Wisdom teeth – check when the eights grow, what are the symptoms, when removal is necessary and what is the treatment and prevention.
Table of contents
- What are wisdom teeth (eights) – characteristics and function
- When are wisdom teeth most likely to erupt?
- Symptoms and most common ailments associated with eights
- When is it a good idea to remove wisdom teeth? Indications and contraindications
- Course of wisdom teeth removal and recommendations after the procedure
- Prevention and care of wisdom teeth
What are wisdom teeth (eights) – characteristics and function
Wisdom teeth, commonly referred to as eights, are the last, third molars in a person’s dental arch, which usually erupt last among all permanent teeth. Their name comes from the fact that they appear later in life, usually between the ages of 17 and 25, a period symbolically referred to as the “age of wisdom.” However, the process can be individual in many people – eights can appear earlier or only at a later age, or sometimes not at all. Wisdom teeth are located at the end of the dental arch in both the maxilla and mandible, one pair in each quadrant of the mouth, meaning that a full set of wisdom teeth is four teeth. Characteristic of eights is that they often have a variable anatomical structure: they can be smaller, have an unusual number of roots or crowns, and differ in size from the rest of the molars. It is not uncommon for the eruption of eighths to be accompanied by various complications, which result, among other things, from the lack of sufficient space in the dental arch, which is sometimes a consequence of evolutionary changes in the structure of the human skull.
Functionally, the eighths originally played an important role in grinding hard, raw food, which was especially important in the diets of our ancestors. The modern diet, based on more processed and softer foods, and changing lifestyles, have meant that the role of the eighths has diminished significantly. Thus, in many people, wisdom teeth are now not necessary for proper chewing of food, and premolars and other molars are completely sufficient for this function. In addition, due to their location in the mouth, eighths are difficult to access during daily oral hygiene, making them more prone to plaque buildup, decay or inflammation of the gums. Modern dental research also indicates that the presence of wisdom teeth can sometimes lead to complications such as shifting of other teeth, pressure on the roots of neighboring teeth, infections or cyst formation. It is for this reason that surgical treatment, including extraction of these teeth, becomes necessary in some people, especially when the eighths are misaligned or lack space in the arch. Despite their limited function these days, properly erupted and healthy eighths can serve for many years, and can be used as pillars for prosthetic bridges if other teeth are lost. In the end, although their biological importance has diminished, wisdom teeth still raise a lot of controversy and questions about their role in the oral cavity and the proper preventive and therapeutic management of any problems they may cause.
When are wisdom teeth most likely to erupt?
Wisdom teeth, also known as eights, are the last molars to appear in the human dentition, and the process of eruption usually begins between the ages of 17 and 25. However, this is not an absolute rule – in some cases, the eruption of the eighths can occur even after the age of 30, and sometimes the wisdom teeth do not appear at all or remain in the jawbone throughout life. Nowadays, there is considerable variation among populations in the number, alignment and timing of the eruption of eights, which is the result of both genetic and environmental factors. Genetic factors determine not only whether or not a person will develop wisdom teeth buds, but also a predisposition to anatomical abnormalities, such as abnormal shape or position of teeth. It is also increasingly common to find people in whom the eighths do not appear at all – according to studies, up to 10-35% of the population may not have all their wisdom teeth, and complete absence of their buds affects 1-2% of people. The process of eruption of eighths differs from the eruption of other teeth – not only because of the later stage of appearance of these teeth, but also because of the structure of the bone and the limited space in the dental arch, which often leads to retention of the eighth in the bone (the so-called retained tooth) or partial eruption (partially retained tooth), causing discomfort and health complications.
The average age for the eruption of eights is in late adolescence and early adulthood, a time when the development of the jawbone and mandible is coming to an end. By then, the body is almost fully developed, but often the amount of space in the dental arch is too limited for the proper emergence of third molars. From an evolutionary point of view, human ancestors had wider jaws and skulls, which allowed all teeth, including eights, to appear without problems. Nowadays, as a result of dietary changes (prevalence of processed, soft foods) and the associated reduced need to grind food, our jaws are becoming narrower, and wisdom teeth often have no room to erupt properly. As a result, this process can drag on for months or years, producing symptoms such as pain, swollen gums, difficulty opening the mouth wide, and sometimes even migraine headaches. It’s also worth noting individual factors, such as genetic conditions inherited from parents, the size and shape of the jaw, and orthodontic history – people who have undergone orthodontic treatment with braces in place often have even less room for the appearance of eights. Sometimes a dentist can predict when and how a wisdom tooth will begin to erupt based on a panoramic radiograph. In conclusion, although third molars most often erupt between the ages of 17 and 25, their appearance is a highly individual process, dependent on many factors of both genetic and environmental nature.
Symptoms and most common ailments associated with eights
Wisdom teeth, or eights, are quite often associated with the occurrence of characteristic symptoms and discomforts that can impede daily functioning and affect the overall health of the oral cavity. The eruption of eighths can be a long and painful process, especially when there is not enough space for them in the dental arch, which translates into a variety of symptoms. The most common symptom is pain – usually of a dull nature, radiating to neighboring teeth, the jaw, and even the ear or head. It is not uncommon for this pain to intensify when eating or touching the area around the gum where the erupting eighth tooth pierces through the tissues. Common symptoms also include swelling and redness of the gums in the region of the eight, which is a typical manifestation of an inflammatory reaction. Sometimes the eruption process is accompanied by swelling of the cheek and difficulty in opening the mouth (trismus), as well as an unpleasant aftertaste in the mouth and bad breath – these effects can result from the accumulation of food debris and the growth of bacteria in hard-to-reach areas. If a wisdom tooth grows abnormally, it can cause pressure or displacement of adjacent teeth, sometimes leading to crowding, curvature of the dental arch, and injury to the gums and cheek. This situation carries the risk of aggravating orthodontic problems, and can also be the beginning of recurrent inflammation, called pericoronitis – inflammation of the tissues surrounding the crown of a partially erupted tooth. This manifests as severe pain, purulent exudation from under the gums, swelling and enlargement of the lymph nodes of the submandibular region.
Another group of common complaints associated with eighths are infectious complications and complications related to poor hygiene of this part of the oral cavity. Due to the difficult access to the wisdom teeth, regular removal of bacterial plaque and food debris is difficult, which promotes the development of caries both in the eighth tooth itself and in the adjacent tooth. Caries of the eighths is often asymptomatic for a long time, and can only be detected during a dental examination or with the help of an X-ray. Complications also include the development of abscesses, periostitis and cysts associated with the retained eighth – these conditions can lead to increased pain, fever, general malaise and require immediate medical intervention. Some patients experience recurrent sore throat, difficulty swallowing and even pain radiating into the ear, as a result of the inflammatory process spreading to the surrounding tissues. In the case of partially retained wisdom teeth, common symptoms include chronic inflammation of the gums, bleeding during brushing and a feeling of tension and distension in the jaw. An additional complaint, now more widely described, is chronic headaches and neck pain, which may originate from temporomandibular joint disorders resulting from abnormal eruption of the eights. Sometimes wisdom teeth remain completely asymptomatic – such a situation occurs when they grow properly and are provided with the right anatomical conditions. However, even then, regular dental check-ups are advisable, as potential risks associated with the eighths may arise at a later time.
When is it a good idea to remove wisdom teeth? Indications and contraindications
Removal of wisdom teeth, or extraction of eights, is one of the most commonly performed dental surgery procedures, but it is not always necessary. The decision to extract should be made on an individual basis, based on a detailed diagnosis and assessment of the patient’s oral health. The most important indication for the removal of wisdom teeth is the pain that occurs during the eruption of the eights, especially recurrent inflammation of the gums around these teeth, known as pericoronitis. Another important consideration is the lack of space in the dental arch, leading to crowding of teeth, pressure on neighboring teeth, worsening bite alignment and even orthodontic complications that may require further treatment. Eighths are also a common source of recurrent abscesses, cysts, infections and carious lesions, both on themselves and on neighboring teeth, due to the difficulty in cleaning them. If radiological examination shows that a wisdom tooth is growing at an abnormal angle (such as horizontally or semi-recumbent), there is a high risk of damage to the roots or the rest of the teeth. Removal of eighths is also recommended for patients who are planning orthodontic treatment – the presence of these teeth can hinder optimal results of the therapy or cause recurrence of malocclusion. Extraction of unerupted or retained eighths is also often recommended, especially if they cause chronic, latent inflammation or negatively affect the condition of periodontal tissues. Indications can also be situations related to planned prosthetic procedures, where the presence of an eighth tooth hinders the performance of a bridge or other prosthetic structure. It should be noted that not all eights need to be removed prophylactically – if they are healthy, properly erupted, do not cause problems and can be kept clean, the dentist often recommends leaving them in the mouth and checking them regularly.
While there are many indications for extraction, equally important are contraindications that every doctor must consider before deciding on the procedure. First of all, wisdom teeth extraction is postponed in patients with acute conditions, such as sudden systemic infections, active viral disease or high fevers, as well as in situations of decompensated chronic diseases (e.g. diabetes, hypertension, heart failure), when the risk of surgical complications is too high. Removal of the eight may not be recommended for women in advanced pregnancy (especially in the first and third trimesters), due to the risk of complications for the mother and the fetus, although in emergency cases the intervention is sometimes necessary. Nevertheless, an important contraindication is blood clotting disorders, both congenital and those caused by anticoagulants – appropriate consultation and preparation of the patient in cooperation with the attending physician is necessary before the procedure. Extraction is also not performed during intensive chemotherapy, radiation therapy in the oral cavity, and after recent major surgery for other reasons. In addition, in justified cases, if the anatomical structure of the tooth (e.g. strong root overgrowth with bone, proximity to important structures like the inferior alveolar nerve or maxillary sinus) poses a high risk of nerve damage or other surgical complications, the doctor may decide to postpone or abandon the procedure. It is also worth remembering that in elderly patients with multiple medical conditions, the risks associated with wound healing and the possibility of infection may outweigh the potential benefits of tooth extraction. The final decision to extract an eighth should be preceded by a thorough medical history, analysis of imaging studies and consultation with an oral surgery specialist to minimize the risk of complications and achieve the best possible treatment outcome.
Course of wisdom teeth removal and recommendations after the procedure
Wisdom tooth removal is a surgical procedure for which the patient should be properly prepared both mentally and physically. Before the procedure, the dentist performs a thorough diagnostic, usually using a panoramic radiograph or CT scan, to assess the position of the eighth in relation to other anatomical structures of the mouth, such as nerves, maxillary sinuses and neighboring teeth. This allows the doctor to plan the procedure and avoid possible complications. On the day of wisdom tooth removal, the patient usually receives local anesthesia, which provides comfort and eliminates pain during the procedure. For very difficult eights or high anxiety, sedation or anesthesia may be considered, but most extractions are performed under local anesthesia. The procedure itself varies depending on the severity of the case – some wisdom teeth are completely erupted and can be removed with standard dental instruments in several minutes, while others – retained under the gum or in the bone – require an incision in the gum and possibly removal of a small amount of bone. In more difficult cases, the dental surgeon may separate the tooth into smaller pieces to facilitate extraction and minimize damage to surrounding tissues. After removal of the eight, the wound is thoroughly cleaned and, if necessary, resorbable or traditional sutures are placed, requiring removal after a few days. The entire procedure usually takes between 20 minutes and an hour, depending on the complexity, and after the procedure is completed, the patient is given precise recommendations for post-operative management.
After wisdom tooth extraction, post-procedure recommendations are crucial to promote proper healing and prevent complications such as decay and dry socket. For the first 30 minutes after the procedure is completed, keep a gauze pad on the wound to stop bleeding. It is advisable to avoid drinking hot beverages and eating food for several hours to give the tissues time to heal initially. Smoking and alcohol consumption should be avoided for 24 hours, as these factors increase the risk of complications and delay the healing process. Using cold compresses for the first 24 hours after surgery helps minimize swelling and pain. Oral hygiene is very important – teeth can be gently brushed from the first day, avoiding the operated area; and mouthwash should be avoided for the first 24 hours to avoid flushing out the clot that protects the wound. After this period, it is recommended to rinse the mouth with mild antiseptic solutions, such as salt water or dedicated preparations available at pharmacies. Pain after the procedure is a normal symptom and can be relieved with painkillers as prescribed by the doctor, but avoiding non-steroidal anti-inflammatory drugs of the aspirin group, which can prolong bleeding. It is worth observing the area after tooth extraction – if there are alarming symptoms, such as prolonged heavy bleeding, increasing swelling, high fever, purulent discharge or intense pain, consult a dentist immediately. A return to normal activity is sometimes possible after just 1-2 days, but it takes several weeks for the wound to heal completely. Regular adherence to post-operative instructions significantly accelerates tissue regeneration, reduces the risk of complications and ensures proper healing, so it is worth treating with due care.
Prevention and care of wisdom teeth
Prevention and proper care of wisdom teeth are key elements in preventing many of the complications that can be associated with the presence of eights. Due to their unusual location in the dental arch, it becomes a challenge to maintain an adequate level of hygiene, so it is advisable to implement special precautions especially when they erupt or are already completely present in the mouth. The first step in effective prevention is careful daily oral hygiene. Brushing your teeth at least twice a day with a soft-bristled toothbrush and using fluoride toothpaste helps reduce the development of carious bacteria and inflammation. It is worth paying special attention to the back of the mouth, where the eighths are located, as food debris and bacterial plaque tend to accumulate precisely in these hard-to-reach areas. Dentists also recommend regular flossing and the use of dental irrigators or specialized interdental brushes to help effectively remove debris from the spaces around the erupting eights. It is also extremely important to rinse the mouth with appropriate antibacterial liquids, especially during periods of increased risk of gingivitis. Particular caution should be exercised by those with braces, as the presence of these devices can further impede access to the eights and reduce the effectiveness of daily cleaning.
Regular follow-up visits to the dentist, preferably every 6 months or as individually recommended by the doctor, are the cornerstone of preventive care in the context of wisdom teeth. During such visits, the dentist assesses whether the eights are growing properly, and also examines the condition of the gums and bone tissue around these teeth. If there are difficulties in maintaining proper cleanliness or recurrent inflammation, the dentist may apply local hygienist treatments, such as professional tartar removal or rinsing of gum pockets. X-rays are also recommended to help monitor the development and position of wisdom teeth even before serious symptoms appear. Early diagnosis makes it possible to implement optimal management – for example, prophylactic removal of retained eights or planning surgery well in advance. In addition, taking care of general health, a proper diet and avoiding habits such as smoking influence better blood supply to the tissues and resistance to inflammation. It is also worthwhile to avoid excessive consumption of simple sugars, which promote the development of tooth decay, and to eat foods rich in vitamins and minerals that support the health of teeth and gums. Maintaining a close relationship with your dentist allows you to react quickly to any changes, minimizing the risk of complications such as cysts, abscesses or extensive inflammation. Prevention and proper care of wisdom teeth is an investment in oral health and the comfort of daily life, avoiding many problems that may require surgical intervention if the eights are not properly cared for.
Summary
Wisdom teeth, or eights, typically appear between the ages of 17 and 25 and bring with them a number of health challenges. Symptoms such as pain and inflammation are a common reason for visits to the dentist. Removal of eights is recommended when they cause discomfort, are misplaced or lack space. The wisdom tooth removal procedure itself is performed under local anesthesia, and proper post-extraction care accelerates healing. Regular check-ups, prophylaxis and prompt response to symptoms help maintain oral health and avoid serious complications associated with eighths.
