What are Third Molars?
A permanent dentition typically consists of 32 teeth and third molars or wisdom teeth are the most posterior teeth present on each quadrant. They are located the farthest in a dental arch and are usually the last ones to erupt. The third molars are formed due to evolutionary factors but with modern lifestyle and eating habits, they are no longer necessary. This is why smaller jaws have inadequate space to accommodate the eruption of third molars and all they do is cause pain, infection and discomfort.
When Do Wisdom Teeth Erupt & Why?
Wisdom teeth usually erupt between the ages of 16 to 25 but they may also erupt at a later stage for some. According to popular belief, wisdom teeth were used by ancestors for grinding plant tissues. Since our ancestors had a huge mouth which accommodated more teeth for digesting cellulose, third molars became a part of the tooth development process. This is why most of the time wisdom teeth either remain submerged under the gum or erupt only partially.
Indications of Extraction
If the jaw is large enough to accommodate the eruption of third molars and if they are aligned correctly, an extraction is not needed. However much of the time, third molars don’t have adequate room to grow. This lack of space can cause the newly erupting teeth to come out crooked and misaligned. If the tooth erupts partially, bacteria can invade the surrounding gum tissues and cause an infection. If this results in stiffness, bad breath, swelling and pain, removal of the wisdom tooth is recommended. Other signs and symptoms that could indicate the need for a tooth extraction are:
- Tumor or cyst
- Persistent pain
- Gum diseases
- Partial eruption
- Bad breath
It is best to consult a dentist or oral surgeon who will evaluate the eruption to determine if an extraction is necessary.
Can a wisdom tooth cause TMJ pain?
When a wisdom tooth erupts, it does cause some pain in the gums and jaw but if this pain gets severe with the passage of time, it may be a symptom of an underlying condition. The most common cause of jaw pain is TMJ (temporomandibular joint syndrome) and it adversely affects the movement of your jaw. The causes of jaw pain include clenching or grinding of teeth, previous fractures or anxiety. But when a wisdom tooth is erupting through the gum surface, the TMJ pain is often mistaken.
Considerations for Patients Suffering from TMJ Pain
TMJ pain does not require the extraction of an erupting wisdom tooth. Wisdom teeth only need an extraction if they are causing repeated pain, inflammation, and nerve damage. Patients with a TMD history must be handled carefully as TMJ pain is orthopedic in nature and wisdom tooth extraction can result in a painful relapse. The trauma to the jaw during the extraction of wisdom tooth can aggravate the problem and have long-term implications. However, if an extraction is recommended while your TMJ treatment is ongoing, the surgeon must exert as little force as possible and use bite blocks to keep the patient’s mouth open during the procedure. Even if your TMJ symptoms may have surfaced at the same time that your third molar erupted, it is important to know that wisdom tooth eruption does not cause TMJ pain. TMD is a musculoskeletal disorder and wisdom tooth eruption is a dental problem and both of them should be treated using tried and true approaches by experienced doctors.
Shen Chao is part of Dr. Joshua Hong’s Smile Clinic. While working at the Smile Clinic, he has witnessed how dental implants can improve people’s smile and boost their self confidence. If you are interested in improving your smile or need a dental procedure contact Shen Chao to learn more by emailing him at firstname.lastname@example.org or get more information at www.joshuahongdds.com .