Wisdom tooth, that hurts!
Wisdom tooth, that hurts!
Feeling a wisdom tooth pain is one of the least pleasant situations one can experience, because it is generally very intense and the associated inflammation can also extend to the nerves of the face that run nearby, causing secondary neuralgia, and lead to earache.
The wisdom tooth pain may also be associated with infections of the mucous membranes of cheek, tongue, throat or gums (periodontitis), even causing actual abscesses. And, in these cases, one can really say: "Wisdom tooth, that hurts!".
Why does the wisdom tooth hurt?
The wisdom teeth, or third molars, are the last to erupt from the surface of the gums, at the terminal end of each hemiarch (though, sometimes, not all four "come out"). This usually happens at the end of adolescence or at the beginning of adulthood, when all the other definitive teeth have been present for a long time and occupy most of the available space.
There is therefore little room for each wisdom tooth to erupt and the result can be a partial eruption from the gums or an imperfect placement (i.e., leaning against the 2nd molar or badly tilting). Both situations facilitate the appearance of inflammation, gum disease, caries (affecting the wisdom tooth itself or the 2nd molar) and, of course, wisdom tooth pain.
Regular and careful oral hygiene can help prevent these problems, but unfortunately in many cases it is not enough because, due to its very backward position, the wisdom tooth is difficult to reach with a toothbrush and floss. Furthermore, when the wisdom tooth remains partially included in the gum, cysts can form in the surrounding tissues, which are also annoying.
It must be said, however, that the wisdom tooth pain mostly starts even before seeing it emerge from the gum, while the large crown makes its way to the surface and breaks it. In this case, the pain is essentially inflammatory and can last 1-2 weeks, only to be resolved without having to go to the dentist when the wisdom tooth has reached its final position.
Wisdom tooth: when to remove it
If there is no pain in the wisdom tooth or any other of the problems mentioned, it is neither necessary nor advisable to proceed with its removal, even if it is partially included or misplaced, because the risk of complications is greater than the possible benefits.
Even in case of wisdom tooth pain due to occasional inflammation, before resorting to dental surgery it is preferable to try to resolve the situation by taking non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen arginine salt (Spididol®), and possibly applying a cold compress on the painful cheek (but only after having the situation evaluated by a dentist). The same approach is also adequate to control wisdom tooth pain as it erupts from the gum.
When, instead, the wisdom tooth causes unbearable and/or recurrent pain and there are additional problems (in particular, infections or cysts), there is nothing else to do but remove it. The operation is a little more difficult than the extraction of other teeth, but generally it does not require more than 20-30 minutes and is performed under local anesthesia. At the end, the dentist applies a couple of stitches to close the small incision needed to facilitate the removal of the wisdom tooth and it is useful to keep a cold compress on the cheek for 1-2 hours.
Tooth wisdom: against postoperative pain
The intermittent application of ice continues to be useful when anesthesia completely ceases to have its effects, both to avoid minor bleeding and to control the pain in the wisdom tooth (now removed).
For a better control of the symptomatology it is possible to take an NSAID by mouth (like ibuprofen), possibly associated with paracetamol, if the pain is very intense and is not relieved sufficiently by the NSAID alone. In both cases, the dentist will give you all the information.
In general, to prevent infections (alveolitis), an antibiotic is also prescribed after the extraction of the wisdom tooth: it should be taken strictly following the times and doses indicated by the dentist, without exceptions of any kind.
Other advisable measures to limit the discomfort in the 2-3 days following the extraction of the wisdom tooth, consist in: eating fresh, semi-solid (or in any case soft) food, slightly salted, not spicy or acid; not chewing on the side of the wound; avoiding smoking (which increases the risk of infection) and alcohol; not using the toothbrush near the wound and only rinsing with an antiseptic mouthwash.
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