I was asked by a patient the other day – 'why is a wisdom tooth called a wisdom tooth'? I responded with what I thought sounded like a very intellectual answer 'Wisdom teeth are so named because of the time they appear, generally in the late teens or early twenties, when people are supposed to be gaining some bit of wisdom in life.' Good answer, I thought. She then proceeded to ask me 'So if I have no wisdom teeth, are you insinuating I have no wisdom?' So what I learnt from that experience was, before I answer the same question in future, I must check whether or not the person in question has had their wisdom teeth or not.

So here I have prepared some FAQ about wisdom teeth.

If you would like to know more or have a wisdom tooth that is causing you pain conact us and get help from our london dentists

What is the wisdom tooth?

Your wisdom teeth are your third molars. Everyone has a natural complement of 32 adult teeth in their lifetime. Some people have more than 32 teeth, some have less. The third molar will be the last adult tooth to erupt and it normally surfaces around 18-21 years of age.

What is an impacted wisdom tooth?

An impacted wisdom tooth is one which has grown in a wrong or unnatural position. An impacted wisdom tooth may require wisdom tooth surgery to remove it. Your dentist will take x-rays to determine the degree of impaction before removal.

Why does the wisdom tooth give problems?

Due to its late eruption and the lack of space that the jaw may have to accommodate it, the wisdom tooth may not be able to erupt properly or may even remain buried. An impacted wisdom tooth can cause food to be easily trapped and cause gum inflammation and swelling leading to pain and infection.

Do I have to remove an impacted wisdom tooth is?

Removal of the wisdom tooth depends on a case to case basis. If the wisdom tooth has come through properly and you are experiencing no problems from it, then it is best to leave it as it is. If however there is difficulty in keeping it clean and there is a high chance that it might give problems in the future then it may be an option to consider removal.

Our london dentists normally recommend at least 3 repeat infections before we consider extracting the wisdom teeth.

How is the wisdom tooth removed?

This will depend on the degree of impaction of the wisdom tooth.

• Simple wisdom tooth extraction: this is for wisdom teeth which have erupted fully and there is no need for surgery. The procedure is normally done under local anaesthesia.
• Wisdom tooth surgery: this is for impacted wisdom teeth or a difficult wisdom tooth extraction where surgery needs to be performed in order to remove the wisdom tooth.

This can be done under

• Local anaesthesia: the surgeon will administer local anaesthetic and proceed with the surgery once the surgical site is numb
• General anaesthesia: a general anaesthetic drug is administered by a trained anaesthesiologist before the surgical procedure is initiated
• Sedation: a sedative drug is used to help you relax, you are fully awake during the procedure, but will have no recollection of the treatment being carried out.

What are the risks and complications of wisdom tooth surgery?

Wisdom tooth surgery as with all other surgical procedures does not come without its own set of risks and complications.

The most important risks are

• Paraesthesia ( altered sensation )
• Anaesthesia ( total numbness) of the lips,chin and tongue on the damaged side.
• Tooth sensation on the damaged side may also be affected.
• The above are mostly caused by nerve injury, and the chances of this occurring are 1- 5 % and the chances of a nerve injury might go higher depending on the anatomy of the patient involved.

I recently had the pleasure of visiting the Iguazu Falls. Breathtaking is an understatement. Water gushing from above, spraying everyone in close proximity. They seemed to go on and on for miles, falling 2.7km along the Iguazu river. I had seen pictures and read about the falls before I visited them, but the experience was over and beyond what I expected. The Iguazu falls can be seen on the Argentine side, the excursion took a whole day and this also involved a speed boat ride which took us up river, right up to where the water falls over the highest cataract which is 82 meters high, 'Garganta del Diablo' or the 'Devil's throat'. It was an exhilarating experience.

On the next day, I crossed over to Brazil, as the falls sit on the boarder of the two countries. This too was fantastic, the panoramic views were great and I also went on a helicopter ride which allowed views over the falls. On entering the national park in Brazil, I paid for my ticket, and the lady that served me smiled. I noted she had braces – the 'Ugly Betty' metallic type braces which we rarely see anymore in England. From the ticket office, I took a stroll to a kiosk to buy a bottle of water and the young lady who served me said something in Portuguese, I didn't understand her, she smiled trying her best to communicate in English. And guess what – she too had braces, the same metallic type. Maybe they are sisters I thought to myself and brushed it off as a coincidence. I went to board the bus which took us to closer the falls, the bus driver had metal braces, and the bus conductor had metal braces. Our tour guide had metal braces. When I went to sit down for lunch, my waitress – yes, you guessed it, she had metal braces too! I started to feel like I was in a 'metal braces colony'. No word of a lie – at least a third of the Brazilians I interacted with in the few hours I was in Brazil had metal braces.

Metal braces are a rare sight in England and rarely used by London Dentists. We have gone the exact opposite way – when people consider having braces here, it is all about being discreet, you don't want anyone to know you are undergoing orthodontic treatment. Being seen with a mouth full of metal is almost taboo.

This got me thinking – Is it the social stigma? Are we generally more secretive in England? All of the marketing we do towards braces is about 'hidden braces' 'invisible braces' 'clear braces' 'tooth coloured braces'.

Meanwhile on the other side of the world, it is fashionable to have big metal braces – the bigger the better! I wondered to myself, as I watched the self assured Brazilians with their metal braces, smiling with a confidence undeterred by the fact that they were wearing metal braces, whether this trend of going back to basics would ever do a full circle here in England.

I guess programmes like Ugly Betty have made people realise there is no harm in having the big metal braces. Betty's character makes us realise it is all about the confidence and the personality exuded beyond the braces that counts.

But for now, as everyone around me wants to go invisible, I think it best I listen to the needs of my patients. There are now so many options available for 'Invisible' braces, one is spoilt for choice: Invisalign Braces, Lingual Braces, Clear Step Braces, Inman Aligner are all popular choices.

Invisalign is by far the most popular, although the Lingual braces are fast catching up.

It is National Orthodontic Week – 22 February 2011 to 29 February 2011. The London Dentist Covent Garden Dental Spa will be hosting an open day which will give people the chance to come in and discuss their treatment needs with us. There are only a few slots remaining, so if you are interested, please call us so we can see if we can accommodate you on the day.