Dental Education Lecture: Pain Associated with Hidden Wisdom Teeth
Sometimes patients come to my office, complaining pain and swelling in the back of the mouth. Some of them are pretty sure that the wisdom tooth is a trouble maker, but they cannot see the wisdom tooth. Let us use X-ray, two pictures (2 insets) and one illustration to show how the hidden wisdom tooth causes severe discomfort.
X-ray reveals the back of the lower jaw (mandible, M), 2nd and 3rd lower molars. When our jaw does not develop large enough, the wisdom tooth has no space to come out (erupt). A piece of bone (red arrow) blocks the wisdom to come out. On the top of 3rd molar are gums (G). The relationship among 2nd and 3rd molars, mandible (M) and gums (G) is illustrated on the right. There is a narrow opening between the gums (G) and 3rd molar, allowing food debris and germs to enter (curved arrow) and causing infection, pain and swelling (red gums).
On the lower left corner of X-ray, there are two insets. The left one shows the side view of the extracted 3rd molar. If we turn the crown for 90 degree toward us, we look at the biting surface of the crown. There is a lot of stain, i.e., dirty stuff, produced by food debris and germs. If we do not have a chance to remove the painful wisdom tooth immediately, it is the best for us at home to use a fine needle underneath the gums (G) as shown in the Illustration to flush and clean. We need warm salted water or a special mouth rinse. The maneuver can get rid of the dirty stuff and alleviate swelling and pain quickly. The doctor may also prescribe an antibiotic and pain killer.
Next lecture will further discuss how you feel when you have wisdom tooth infection and why we should take out the painful tooth immediately.
Xin Wei, DDS, PhD, MS 1st edition 01/17/2009, last revision 05/30/2010