Solving questions & myths regarding wisdom teeth

There is a saying, “the experiences of toothaches are worse than suffering from serious illnesses.” Every time wisdom teeth are mentioned, it evokes painful memories for many. Whether people choose to have them removed or not, most will inevitably go through the torment of tooth pain. Wisdom teeth are one of the molars; if there isn’t enough space for them to grow, they may be misaligned (known as impacted wisdom teeth), causing excruciating pain. If you want to have a healthy and beautiful smile, oral health cannot be ignored. Let dental expert answer your questions, myths, and care methods related to wisdom teeth.

Do You Think Everyone Has Wisdom Teeth?

Actually, not necessarily. According to forensic odontologist Li Man Wah, wisdom teeth are the third molars, located at the back of the mouth and are the last to emerge, typically between the ages of 17 and 25. The number of wisdom teeth varies from person to person; most people have four, but having fewer than four or more than four is not uncommon. Some individuals are even born without wisdom teeth. If you are currently troubled by wisdom teeth, Dr. Ng can provide answers to your questions.

Q1: Do Wisdom Teeth Have to Be Removed?

Wisdom teeth serve the same function as regular molars. If there is enough space for them to grow normally, removal is not necessary. However, the following situations may require extraction:

1. Cavities, periodontal disease, or fractures in the wisdom teeth.
2. Causing decay or periodontal disease in adjacent teeth.
3. Cystic changes in the wisdom teeth.
4. Patients suffering from pericoronitis.
5. Need for orthodontic treatment or dentures.
6. Required removal during orthognathic surgery or fracture treatment.

Q2: How Painful Is It to Remove Wisdom Teeth?

Before the extraction, the dentist will administer local anesthesia (if all four wisdom teeth need to be removed at once, general anesthesia will be used), making the procedure painless. After the surgery, there may be some discomfort, but taking painkillers as prescribed can minimize the pain.

Q3: Can Wisdom Teeth Cause Sore Throats?

Wisdom teeth grow in the back of the jaw, close to the throat. When they begin to emerge, many people mistakenly think the pain is sore throat or lymphatic pain, when in fact it is the wisdom teeth causing the discomfort.

Q4: Is It Better to Extract Wisdom Teeth in the Morning Than in the Afternoon?

The body’s steroid secretion is highest between 7 AM and 11 AM, making it more resilient to external stimuli. It is recommended to schedule extractions in the morning, but don’t forget to have breakfast beforehand to avoid low blood sugar from anxiety.

Q5: Can All Wisdom Teeth Be Removed at Once?

Generally, patients can choose to have all wisdom teeth removed at once, but to avoid interfering with eating, it is advised to split the procedure into two sessions. First, remove one or two wisdom teeth from the same side, and then decide when to remove the other side based on post-operative pain and recovery. If recovery is not satisfactory, it is recommended to wait more than two weeks before the second surgery; if recovery is good, another extraction can be done after a week.

Q6: Can Removing Wisdom Teeth Slim the Face?

There is a common belief that removing wisdom teeth results in a slimmer face; however, there is no direct correlation. After tooth extraction, the gums may swell for a while, creating an illusion of a slimmer face once the swelling subsides. However, if you have a wide lower jaw or habitually use all four wisdom teeth for chewing, removing them may affect the muscle atrophy in the lower jaw, resulting in a visual slimming effect.

Aftercare for Wisdom Tooth Removal

If you’ve decided to remove your wisdom teeth, don’t think the job is done. Dentist Fu Yau Yu reminds you to be cautious as there are still risks and potential complications.

Post-Extraction Care Instructions

• Local anesthesia lasts 3 to 4 hours: After the anesthesia wears off, it is advisable to eat soft foods and avoid hot items to prevent burns or biting your lips and cheeks.
• Blood in saliva: Avoid rinsing or spitting frequently on the day of the extraction, as this can dislodge blood clots and hinder healing.
• Facial swelling: Use ice packs externally, and the next day, rinse with warm salt water to help reduce inflammation.
• Wound pain: Painkillers will help; if necessary, the dentist may prescribe antibiotics.
• Maintain good oral hygiene: Regularly clean your mouth to prevent wound infections.
• Avoid infection: Post-operative infections can delay healing.
• Temporary jaw pain: Prolonged mouth opening during surgery can cause temporary discomfort.
• Numbness in lower lip, chin, and tongue: A low percentage of people may have wisdom teeth very close to the lower alveolar or tongue nerves, and may have the risk of having the nerves injured during surgery, causing numbness, which usually resolves quickly, although rare cases may result in permanent nerve damage (specific to lower molar extractions).

Dentist’s Advice

Even if you strictly follow your dentist’s instructions, common issues may still arise.

1. What if I develop a hole after wisdom tooth extraction?
   The wound will heal over about three months. During this time, food debris may accumulate in the hole; it’s best to maintain good oral hygiene and rinse lightly as needed.
2. Why does the extraction site smell?
   Poor oral hygiene can lead to inflammation, causing a foul odor. Immediate medical attention is required.
3. Can patients develop “dry socket” after extraction? What can be done?
   Dry socket occurs 3 to 4 days post-extraction with severe, persistent pain radiating to the ear, jaw, or head. The socket appears empty without a blood clot or may have decayed remnants, and treatment involves saline rinsing and placing medicated gauze while prescribing antibiotics.
4. How can I effectively relieve wisdom tooth pain?
   First, determine if the pain is from the wisdom tooth or nearby teeth. Seek a dentist’s diagnosis to address the root cause. Pericoronitis is a common issue related to wisdom teeth. If immediate care isn’t possible, use medicated mouthwash or warm saltwater and maintain oral cleanliness. Consult your dentist to decide whether to extract the wisdom tooth or clean it instead. Antibiotics may help with inflammation and pain.

What Can I Eat After Tooth Extraction?

Since it’s a minor surgery, after extraction, avoid irritating the site and focus on a diet that promotes healing. What can you eat? Nutritionists recommend the following foods that help with bleeding and promote healing.

• Yogurt, pudding, jelly, ice cream: About four hours post-surgery, cold foods can constrict blood vessels, aiding in stopping bleeding and reducing swelling and pain. Focus on soft, semi-liquid foods like yogurt, pudding, jelly, and ice cream, which help with protein repair.
• Milk: Vitamin A and proteins in milk assist in healing.
• Bananas: Rich in vitamins and minerals, bananas are high in calories and easy to chew. You can mash them or blend them into a smoothie with milk or almond milk for a texture similar to ice cream but with much lower sugar content.
• Steamed eggs, congee, oatmeal, tofu pudding, vegetable puree soup: For 1 to 2 days post-surgery, avoid hot and spicy foods, and refrain from meats that may get stuck between teeth. Opt for light foods that require minimal chewing.
• Clear soups: If there is no ongoing bleeding, you can start consuming liquid foods like clear broth and vegetable soup, ensuring they aren’t too hot and avoiding straws.
• Salmon: If you crave meat, salmon is a good option. It’s soft and easy to chew, high in protein, and rich in Omega-3 fatty acids, which have anti-inflammatory properties.

Dental Care Tips

To maintain healthy teeth, prevention is key. According to the Hong Kong Department of Health’s Oral Health Education Unit, the following five methods can effectively protect your teeth.

Fluoride:
Common oral care products like toothpaste, mouthwash, and dental floss often contain fluoride. Studies show that brushing with fluoride toothpaste daily can reduce the risk of cavities by 20% or more. Since fluoride was added to Hong Kong’s drinking water in 1961, the cavity rate among residents has significantly decreased. Additionally, tea leaves and certain seafood like fish and seaweed also contain fluoride.

 

Avoid high-acid and hard foods and drinks:
Regular consumption of high-acid foods or drinks can erode enamel, exposing dentin and making teeth sensitive. Foods and drinks that are cold, hot, acidic, or sweet can cause discomfort. Avoid biting hard foods like bones or shells to prevent tooth fractures.

 

Chew sugar-free gum:
Sugar-free gum contains sugar alcohols and sweeteners that bacteria in the mouth cannot metabolize, preventing cavities. Chewing sugar-free gum stimulates saliva production, which neutralizes acids in the mouth and replenishes lost minerals, thus reducing the likelihood of cavities.

 

Quit smoking:
Smoking can cause bad breath, lead to stains on teeth, and increase the risk of periodontal disease. Research indicates that smokers are up to five times more likely to develop periodontal disease than non-smokers. Nicotine in cigarettes weakens the body’s immune response and hinders oral tissue healing, increasing the risk of oral cancer.

 

Use a soft-bristled toothbrush for thorough cleaning:
Brushing removes plaque from the tooth surface. Brush thoroughly every morning after waking and every night before bed to prevent periodontal disease. Brushing only cleans the surfaces of teeth; use dental floss to clean between teeth. Plaque buildup can lead to gum inflammation, resulting in bleeding and pain during brushing. Using a soft-bristled toothbrush to clear plaque can gradually eliminate inflammation and restore gum health.