant taste.
Crowding of Other Teeth: Overcrowding and misalignment of adjacent teeth.
Tooth Decay or Gum Disease Due to Improper Cleaning: Cavities or periodontal issues resulting from difficulty maintaining oral hygiene.
Difficulty Opening the Mouth or Completing Routine Tasks Like Chewing: Trouble with mouth opening and performing essential functions like chewing.
Dark or White Spots on the Wisdom Teeth: Discoloration or spots on the surface of wisdom teeth.
Pain or Jaw Stiffness Near an Impacted Tooth: Discomfort or limited movement around an impacted wisdom tooth.
Bad Breath and Difficulty Cleaning Around the Wisdom Teeth: Halitosis and trouble efficiently cleaning the area around wisdom teeth.

How Common are Wisdom Teeth?

Wisdom teeth are common, growing between 17 and 25. Individuals commonly have between one and four wisdom teeth, but the number of people who have them varies greatly. Studies indicate that anywhere from 5% to 37% of adults worldwide never develop wisdom teeth. The variation is attributed to several factors, including genetics and evolutionary changes in human jaw size and dietary habits. A study published in the Dental Research Journal found that between 5% and 37% of the population have congenitally missing wisdom teeth, a condition known as the absence of wisdom teeth at birth.

Some people do not grow their wisdom teeth. Genetic factors impact the variation. Wisdom teeth do not develop in children of parents who do not have them. External factors such as diseases and head trauma affect the development of wisdom teeth. Any serious childhood illnesses or injuries affect the likelihood that these teeth emerge, as their formation begins around age 8.

Several risk factors influence the growth of wisdom teeth. The primary determinant is heredity, with family patterns determining whether these teeth are present. Environmental factors, including diet and chewing habits, affect the development of wisdom teeth. A modern diet that requires less chewing leads to smaller jaw sizes, contributing to higher impaction rates. Diseases and trauma disrupt the late development of wisdom teeth, preventing their growth altogether. Impacted wisdom teeth, which grow at an angle and become trapped beneath the gum line, pose further risks such as oral infections, tooth decay, pain, and other health issues.

What are the Treatments for Wisdom Teeth Problems?

The treatments for Wisdom Teeth problems are listed below.

Medications: Medications such as pain relievers and antibiotics manage symptoms and infections related to wisdom teeth. These medications are used to control pain and infection before or after an extraction or when immediate surgery is not an option. Medication helps briefly but does not get to the root of the problem. Regular dental checkups are essential to monitor the situation.
Extraction: Extraction involves the surgical removal of the wisdom tooth, done through a simple extraction if the tooth is fully erupted or a more complex surgical extraction if the tooth is impacted. Tooth extraction must be considered if the tooth is causing significant pain, infection, damage to adjacent teeth, or a high risk of future complications. Leaving the wisdom tooth in place is a good option if it is not hurting or causing problems. Regular monitoring by a dentist is recommended to ensure it does not cause problems.
Incision and Drainage: A surgical procedure to drain pus from an abscess caused by an infected wisdom tooth. The treatment is necessary when an abscess forms, causing severe pain and swelling. The infection is treatable with an incision and drainage, but the wisdom tooth needs to be removed to avoid future problems.
Home Care and Remedies: Home care includes non-surgical methods such as salt water rinses, cold compresses, and proper oral hygiene. The remedies alleviate minor symptoms and maintain oral health. Home care helps manage minor symptoms, but a dentist must assess severe or persistent problems.
Monitoring and Regular Dental Checkups: Checkups involve regular visits to the dentist to monitor the development and position of wisdom teeth. Continuous monitoring is crucial if the wisdom teeth are not causing immediate problems. Regular checkups allow for early detection of potential issues, preventing unnecessary removal if the teeth remain problem-free.
Orthodontic treatment: Orthodontic treatment uses braces or other orthodontic devices to correct wisdom tooth misalignment. The treatment is necessary if wisdom teeth cause crowding or misaligning of other teeth. The problem is fixable with orthodontic treatment instead of removing the wisdom teeth if they become misaligned.
Laser Therapy: Laser dentistry is a minimally invasive procedure using laser technology to remove soft tissue around partially erupted wisdom teeth. Laser therapy must be considered if there is pain or risk of infection due to partially erupted wisdom teeth. The procedure relieves and prevents infection without removing the tooth, but regular dental checkups are needed to monitor the situation.

Can Wisdom Teeth Problems Be Treated At Home?

Yes, wisdom teeth problems can be treated at home using various remedies and strategies. Over-the-counter pain medication, such as Ibuprofen, helps reduce pain and inflammation associated with wisdom teeth. Applying an ice pack to the affected area in 15-20 minute intervals alleviates swelling and provides a numbing effect. The over-the-counter numbing gel containing benzocaine numbs the gums and reduces irritation.

Rinsing the mouth with a saline solution (salt water) cleans the area, promotes wound healing, and reduces pain. Clove oil is applied to the wisdom tooth area to reduce inflammation and pain. Essential oils like myrrh, peppermint, and tea tree oil provide relief. Turmeric paste, made with turmeric, baking powder, and toothpaste, helps reduce pain and inflammation when applied around the wisdom teeth area. Home-based items like ice packs, salt, and essential oils are beneficial in managing wisdom teeth pain at home.

Visit a dentist if the pain persists or worsens after using these home remedies. Professional treatment is necessary for long-term resolution, as home remedies do not address impaction, infection, or misalignment.

What are the Research about Wisdom Teeth?

The research about wisdom teeth focused on the incidence, extraction age, clinical outcomes, and management strategies for third molar removal. The “Estimated Cumulative Incidence of Wisdom Tooth Extractions in Privately Insured US Patients” study aimed to determine the cumulative incidence and predictors of wisdom teeth extractions in the US. Researchers analysed a US dental insurance claims database and found that by age 25, approximately 80% of patients had at least one tooth extraction, and 50% had at least one wisdom tooth extracted. Factors included female sex and residence in the West or South regions. The study concluded that wisdom tooth extractions, with significant geographic variation, are common in US adolescents and young adults.

“The Wisdom Behind the Third Molars Removal: A Prospective Study” was conducted at a specialist hospital on 106 patients in August 1953. The study aimed to analyse patients' outcomes and benefits of third molar removal. The researchers focused on understanding the impact of third molar extractions on patient health and identifying any significant advantages of removing these teeth. The study provided early insights into wisdom tooth extraction's potential benefits and risks.

The “Age of Patients at the Extraction of the Third Molar” study involved 106 cases at a hospital and sought to investigate the age at which third molar extractions are commonly performed. The researchers identified trends or patterns regarding the average age of wisdom tooth extraction by reviewing patient records and extraction timing. The findings contributed to a better understanding of the optimal timing for wisdom tooth extractions to minimise complications.

The “Evidenced-Based Decision Making: The Third Molar” study aimed to provide evidence-based guidelines for decision-making related to third molar extractions. The study highlighted the significance of using clinical evidence to guide the removal of third molars. The research aimed to ensure that decisions regarding wisdom tooth extraction are made based on the best available data, improving patient outcomes and reducing unnecessary surgeries.

“A Prospective Study of Clinical Outcomes Related to Third Molar” was conducted on adolescents and young adults aged 16 to 22. The study evaluated and compared the clinical outcomes of third molar removal versus retention in a specific age group. The researchers focused on assessing the long-term health impacts, potential complications, and benefits of removing or retaining wisdom teeth in young patients. The study provided valuable data on the relative merits of different treatment approaches for wisdom teeth in adolescents and young adults.

The “Problems with Erupting Wisdom Teeth: Signs, Symptoms, and Management” study was conducted by Tara Renton and Nairn H. F. Wilson. The British Journal of General Practice published an article in 2016 about how to treat infected and painful wisdom teeth that are erupting. The study highlighted that wisdom teeth, or third molars, are the last permanent teeth to erupt and get impacted in a non-functional position. Eighty percent of third molars must be removed before age 70, and problems like pericoronitis, dental caries, and cyst formation are common side effects. The article provided guidelines for managing acute and chronic pericoronitis and emphasised the importance of early extraction to prevent severe infections and complications.

What are the Differences between Wisdom Teeth and Gum Problems?

The difference between wisdom teeth and gum problems (periodontal disease) is their origin and nature. Wisdom teeth are the last to emerge, emerging in late adolescence or early adulthood. Wisdom teeth cause issues due to a lack of space in the jaw, leading to impaction, misalignment, and pain. Gum problems (periodontal disease) are the inflammation and infection of the tissues supporting the teeth, including the gums, which progress to severe conditions like gingivitis and periodontitis. Gum problems affect any tooth and are caused by bacterial infection from plaque buildup, while wisdom teeth are a specific anatomical development.

Wisdom teeth issues are caused by insufficient space in the jaw, resulting in impaction, crowding, or a partial eruption. Treatment involves surgical extraction to prevent or alleviate pain, infection, and misalignment. Dental plaque buildup results in bacterial infection and gum inflammation, which is the cause of periodontal disease. Treatments for gum problems range from professional cleanings and improved oral hygiene to advanced procedures like scaling, root planing, and gum or bone grafting, depending on the severity of the disease. Early stages are reversed with proper care, whereas advanced periodontitis requires more intensive intervention.

Wisdom teeth and gum problems are distinct but lead to severe pain and other oral issues. The two conditions lead to pain, swelling, and infection, affecting dental health. Regular dental check-ups and good oral hygiene are crucial to managing the issues. Monitoring the development of wisdom teeth and providing timely intervention prevent complications. Maintaining consistent dental cleanings and practising good gum hygiene at home is an effective strategy for controlling gum disease.

Dentist Dr. Dt. Erdem CETIN

He started his professional career in a private practice in Antalya in 2005 and served there until 2012. Between 2012 and 2016, he continued his work as a partner at the institution named KlinikAntalya. In 2016, he founded Myra Dental Centre Turkey and continues his professional activities there. Additionally, he has strengthened his expertise in the field with his membership in the International Congress of Oral Implantology (ICOI).