Wisdom Teeth Care Myths

Many people have unpleasant memories of wisdom teeth. Regardless of whether or not they ultimately choose to have them removed, the process is often unforgettable. Wisdom teeth are actually the third molars of the human body. Due to the smaller jawbones of modern people compared to ancient people, coupled with changes in dietary habits and a shift away from coarse foods, the jawbone lacks space, often preventing wisdom teeth from erupting properly, resulting in impacted wisdom teeth. In this issue, oral and maxillofacial surgeons provide a detailed explanation of the potential problems wisdom teeth may cause, treatment options, and post-operative care.

Wisdom teeth can be categorized as impacted or non-impacted. Dr. Zhou Liqiang, an oral and maxillofacial surgeon at Hong Kong Sanatorium & Hospital, explains that non-impacted wisdom teeth are those that erupt normally and grow at the same angle as other teeth. However, because wisdom teeth are typically located at the back of the mouth, they are easily overlooked during daily cleaning. Failure to clean thoroughly can lead to problems such as tooth decay and gum inflammation. Therefore, even if wisdom teeth are not crooked, extraction may be necessary if they are difficult to clean.

Impacted wisdom teeth, on the other hand, are teeth that grow in an abnormal direction, commonly known as "growing crookedly." They may grow sideways, backward, or lower than other teeth. Impacted wisdom teeth can cause a variety of problems, including tooth decay, pericoronitis, and dental cysts, often requiring surgical removal.

Many people think that as long as wisdom teeth do not hurt, they do not need to be treated. However, Dr. Zhou pointed out that this idea is not correct. He explained that wisdom teeth may cause tooth decay, which not only affects the teeth themselves but also the adjacent teeth. Early tooth decay may not have obvious symptoms, but if the situation worsens andDeep into the dental pulp, which can lead to necrosis of adjacent teeth and even the need for root canal surgery. Furthermore, impacted wisdom teeth can easily cause pericoronitis, a condition in which the gums surrounding the teeth are covered and difficult to clean. Residual food debris can easily breed bacteria, causing gingivitis and symptoms such as facial swelling, pain, and pus. However, during acute inflammation, immediate tooth extraction is generally not recommended. Patients should first take antibiotics to reduce inflammation, and surgery can be performed only after the inflammation is under control. Therefore, in some cases, wisdom tooth extraction is a preventative measure, rather than waiting until symptoms become severe.

The potential risk of impacted wisdom teeth also includes the formation of "dental cysts". Dr. Zhou said that before wisdom teeth erupt, they are usually covered by a layer of tissue called "dental sac", which is the embryonic tissue of tooth development. Under normal circumstances, the dental sac will disappear naturally after the teeth erupt. However, if the wisdom teeth cannot erupt, the dental sac may expand abnormally, which may not only erode the surrounding dental bones, but even push the wisdom teeth out of their normal position, and may also affect the adjacent teeth. In severe cases, it may even causeBroken jawBecause cysts are usually painless, many patients only discover the problem during routine checkups.

Impacted wisdom teeth generally need to be removed surgically. Dr. Zhou explained that the operation will first be performed with local anesthesia around the mouth and gums. Since impacted wisdom teeth are usually located below the gums, the doctor needs to first cut and turn up the gums to see the wisdom teeth covered by the bone. During the operation, in order to reduce the area of the wound, the doctor will usually divide the wisdom teeth into several pieces and then gradually remove them, and then clean the wound and suture it. In addition, even if the wisdom teeth are not impacted, if the patient needs to make room for orthodontic treatment or dentures, they may need to be removed.

Postoperative care is equally important. Generally, postoperative swelling and pain will last two to three days, and full recovery takes about a week. Maintaining oral hygiene is still necessary after surgery, but avoid excessive rinsing or vigorous brushing until bleeding stops. Patients should maintain good oral hygiene to reduce the risk of infection, temporarily avoid eating hard or hot foods, and take medications as directed by their doctor.

Regarding whether wisdom tooth extraction can affect nerves or even cause facial paralysis, Dr. Zhou explained that near lower wisdom teeth are the inferior alveolar nerve and lingual nerve, branches of the trigeminal nerve that primarily provide sensation to the lower lip and tongue. If the wisdom tooth root is close to these nerves, there's a chance the nerves could be slightly stretched during surgery, causing temporary loss of sensation in the lower lip or tongue. In severe cases, permanent damage could occur, but it will never cause facial paralysis. With advances in medical technology, many doctors now utilize 3D computer scanning to precisely determine the position of wisdom teeth in relation to nerves, helping to reduce the risk of nerve damage during surgery.