Category Archives: tooth ache

Wisdom Teeth are the last set of adult teeth to grow in oral cavity which is in late teens or early 20s (in between 17-24). They are located at the back of the upper and lower, right & left jaws. In general Wisdom tooth doesn’t grow in proper direction (within the occlusal level), it grows partially or fully imbedded in gums or bone. Some people may not have all the wisdom teeth.

1. Does my wisdom go away with removal of Wisdom Teeth? NO. Wisdom tooth Removal and wisdom of person have no relation to each other.
2. Should I not eat after Wisdom Tooth Removal? NO. After removing the Wisdom Tooth, dentist will definitely ask patient to take ice-cream, or any cold and soft food because it soothes pain and swelling.
3. Wisdom tooth has no Use! – NO Stem cells of wisdom tooth can be harvested and preserved for later uses.
4. Does Wisdom tooth removal affect eyesight? NO There is no effect on eyesight because the nerve supply for tooth and eye varies.
5. Should a Wisdom tooth always be removed? NO If wisdom tooth is well erupted in oral cavity with proper angulation, there is no need to remove it and it can be taken as abutment if there is no other option for replacement of missing tooth.
6. Is Wisdom tooth removal, a major surgery. NO wisdom tooth removals are very simple surgeries.

Severe Pain or Swelling of the jaw or face is the main symptom.
Swollen and bleeding `gums.
Gum overgrowth (Pericoronitis) and cheek bite.
Bad taste in mouth and frequent food lodgment.
Radiating pain to the jaw, ear and/or head.
Difficulty while chewing food and opening the mouth.

Mesio-angular, Disto-angular, Vertical, Transverse (or Horizontal), Bucco-angular, Linguo-angular, Inverted, most common type is Mesio-angular.

1. If wisdom tooth causes any pain or swelling which in turn leads to difficulty to open or to chew food.
2. If position of the wisdom tooth is inappropriate which causes gum overgrowth or food lodgment or adjacent tooth damage.
3. If there is any injury near the wisdom tooth.
4. If the tooth is broken due to decay/trauma it causes irritation to the adjacent tissues (like Tongue, cheeks, Gums)
5. If opposing tooth is missing and wisdom tooth is shifting towards opposing side.

Most possible complication is gum disease, due to food lodgment. Even properly erupted wisdom tooth or impacted are susceptible to caries and further infection.
Damage to adjacent tooth as improperly emerging wisdom tooth pushes the neighboring tooth out of alignment and subsequently change the dentition and also damages the roots of second molars by their improper positioning or spreading infection/caries.
The sac within the gum lime which houses the wisdom tooth can become fluid-filled during impaction and form a cyst which cannot be noticed earlier in mean time the damage occurs. Cyst formation damages the adjacent tooth and also the underlying nerve.

Wisdom tooth Removal is recommended. It can be done by surgical method in some conditions as they are hidden in the bone.
In some cases, like if there is no pain and eruption of tooth is proper, only problem of gum overgrowth present then operculectomy procedure can be done. It is a procedure to cut the gingival overgrowth which disturbs the occlusion, and it can be done by surgical or laser method.
Treatment plan is to do blood investigations prior to any contagious diseases or conditions and levels of hemoglobin, clotting and bleeding time, complete blood picture.
Prior antibiotic prophylaxis should be given in case of surgical removal of wisdom tooth and after the tooth removal sutures may or may not be placed.

Post-operative pain: This is usually managed sufficiently with over-the-counter analgesics, even then if pain doesn’t subside.
Dry Socket: If pain continues after 3-5 days of extraction, then it can be diagnosed as Alveolar osteitis, known as Dry socket. It occurs due to breakdown of blood clot in a socket before wound organization has occurred. If post operative instruction not spitting or gargling for 24 hrs is violated clot would dislodge and reason to the dry socket condition.
Post-operative bleeding: This is a normal occurrence after dental extraction. Any medical factors in the patient’s history predisposing them to prolonged bleeding. In this case pressure is placed on the area, then local hemostatic agents should be used to arrest bleeding. If these attempts are unsuccessful, localized use of tranexamic acid can also be considered.
Post-operative bruising: This is common in surgical extraction. It usually resolves time being following extraction priorly patient should be warned about it to avoid concern.
Post-operative swelling: This is common with surgical exodontia. It usually resolves in 3-7 days.
Damage to adjacent teeth: It can be avoided by thorough pre-operative preparation and avoiding luxation or elevation by using adjacent tooth.
Paresthesia (Nerve injury): Usually mandibular third molars are near to or passing through the inferior alveolar nerve which are very complicated to do the extraction as the nerve may be compressed or damaged, which can cause paresthesia or permanent nerve damage.

It varies according to the condition, angulation, dilaceration of root tips, size of the tooth.

Bite on the gauze for 30-60 minutes. Do not chew on the gauze.
If bleeding starts again, place gauze over the area, and bite on it with firm, steady pressure for one hour.
Do not smoke for 3-5 days.
Do not use a straw to drink for at least 24 hours. The suction could cause the bleeding to start again.
Brush your teeth carefully and do not brush on the side of extraction site.
Do not spit or rinse for 24 hrs. It will cause blood clot dislodgement and more bleeding.
Take prescribed medication of antibiotics as directed, it is important to take medication even if there is no pain or swelling.
Do not take aspirin or aspirin-based products, since they may prolong bleeding.
After 48 hrs., if pain increases or if abnormal bleeding continues, contact your dentist immediately.
Use ice packs immediately after surgery, and for next 24 hours to reduce swelling. Apply ice packs for 20 minutes on the affected area and then keep it aside for 20 minutes.
Black and Blue marks, bruising and discoloration are normal occurrences after surgery. Do not worry about them.
Drink lots of liquids.