“Why the last third molars are called wisdom teeth? “
Simply because they are the last teeth to erupt in the oral cavity, their eruption occurs between 13 to 16 years. Located in the most posterior position in the mouth and often they erupt in improper position leading to “wisdom teeth pain” due to their large size and the small area of the arch.
It’s unpleasant period during their eruption as it causes pain in posterior part of the mouth, gum itching, gum swelling and difficulty during eating and swallowing. Pain will gradually increase with time as the wisdom teeth continue to grow in misaligned or sideways, pressing on nerves and bone, and crowding surrounding teeth. The eruption of wisdom teeth through gingiva allow bacteria to enter the open tissue and cause oral infection. Late eruption of third molars leads to an improper position as they may be angulated “mesioangular, distoangular, horizontal“, completely impacted in the bone of the jaw and may be impacted in soft tissue. However wisdom teeth aren’t erupted to be extracted, they have the same function as the other molars only in case of their proper position.
Home Remedies for Quick Wisdom Teeth Pain Relief:
Before the dentist decision to extract the wisdom tooth there are some home remedies to relieve pain before its extraction, they can also be used during their eruption.
- Ice pack: using an ice pack on swelled area will relieve pain and decrease the inflammation, you can use it for 15 minutes then take it off until pain reliefs.
- Salt: considered the easiest and the most effective way to relieve the pain, by putting some salt in warm water then rinse your mouth with it will relieve the pain.
- Cloves: it is the oldest way used to relieve the pain, you can use the whole clove or its oil, simply by putting the clove inside your mouth on the affected side without chewing or spitting out just leave until the pain reliefs and in case of using cloves oil you can put it on your finger then run gently on gum and affected tissue.
- Peanuts butter: applying it on affected tissue will relieve the pain.
- Onions: Despite its bitter taste, using onions is an effective way to relieve the pain by putting it on the cheek on the affected side and leaving it inside the mouth with biting on it to extract the juice.
- Guava: Guava leaves one of the most effective ways to get rid of tooth pain by boiling it in water for few minutes then chewing the boiled leaves for 30 seconds without swallowing it. You can also use the boiled water and put salt in it and use it as mouthwash this will give you a good result.
- Olive oil: by heating some olive oil then leaving it to cool down and reach lukewarm temperature then put in on the ear of the affected side, this will relieve the pain, But be careful to use a small amount of olive oil.
- Vanilla: it is uncommon to use vanilla to relieve a toothache but it is an effective way to relieve the pain by taking a cotton ball and put in vanilla essence and but it on related gums then you will notice the difference.
- Whiskey: Whiskey was once the preferred method for getting rid of tooth pain, just take an ounce of whiskey and hold it in your mouth then spitting it out or you can swallow it.
- Peppermint: you can either use peppermint leaves or its extract to relieve toothache. You can use peppermint leaves by packing the leaves and put it on the site for 20 minutes or you can use peppermint extract putting it on a cotton ball and apply it on gum will relieve the pain.
- Tea tree oil: few drops on your finger and rub the related tissue gently will relieve the pain.
- Baking soda paste: mixing a small amount of baking soda paste with regular toothpaste then putting the mix on the site will relieve the pain and reduce the swelling.
- Plantain: it is a good herbal remedy, just take some leaves and crush then put it on the affected tooth.
- Tea bag: it is a common way to relieve the pain by using it on the cheek on the same side of the pain.
- Cheese: it uncommon to use cheese to relief pain, you can put soft cheese on the pain site it will also prevent gum bleeding.
- Ginger root: it is a classic way to relieve the pain, all you need is just a slice of ginger and taking its skin away and put it on the affected site and hold it for minutes, it will relieve the pain immediately.
- Sage, Salt, and Alcohol: using a mixture of sage, salt and alcohol will not only relief the pain but also it will decrease the inflammation and promote healing, you can make the mix by crushing sage into a small bowl then add teaspoon of salt and add some alcohol then mix the component until the clear mix becomes in a green-brown color then take a small amount of the mix and put it in the mouth, it will give you a rapid effect.
- Garlic: garlic gives a brilliant result with tooth pain you can use a crushed garlic clove and add some salt then put the mix on related gums it will give you an immediate effect.
- Chilled potato: it a great method to use in relieving of wisdom teeth pain, put a potato in the freezer for 10 minutes then cut a slice and put it on the pain site it will relieve the pain, numb the nerve.
- Black pepper: using powdered black pepper on the affected site will cause burning sensation at first but it will relieve the pain after that, it can also be mixed with salt to give a better effect.
Wisdom teeth pain during extraction:
The difficulty of extraction depends on the position and condition of wisdom tooth, the normal position of the tooth results in easy and simple extraction while badly destructed tooth may lead to surgical extraction which causes more pain and complication after surgery.
Surgical extraction of impacted tooth will take longer time and cause more complication due to bone removal and trauma occurring during extraction, So Post-operative care is very important to minimize pain and swelling occurring after surgery.
Instructions after wisdom tooth extraction:
- Hold a pack of gauze on the site of extraction until you reach home (approximately 2 hours).
- Remove the gauze gently and try to eat yogurt or anything cool and softly take the first dose of pain medication.
- Avoid vigorous mouth rinsing and touching site of extraction to avoid blood clot removal.
- Use on the cheek on the site of extraction warm pack for first few hours to increase blood flow and healing then use the ice pack to relieve the pain and reduce the swelling.
- Diet after extraction: liquids should be taken but not through the straw as the suction action leads to dislodging of the blood clot and persistent bleeding, High-calorie/high-protein intake is very important, you should prevent dehydration by drinking fluids regularly.
Commitment to instructions mentioned above help in avoiding wisdom teeth pain.
Complications after wisdom tooth extraction:
- Bleeding after extraction: slight bleeding for short time is common and can be controlled putting a pack of gauze on the extraction site with quite pressure to allow the formation of blood clot. If bleeding persists, biting on a moistened tea bag.
- Pain after wisdom extraction: For severe pain, take the pain medication as prescribed (usually every 4-6 hours). For moderate pain, over the counter Ibuprofen can be affected. If the pain persists then you should call the dentist.
- Nausea and vomiting: Nausea after extraction can be caused by the anesthesia, in this case, stop taking anything by mouth for at least an hour including the prescribed medicine.
- Swelling: the swelling after wisdom extraction may be minimized by the immediate use of ice packs. Two baggies filled with ice or ice packs should be applied to the sides of the face where surgery was performed.
- Bruising and Discoloration: This is a normal post-operative occurrence, which may occur 2-3 days post-operatively, occurring due to blood spreading beneath tissue, applying moist heat on this area will lead to discoloration relief.
- Antibiotic: should be taken for 5 days and prescribed by the dentist.
- Dry socket is a condition that occurs when the blood clot dissolves or becomes dislodged prematurely from the extraction socket which leads to increase in pain, swelling at the surgical site. In this case, you should call the dentist
- Infection: Infection following wisdom teeth extraction is rare, but can occur. Signs and symptoms of infection include increased swelling after 3 days of extraction, increased pain, and pus oozing from the extraction site. In this case, you should call the dentist
- Trismus of the jaw muscles may cause difficulty in opening your mouth for a few days.
Pain due to tissue overlying partially erupted wisdom tooth: (Pericoronal Infection)
Pericoronitis is the most common infection occurs in partially erupted and angulated third molar tooth which means inflammation of tissue around wisdom tooth & commonly seen in the lower third molar.
Causes: occurs as result of food and bacterial accumulation in pericoronal tissue due to inaccessibility during brushing.
Signs and symptoms: accumulation of food and bacteria lead to redness, hotness, and swelling of pericoronal tissue, bad taste due to pus expressible beneath related tissue & sometimes may cause bad breath, limited mouth opening and cervical lymphadenopathy “enlargement of cervical lymph nodes”.
Treatment: Dentist should first resolve the acute phase of the infection to be able to do the correct treatment later which include:
1-Irrigation of pericoronal tissue to remove debris mechanically, irrigation solution may be: normal saline, water for injection, chlorohexidine and local anesthetic solution.
2- Removing of the opposing third molar to avoid trauma of inflamed tissue
3- Use of analgesic drugs to relieve pain and depress the inflammation like NSAID drugs unless it is contraindicated.
4- Use of appropriate antibiotic: broad spectrum antibiotic is indicated as bacteria located in pericoronal tissue are a mixture of gram +ve and gram –ve bacteria.
5 – Oral hygiene instructions: brushing, using of warm saline will relief the condition and 0.12% chlorhexidine mouthwash is advisable.
After resolution of the acute phase “Operculectomy” will be done. Operculectomy means surgical removal of overlying soft tissue using the surgical blade or electrocautery under local anesthesia.
If there is a possibility of regrowth of soft tissue during healing causing recurrent pericoronitis then extraction of the third molar will be indicated.