Wisdom teeth and orthodontic treatment
How do wisdom teeth affect straight teeth? Should I be worried about my wisdom teeth coming through and moving my teeth? Should I have these teeth removed, and when should I do this?
- 1 What are wisdom teeth?
- 2 Does everyone have wisdom teeth?
- 3 Why do we have wisdom teeth?
- 4 What are the symptoms of wisdom teeth?
- 5 Do wisdom teeth always hurt when they come through?
- 6 Why can it hurt when these teeth come through?
- 7 How long can wisdom tooth discomfort last?
- 8 How to stop wisdom teeth from hurting?
- 9 Should I have my wisdom teeth removed?
- 10 Are wisdom teeth hard to remove?
- 11 What to eat after wisdom teeth removal?
- 12 Do your teeth shift after wisdom teeth removal?
- 13 What happens if I ignore painful wisdom teeth?
- 14 Should I get my wisdom teeth removed before getting braces?
- 15 Why do we get wisdom teeth so late?
- 16 What else can affect my straight teeth?
- 17 When in doubt, ask your orthodontist
Orthodontists are often asked these questions by new patients and those that have finished their orthodontic treatment. In this blog post, we discuss the common questions and concerns associated with wisdom teeth, their affect on the other teeth in the mouth, and encourage you to consult a specialist orthodontist before stocking up on supplies for your recovery.
What are wisdom teeth?
Wisdom teeth are the third and last molars, found at the very back on each side of the upper and lower jaws, and are the final teeth to grow through the gums (erupt). They usually appear in the mouth when a person is in their late teens or early twenties. This tooth often erupts without problems; however, sometimes, this tooth has insufficient space to erupt properly and becomes “impacted”.
No, not everyone has wisdom teeth. Most adults will naturally have four wisdom teeth, but about 15-20% of people never develop at least one of these four teeth. The fact that they come through when you’re older is one of the reasons they’re related to wisdom: you only get them when you have matured and are ‘wiser’!
Anthropologists believe that our wisdom teeth originally evolved to help our ancestors get the most from their diets, which involved a lot of coarse and rough food such as leaves, roots, nuts and meats. Historically, our ancestors needed large and powerful jaws to be able to chew this food. The jaws of modern humans have evolved to be much smaller than our Neanderthal ancestors, which means for many of us such teeth simply don’t fit in anymore.
As our diet has changed dramatically over the millennia to include more soft foods that don’t wear down our teeth as much, our wisdom teeth are no longer necessary for our survival. In fact, this tooth is now so redundant that evolutionary biologists consider it to be ‘vestigial organ’, meaning it is now entirely functionless thanks to evolution.
There are a number if signs that will tell you that your wisdom teeth are going to cut through your gums. This includes:
- Sore, red or tender gums
- Persistent pain or bleeding in the mouth
- Difficulty opening your mouth and swallowing
- Sinus and breathing challenges
- Bad breath
Not always! For some people, these teeth will come through properly aligned, and while it’s likely they’ll experience some tenderness and ‘teething’ around their gums as the teeth erupt into the mouth, it won’t necessarily be painful. In this instance, it’s unlikely any action will need to be taken.
However, as you’re no doubt aware, some people have a very different experience!
There are a number of reasons why such teeth can be painful or uncomfortable when they come through. It could be that there’s not enough room in your mouth for them, so they are putting pressure on the other adjacent teeth possibly shifting their positions. It could also be because the tooth is trying to come in sideways or has become jammed or “impacted” behind the last tooth in the mouth. In this instance, the gum covering the wisdom tooth can become swollen and infected, which might make your jaw or the area around your ear sore.
The discomfort can last for one to two weeks, but this will vary between individuals because each case is unique. The pain is rarely static, and might increase and decrease at certain times of day. As these teeth grow in stages rather than all at once, it’s likely you’ll experience a few rounds of discomfort before your wisdom tooth has fully come through.
It’s normal to experience some discomfort when your wisdom teeth are coming through. Thankfully, there are some things you can do to help:
- Consider purchasing over-the-counter pain relief medication to help with soreness
- Apply Bonjela directly to the area around the tooth
- Try wrapping an ice-pack or a bag of frozen vegetables in a tea towel and place it in the sensitive area
- Swish your mouth with warm, salty water
- Make a hot cup of black or herbal tea
If the pain from the erupting wisdom tooth is severe you should make an appointment to visit your general dentist as this is a sign that the area around the erupting tooth may be infected.
Although this is a common question, there is no one-size-fits-all answer, as it will depend on the severity and frequency of your symptoms, as well as the impact these teeth are having on the rest of your mouth.
The main reasons for wisdom tooth removal are:
– Recurrent infections caused from the teeth only partially erupted and impossible to clean properly
– The potential damage to the adjacent healthy molars from the erupting wisdom tooth.
One of the best ways for your orthodontist to tell how your wisdom tooth is coming through will be to take an x-ray of your mouth.
Again, there’s no one-size-fits-all answer to this, as it depends on how the teeth are growing, the length of their roots and the proximity of this tooth to other structures in the jaw such as nerves and blood vessels.
In general, these teeth in your lower jaw are more likely to be ‘impacted’ and tend to be harder to remove than these teeth in your top jaw. Your orthodontist may refer you to a specialist oral and maxillofacial surgeon, or back to your general dentist to assess this further. Your surgeon will discuss risks associated with wisdom tooth removal. In general, the risks and complications of wisdom tooth removal are very low, but post-operative infection, delayed healing, and nerve damage can occur.
The removal of this tooth can be done under a local or general anaesthetic, depending on the number of teeth that need to be removed, the level of difficulty involved in their removal and your personal preference.
After these teeth are removed, it is common to experience some swelling and discomfort for a few days. It’s possible that you’ll have couple of stitches to help keep the wound closed and aid with its healing. Your surgeon will give you personal instructions on how best to care for your mouth following the procedure, for example whether you should be using any particular mouthwashes to help with your recovery.
If you are still using retainers provided by your orthodontist, they may be too uncomfortable to wear for the first few days after the procedure. But it is important to go back to wearing your retainers again as soon as your mouth feels comfortable enough to do so.
There are not usually any dietary restrictions after you’ve had your wisdom tooth out, but it’s likely you’ll want to avoid hard foods such as nuts and seeds, or crunchy foods like chips until your mouth heals. You should also avoid alcohol and smoking for at least 24-hours following your procedure, or in line with your surgeon’s guidance.
Do your teeth shift after wisdom teeth removal?
Shifting teeth is a fact of life. Mesial drift occurs over our lifespan, where teeth gradually drift to the front and centre of our mouths. Wisdom teeth are a little different as they seem to erupt almost suddenly. If your wisdom teeth come through straight, then there is little movement in the teeth in the rest of your mouth. But if your wisdom teeth are impacted (growing inwardly toward the gum) or growing crooked/angled, then it is likely that other teeth will have shifted and will then shift after the removal of the wisdom teeth.
If you ignore painful wisdom tooth, it may turn into a more serious infection. Soreness around your wisdom tooth and pain in your jaw, ear or the side of your face can all be symptoms of infection. If that infection isn’t treated, it can spread to the surrounding areas. In severe, untreated cases, the spreading infection may cause facial swelling and compromise your airway, restricting your ability to breathe and swallow, which is a true medical emergency.
It can also be difficult to clean these teeth that have not properly come through. Thanks to their location at the back of your mouth, they’re much more prone to a build-up of food particles and plaque that can cause infection around your tooth, leading to decay and the possibility of developing cysts. As well as having a negative effect on the tooth itself, this can also impact on the health of the surrounding gums, teeth and bone.
Should I get my wisdom teeth removed before getting braces?
For some people in their late teens and early 20s, wisdom teeth erupt into cleanable and functional positions and may not need to be removed at all. However, impacted wisdom teeth can become a significant dental health issue if they are hard to clean and become a source of pain or infection. If you start to feel wisdom teeth coming through, you should visit your family dentist or orthodontist to discuss the relevant treatment options for your individual case. They will be able to take a closer look at how the wisdom teeth are impacting on the rest of your teeth, arrange an x-ray of the teeth and jaws, and advise on whether you’ll need to take further action.
Why do we get wisdom teeth so late?
Wisdom teeth, or our third molars, generally erupt in our late teens and early 20s, hence their name – supposedly signifying the transition to adulthood and the gaining of wisdom. Though some people get them comparatively early and some people’s wisdom teeth don’t come through until they’re in their 30s. As human anatomy and development can vary widely, your family dentist and/or specialist orthodontist can provide more information regarding the best individual management strategy for your wisdom teeth.
What else can affect my straight teeth?
There are a number of other factors that can cause teeth to become crooked over time. Even people without wisdom teeth will notice changes to the alignment of their teeth after many years, so clearly these teeth are not the only culprits for these long term changes in tooth position.
We now know that as we age our body continues to change – we get grey hair, more wrinkles and our teeth also slowly move with time. Retainers help teeth to maintain their alignment following orthodontic treatment, so because of these natural changes most orthodontists now advise the long term or life time wear of orthodontic retainers after treatment with braces or aligners.
Your orthodontist can advise the best way to ensure your newly straight teeth remain in place well after your braces come off.
When in doubt, ask your orthodontist
While wisdom teeth typically will not harm a straight smile achieved through orthodontic work, removing them may still be recommended to ensure the overall health of your mouth.
Because every person and every case is different, it’s always best to consult with a specialist orthodontist for further advice about whether you should have your wisdom tooth removed and how this might affect your orthodontic treatment in the long term.
The best person to offer you advice and guidance on how wisdom teeth may affect your teeth after orthodontic treatment is your specialist orthodontist. If you are unsure of where to find a registered orthodontist, check the Find An Orthodontist tool to find your nearest practice.