Wisdom teeth are the last teeth to come through in humans. They usually break through into the oral cavity at the age of 18-25 as the rear molars. The term comes from the "old" age at which they break through. Normally every person has four wisdom teeth that were created before birth. However, some people do not have all four or no wisdom teeth at all.
The teeth do not necessarily have to be removed. But often there is no room in the jaw to get through. This is because our jaws get smaller and smaller in human development. How many wisdom teeth you have and whether they have room to erupt can be determined by the dentist using an overview X-ray.
SYMPTOMS ASSOCIATED WITH WISDOM TEETH
While most of the time symptoms seem to be attributed directly or indirectly to wisdom teeth cannot be responsible for everything that happens in a person's mouth and face (orofacial region). Third molars can indeed cause several problems during their development and eruption, even after their extraction, but it seems too often that, when one cannot find another cause for certain symptoms in the orofacial region, the wisdom teeth quickly become the ideal scapegoat, sometimes with good reason, but very often also without scientific basis!
The scientific literature reports that several symptoms and problems can be associated with wisdom teeth which, let's say, represent "surprise boxes" when not outright "time bombs". Indeed, a wisdom tooth that has always been asymptomatic can suddenly cause a whole host of problems at any age.
Here we will try to make the difference by describing what could be related to these third molars and what is not or is less likely to be.
In some cases, and they are not uncommon, wisdom teeth do not cause any symptoms, despite the possible complications they can cause. It is therefore important to have them monitored regularly by a dentist from adolescence if they are not extracted. The dentist is the healthcare practitioner who has the expertise to assess them as they grow, determine their direction of eruption and the potential problems they may cause, as well as make recommendations on their management and extraction. Third molars are sometimes missing, even in adulthood, so they might never be a problem, but they shouldn't be ignored!
THE MOST LIKELY SYMPTOMS
Symptoms that are most likely related to wisdom teeth are accepted and well documented in the scientific literature; they are among the common and frequent symptoms. It should be noted that the different symptoms described below can be mild or severe, depending on each individual.
LOCALIZED OR RADIATING PAIN
This pain, when associated with wisdom teeth, is most often felt in the immediate area of the wisdom teeth. It can also be felt or radiated in the region of the temporomandibular joints ( TMJs ), in the back of the mouth near the ears, or in the upper or lower jaw.
In such a case, pain is often a sign that the third molar is advancing through the alveolar bone and gum tissue toward the surface or against the adjacent tooth. It is in fact trying to erupt.
This pain can be cyclical, like some other symptoms, because teething can be done "in waves" with moments of lull.
Gums that are tender, swollen, red (inflamed), or bleed more easily in the back of the mouth may be associated with wisdom teeth. Be careful, bleeding gums and redness can very often be symptoms of gum or periodontal disease that must be taken seriously; these symptoms then have no connection with wisdom teeth.
It is common to see the third molars as the site of infection, whether it is visible or not.
Wisdom teeth are more likely to become infected when they have come out partially (semi-impacted) or completely in the mouth. Poor oral hygiene allowing the buildup of dental plaque is a major cause of infection in the wisdom tooth area. The formation of tooth decay also contributes to the spread of infection in the tooth and its environment.
When they are still under the gum (impacted tooth), a wisdom tooth can also become infected even in the absence of symptoms and therefore without the person realizing it, especially at the early stage of the infection.
THE MOST COMMON SIGNS OF INFECTION ARE:
pain accompanied by other symptoms described below;
swelling of the gums (swelling) or an abscess surrounding the tooth or which is located in the back of the mouth. Sometimes, the person may even have difficulty swallowing, be swollen near the eye, or have a stuffy nose due to swelling of the gums.
redness (inflammation) or a feeling of localized heat near the tooth.
presence of pus (suppuration) that drains near the tooth.
persistent bad taste in the mouth or chronic bad breath (halitosis)
feeling of pulsation in or near the affected tooth.
swollen glands in the neck, when the person is not already suffering from another disease.
fever not associated with another disease.
It should be noted that if an infection associated with a wisdom tooth, or any other tooth, spreads, it can generate various symptoms far from the site of infection and cause other symptoms. In more severe cases, systemic problems can arise, such as blood infection (bacteremia, sepsis, etc.) which can cause death.
Any sign of infection in the mouth should therefore be taken seriously!
The presence of a more or less large and painful bump in the mouth or visible on the face, either around a wisdom tooth that has erupted or is impacted. Moreover, it is not uncommon to see cysts or benign tumors around an impacted wisdom tooth.
A pressure, a twinge or a pulsating feeling near the ears, in the TMJ or in the jaws.
A pain in the cheeks , especially if the wisdom teeth grow so that their crown tip to the outside of the jaw and that irritates the inside of the cheek or there is the presence of swelling or a cyst on the side of the cheek.
A mandibular opening limitation is when a person has difficulty opening the mouth while she normally opened before or difficulty chewing, especially in the back of the mouth.
A stiff jaw is also often felt and the inability to close the teeth together completely, which was possible before.
PERICORONITIS AND OPERCULITIS; PARTICULAR INFECTIONS
A “typical” pericoronitis is an infection and inflammation of the gum that partially covers a tooth (often a wisdom tooth) that is trying to erupt or complete its eruption. Sometimes a small piece of skin (gum) called an “operculum” covers the partially erupted tooth. The fact that a tooth has partially protruded from the gum creates a gateway for bacteria that can cause infection.
Food debris and bacteria (dental plaque) can accumulate there and cause infection. These conditions are often very painful and need to be treated. See your dentist as soon as possible to have this problem assessed and treated. Your doctor will probably suggest that you remove the part of the gum (operculum) that covers your molar (operculectomy). Your doctor may also prescribe antibiotics if an infection is already well established. Until your dentist can see you, be sure to cleanse and debride this area well, even if it is painful, to avoid the buildup of plaque and food debris which will only make the problem worse.
The term “pericoronitis” comes from “peri” which means “around” as in “periphery” of the tooth and “coronitis” which is an adjective relating to the “crown” of the tooth.
This condition is more common in young adults when wisdom teeth are trying to erupt (± 17-21 years) but can occur at any age.
A semi-impacted wisdom tooth is an excellent gateway for infection (pathogens, bacteria, accumulation of various food debris, etc.) and can lead to the development of gum problems (pericoronitis, operculitis), cavities and loss. bone (periodontitis to varying degrees) and, as previously mentioned, cause the infection to spread more systemically, which can have serious consequences, even death.
VARIOUS PROBLEMS AND PAIN AT TMJS, NEAR THE EARS
When these problems arise, either suddenly or gradually, it is important to see a dentist as soon as possible to have a complete evaluation of the mouth. A panoramic x-ray can reveal the presence of wisdom teeth when they have not yet erupted or problems that are invisible to the naked eye. Intraoral x-rays can also be taken in the dental office to get more precise details of wisdom teeth that are already in the mouth.
Unlikely or rarer symptoms are symptoms and problems that can affect a person, but which have rarely been linked to wisdom teeth, without concluding that it is impossible to establish.
Pain in the ears , when the pain in the jaw related to the wisdom teeth is very intense. Various headaches and migraines. It should be noted that headaches can have a multitude of causes. Wisdom teeth can be the cause indirectly (the pain in wisdom teeth is very intense, which promotes the onset of headaches). Often, headaches do not go away with the extraction of wisdom teeth.
Significant tooth movements , although slight tooth movements may occur near the area where the third molars are located. The eruption of wisdom teeth is often accused of causing tooth overlap in the lower anterior region because these two phenomena can occur at the same time, but several studies have shown that they are not a significant cause of these tooth movements. Find out more.
VERY UNLIKELY SYMPTOMS
Very unlikely symptoms are problems that some people experience but are very rarely associated with wisdom teeth as no cause and effect relationship can be established.
Complete loss, alteration or significant decrease in vision or hearing . Among the visual impairments, we can suffer from blurred vision, double vision, difficulty concentrating on objects, etc.
Neck and upper back pain and muscle spasms. So many neck and back pain can be explained by posture, neurological disease, fatigue, stress, draft, displacement of vertebra, contraction of cervical muscles (torticollis), etc. A person who suspects that their wisdom teeth are hurting their neck or back should first try to see if the hurt is not caused by something else instead.
Of tinnitus or ringing in the ears. These are noises (high-pitched, low-pitched, jerky, continuous, etc.) that a person hears, but others around them cannot. Find out more about tinnitus.
Irritation of the throat and difficulty in breathing.
Loss of balance, dizziness and nausea.
A feeling of blocked ears.
Extreme fatigue, to the point of not being able to do a full day of work, either during the growth of wisdom teeth or a few days after their extraction.
The movement of the front teeth (incisors, canines), despite a horizontal position of wisdom teeth. These are located too far from the front of the dentition to have any influence on the displacement of the anterior teeth. When wisdom teeth have erupted in the mouth, they are even less able to move other teeth. There are a multitude of causes that can explain dental displacements; in case of doubt, consult a dentist or an orthodontist. to learn more about this topic.
A generalized toothache, that is, all the teeth are sore at the same time.
Note that wisdom teeth would not directly cause the above symptoms, but the presence of a serious infection could contribute to some of these symptoms. Always see a dentist if you suspect an oral infection.
THE IMPOSSIBLE SYMPTOMS
Some people have mastered the art of pushing the cause and effect relationship of physical symptoms in order to correlate everything that is happening at the same time, even if it is logically impossible to establish a link between the symptom and the symptom. the cause.
In the category of impossible symptoms, problems that are certainly not associated with wisdom teeth, we find:
a loosening of the other teeth, no matter if wisdom teeth are retained or removed;
auditory or sensory hallucinations, such as the sensation of being touched in the head or face, while the wisdom teeth are still in the mouth;
a feeling of discomfort under the tongue, as if a foreign body is constantly under the tongue. Wisdom teeth are located too far from the underside of the tongue to have any effect on it;
herniated discs, back pain, muscle weakness, extreme fatigue;
the feeling of having a heavy head;
the onset of a cold or flu, with the onset of coughing and certain complications, such as ear infection or sinusitis; the fact that wisdom teeth suddenly start growing due to pregnancy or other significant hormonal imbalance or moon phase; problems with different joints (other than ATM); knees, hip, wrists, etc.
various muscle and motor problems;
problems with attention, concentration and functioning, ADHD, (although it is understandable that very severe pain can affect someone psychologically and in the performance of their normal activities!);
of vaginal bleeding !
earthquakes, tsunamis, hurricanes, tornadoes, floods and storms, although wisdom teeth can cause a “storm” of pain in a person's mouth! We really seem to blame wisdom teeth for all ailments ...
We have had, over the years, questions about the possible relationship of wisdom teeth and all of these symptoms… except for tornadoes and tsunamis, which is our pure invention!?
BEFORE THEIR EXTRACTION
Wisdom teeth can cause several complications if they are not properly managed by an oral health professional. In the event that wisdom teeth are left in place or before their extraction, an X-ray follow-up with a dentist is essential in order to monitor these teeth which are “time bombs”.
Third molars can damage teeth in the back of the mouth that have already erupted. In particular, they can absorb the roots of teeth already in the mouth. This damage is more common if the wisdom teeth grow horizontally or towards the other teeth, when there is not enough space in the jawbone to accommodate them or if they are growing out of place. following a bad eruption trajectory.
As mentioned above, a lump in the face or in the mouth may appear. Indeed, it can happen that a wisdom tooth grows in a bag in the jawbone; this sac, when it fills with fluid, becomes a cyst. In rare cases, a tumor, often benign, may also develop around the tooth. Usually, the patient is suggested to have the cyst or tumor removed in the absence of contraindications, as both can damage the jawbone or adjacent teeth.
When a wisdom tooth erupts in the mouth, it is exposed to cavities and gum disease, the most famous of which in wisdom teeth is pericoronitis (inflammation and infection of the gum that partially covers the crown of a tooth). As wisdom teeth are located completely in the back of the mouth, cleaning them can be difficult and some of the gum tissue may cover them. They are therefore more vulnerable to food particles and bacteria that can build up around them, especially if they are semi-included.
When there is not enough room on the jawbone to accommodate wisdom teeth, they usually overlap. Although wisdom teeth do not cause significant dental displacement, especially in the anterior teeth (incisors, canines), they can worsen an overlap problem at the back of the mouth. Indeed, if teeth attempt to erupt while the third molars are in the mouth (a fairly rare case given the late development of wisdom teeth), the position of the teeth that are trying to erupt could be influenced by that of the wisdom teeth. which are in the mouth. Orthodontic treatment can then be one of the solutions considered to correct the problem.
If the roots of a lower wisdom tooth are too close to the lower alveolar nerve and if it must be extracted, damage to the nerve can occur, either being "traumatized", cut or partially affected. This damage can manifest as paresthesia, manifested by partial or total loss of sensitivity, temporary or permanent, in the lower face.
Pain and problems with TMJs (limited opening, among others) can appear before the extraction of wisdom teeth.
DURING THEIR EXTRACTION
Wisdom teeth are located completely behind the dental arches, in the back of the mouth. Access to this area is often difficult, especially if an extraction is done because of pain issues, infection, etc. which are often accompanied by a limitation of the opening of the mouth, which makes the task difficult for the practitioner who must sometimes “force” the jaw to have access to the teeth to be extracted.
Although dentists and surgeons performing wisdom tooth (or other tooth) extractions are aware of the operative risks associated with complex extractions, advise patients of these risks, and take precautions to minimize potential problems, it is still possible that there are complications during an extraction . Here are some examples:
Displacement of other teeth . Wisdom teeth are often impacted or semi-impacted and when they are moved with the help of instruments to dislodge them from the tooth socket, this can put pressure on the tooth in the front (second molar normally) and move it to different degrees. Thus, a patient may feel that their bite or bite is slightly different after the extraction. This condition can be corrected without intervention most of the time, but if the displacement persists, it may be appropriate to adjust the “contacts” between the displaced tooth and the opposing tooth (bite adjustment).
Dental damage . The teeth adjacent to an extracted tooth can be damaged by the pressure and the instruments used during the extraction (fracture, broken restoration, detached crown).
Mandibular fracture . Applying strong force to extract a molar can fracture a mandible if the mandible has a “weakness” caused by a condition that affected and weakened the bone. Severely impacted teeth are at greater risk. The risk is also increased in older patients. The mandible must then be surgically stabilized. Such a complication is however rare.
Bone damage . The alveolar around a wisdom tooth can be damaged during extraction. The bone usually heals without permanent consequences.
The upper wisdom teeth can be located quite close to the maxillary sinus, and their extraction can cause an opening between the oral cavity and the sinus. Such communications usually close on their own without further intervention, but in some cases surgical correction may be necessary.
A tooth can also be accidentally pushed into the sinus while trying to extract it. It will then need to be removed to avoid further complications.
Problems with temporomandibular joints (TMJs) . The extreme opening often required to extract a wisdom tooth can affect TMJs and cause several symptoms. Find out more about temporomandibular joints and bite plate wear.
AFTER THEIR EXTRACTION
Some complications can also arise after the extraction of the third molars.
Pain, swelling (edema), inflammation, or the appearance of symptoms of infection near the extraction sites.
If the situation persists beyond two weeks or if it returns after it improves, see a dentist as soon as possible so that he can assess the situation.
Some problems with ATMs (limited opening, articular sounds like crunches when the jaw moves) may appear due to the original position of the wisdom teeth, if they have been difficult to remove or if their access was restricted to proceed with extraction, causing stress to ATMs. It should be noted that joint noises are frequent, complex and have a multitude of causes, but a cause and effect relationship can be made if the noises appear soon after wisdom teeth extraction.
The edema and swelling of the soft tissues surrounding extraction sites can create a temporary asymmetry on both sides of the face. If healing is normal, everything should be fine after a while. If in doubt, consult a dentist. It is also unlikely that the extraction of wisdom teeth will cause the height of a cheek to rise or fall permanently.
The atmospheric pressure can affect the sinuses and can indirectly affect the extraction sites of upper wisdom teeth causing pain or pressure in the back of the mouth or in the sinuses. These symptoms can appear if there are significant pressure changes in the cabin of an aircraft. On the other hand, tooth extraction sites cannot cause sinus engorgement problems, unless there is an infection near the sinuses.
OTHER SYMPTOMS AND ISSUES ASSOCIATED WITH WISDOM TEETH
If you have any of the symptoms described above, other symptoms, or if you are wondering if:
what goes on in your mouth is related to wisdom teeth,
what you feel is normal or not,
there is an infection, pathology or any other abnormality around a tooth,
this is part of the normal eruption process of a wisdom tooth,
your wisdom teeth will come out or not, will be impacted or not, will cause problems eventually,
your wisdom tooth is present, absent, impacted or semi-impacted, normal, abnormal, etc.,
this condition requires intervention, will improve or worsen,
it is necessary to extract your third molars, when, how, by whom, etc.
it is indicated to take medications and which ones, etc.
First, consult a general dentist who will assess your condition, make a diagnosis and make the appropriate recommendations if necessary (ideal treatment, alternatives and compromises, prognosis, duration and cost of treatment, etc.) and will refer you to other dental specialists if indicated.