One of the most problematic teeth in humans is the wisdom tooth. It often hurts and causes discomfort to neighboring teeth and, in general, to the chewing process. What should you do if your tooth hurts?
The wisdom tooth is the third molar that appears later than the others, or sometimes it does not erupt at all. A person cannot have more than 4 wisdom teeth. The approximate time of eruption is between 18 and 27 years of age.
Modern experts classify wisdom teeth as rudiments – elements that have lost their role for humans in the course of evolution. The specific location of the third molars causes a number of difficulties in terms of their care.
Wisdom teeth are not loaded like the other teeth. In addition, they almost always have a tendency to erupt painfully. No wonder they are called the most problematic, and most dentists recommend removing wisdom teeth at the first opportunity.
Why Wisdom Teeth Hurt
Wisdom teeth almost always grow crooked. Problems during eruption are dictated by the following anatomical features:
- “Wisdom teeth” appear later than all other teeth. As a rule, the jaw bones are fully formed, the dentition is stable, and the “newcomer” simply does not have enough space;
- Third molars have no milk “predecessors”, and the rudiments of wisdom teeth developed too long and not in very favorable conditions. Because of this, they erupt chaotically, damaging the neighboring tooth or causing inflammation of the gum.
When talking about the causes of pain associated with one or more molars, it is worth distinguishing some concepts. Toothache can occur against the background of abnormal eruption, due to soft tissue deformities, neighboring teeth. Such a clinical picture is inherent only in the wisdom tooth, the other teeth are cut much more unproblematic.
However, the cause of toothache can also lie in fairly classic causes associated with common dental pathologies: caries, periodontal disease or periodontitis. If you systematize all the causes of tooth pain, you get the following list:
- The wisdom tooth is leaning too far into the tissues of the mouth, squeezing and traumatizing them;
- The tooth is rotated around its axis. The larger the angle of rotation, the more strained the dental nerve is, which provokes pain;
- Carious cavities have formed on the surface of the wisdom teeth, if they have reached the dental tissues, the pain will increase;
- Tartar deposits have formed, which rub the gums and cause inflammation;
- Because the rapid growth of the wisdom tooth and the crooked eruption damaged the root system of the neighboring molar, it is this neighboring tooth that hurts;
- If the wisdom tooth has begun to clamp the jaw nerve due to an improper position, there is pain at the bottom of the jaw. In this case, this is the manifestation of neuritis;
- A follicular cyst has formed near the neck of the tooth. It often occurs against the background of permanent damage to the gum tissue and the tooth itself.
It is worth noting the fact that a follicular cyst near wisdom teeth is often accompanied by all kinds of complications. For example, an abscess can occur, which can deform even the jaw in a neglected state. The peridental tissues can also become inflamed, and pericoronitis can develop.
Inflammation of the tissue covering the wisdom tooth
Inflammation of the hood is a common phenomenon. If the wisdom tooth erupts with more than one crown cusp, it may be that the chewing surface of the crown is partially covered by tissue. The part of the gum and mucosa that overhangs the molar is called the hood. It is constantly prone to injury and prone to inflammation.
Under the surface of the hood there are particularly favorable conditions for the accumulation of various biological “debris” and the reproduction of pathogenic bacteria.
If the wisdom tooth is affected by caries, the first symptom that indicates the disease will be pathological hypersensitivity of the teeth. They will react painfully to any irritants – acidic, spicy, salty food, sweets, cold irritants.
Often there are situations where a bent wisdom tooth will traumatize the neighboring tooth, causing tooth decay. The most dangerous situation is when a wisdom tooth tooth damages the root of the neighboring molar tooth. Caries develops just below the gum, and the doctor is not always able to visually identify the carious focus. At the same time, the severely neglected form of “root” caries is difficult to treat, and the tooth is almost never saved.
With acute pulpitis, which has affected the wisdom tooth, patients complain of acute pain that occurs in fits. The disease and its main manifestations are characterized by its spontaneous nature. The discomfort may occur spontaneously, lasting from 15 to 30 minutes. At night, the pain increases.
The chronic form of wisdom tooth pulpitis is less pronounced. An unpleasant nagging sensation occurs when exposed to cold or heat. If you eliminate the irritant, the pain continues for some time.
Periodontitis is characterized by nagging pain that bothers the patient all the time. At the same time, to any irritant the affected tooth will react with a sharp, throbbing, shooting pain. Also marked by slight mobility of the affected tooth, in addition, there is often swelling and soreness of the gum.
Interestingly, in chronic periodontitis, the pain is almost non-anxious. Very minor discomfort may occur only when tapping the tissues of the diseased wisdom tooth.
Any pathology associated with the problematic eruption of one or more wisdom teeth should always be investigated through X-ray diagnosis. In order to determine the position of the tooth in the jaw (inclination, shape, configuration, structure, how it grows), an orthopantomogram is used.
An orthopantomogram is a high-quality panoramic X-ray of all teeth on both jaws. Another method of diagnosis that can help you understand why your wisdom tooth hurts is visiography.
Wisdom tooth extraction for carious lesions or when extremely problematic eruption is observed is practiced by specialists in people of all ages. Pain and inflammation signal a serious problem. If it is not solved in time, complications cannot be avoided.
Basic tooth extraction
What to do in each specific situation, the doctor decides, based on the findings. It can be either a simple removal or a rather complex multistep operation.
Before the procedure, the specialist must make sure that the patient is not allergic to the drugs that will be used during the manipulation. First, the soft tissues around the tooth and nerves are anesthetized. After the anesthesia has taken effect, the tooth is extracted using forceps. The duration of the entire procedure does not exceed 10 minutes.
If the tooth has a ruined crown, large branched roots or if the wisdom tooth has not yet erupted at all, but the entire jaw is involved in the inflammatory process, a complex extraction is performed. During the intervention, the dental surgeon makes one or more incisions, removes the tooth, washes the wound surface, and then sews.
It is also worth mentioning the procedure of excision of the hood. If it is the wisdom tooth that hurts at the time of eruption due to inflammation of the mucous membrane, the doctor carries out the removal of fragments of “extra” tissue. It is possible that the wisdom tooth is not extracted, but the soft tissues are corrected. This is the case if the tooth itself does not hurt and is positioned correctly in the cavity.