It’s not necessary for you to get your wisdom teeth removed if they are correctly positioned in your mouth and do not cause any pain or dental problems. If they are impacted and/or cause crowding in your teeth, a dentist will recommend that you have them removed. There are two ways wisdom teeth may grow. 1. Some will grow in like regular teeth and 2. Some will become impacted.
Impacted wisdom teeth are blocked from growing properly. They typically remain below the surface of your gum line and lie horizontally instead of standing upright like they are supposed to, mostly because there isn’t enough room for them to grow. Sometimes they sprout out sideways and towards another tooth. Keeping an impacted wisdom tooth that slightly sprouts can be difficult to keep because it can be a place for plaque and bacteria to accumulate. This is bad because it would promote the development of cavities and could lead to a much larger infection affecting more than just your teeth.
Impacted wisdom teeth can possibly collide with the roots of your molars and that can be extremely painful. In addition, while your impacted wisdom tooth is trying to erupt, the wisdom tooth itself can wear down the adjacent tooth and lead to several dental issues. If you decide not to remove your wisdom teeth, be sure to floss your teeth on a consistent basis, getting all the way to the back teeth. And be sure to use fluoridated mouth wash.
There is no “correct age” for wisdom tooth removal. Some people get their wisdom teeth at a young age, while some others get them in adulthood. But if you need to remove wisdom teeth, it would be better to take them out younger because the healing process would be a bit quicker. However, if you’re in your 40s with all your wisdom teeth and they cause no oral health complications, taking them out is not necessary. If you’re unsure, you should see a dentist to get a proper wisdom tooth examination and treatment plan.
When wisdom teeth cause problems, or X-rays show they might down the line, they need to come out. Other good reasons to take them out include:
1 – Anatomic VariationsEveryone is different. Some people’s jaw flares out wider than others, making it hard to visualize where that person’s nerve is. Some people have a longer jaw or extra muscle and/or fat around their jaw. In patients that are missing lots of teeth in the back of their mouth, it’s harder to visualize where the nerve is. Also, young patients can have different anatomy depending on their stage of growth, making it hard to get the anesthetic in the right spot.
2 – Technical Errors by the DentistDentists aren’t perfect! Sometimes we can put the needle in the wrong place and give the anesthetic too low, too high, or too far to the side. Also, we might not put the needle in deep enough, or we may accdentally deposit the anesthetic in a blood vessel, which is why your heart can beat fast when getting a dental injection.
3 – Anxious PatientsSome anxious patients may think that they aren’t numb and jerk away in fear when we start to drill. In cases like this, I usually tap around their gums on the numb side and then on the side that isn’t numb to let them feel the difference and realize that they really are numb.
4 – Inflammation or InfectionWhen people have swelling in an area, it can be harder to get them numb. One theory says that the acidic tissue makes it harder for the anesthetic to take effect. Antoher theory says that since the patient has been in pain for so long, they have an increased sensitivity to pain which makes it harder for them to get numb.
5 – Defective Anesthetic SolutionsI haven’t had experience with this one, since my dental school has a pretty good quality control program to ensure that the dental anesthetic stays potent. However, sometimes a dentist may use dental anesthetic that has expired or was improperly stored or manufactured. This made me realize that I should always go with a respected brand name of dental anesthetic and not get the cheaper stuff to save money. There’s no point in cutting corners if it will inconvenience my patients.
6 – Having Red HairPeople with red hair have more difficulty succumbing to the numbing effects of dental anesthetic. They also have a greater fear of the dentist.
This article published in the July 2009 Journal of the American Dental Association states, “People with naturally red hair are resistant to subcutaneous local anesthetics and, therefore, may experience increased anxiety regarding dental care.”
7 – Having Joint HypermobilityThose who suffer from Ehlers-Danlos Syndrome can be insensitive to local anesthetics used in dentistry. You can check out this article for more information on local anesthetic failure in those with joint hypermobility.
ConclusionIf your dentist can’t get you numb, more than likely there is a specific reason. In my experience, I’ve found that there are many people who have slightly different anatomy in their jaws which makes it harder to position the needle so that the anesthetic gets deposited where their nerve is located.
Do you have any questions, questions, comments, or concerns about getting numb at the dentist? If so, feel free to go ahead and leave a comment below. Thanks for reading!
Tissue sensitivity can be a common issue with PFM (porcelain fused to metal) crowns and bridges. Base-metal crowns contain nickel, which can cause an allergic reaction in many people, especially women. Restorations that use non-precious metals can sometimes result in gum tissue that is purplish in appearance, and some patients experience irritation and/or gingival recession. Alternatively, zirconia is a biocompatible material and has been used with great success in other medical applications, for example, hip replacements, for the past 20 years. Similarly, zirconia results in excellent tissue response when used in the mouth - gum tissue appears healthy and is pink in color. Further, the tissue does not pull away from the material, which can occur with traditional PFM restorations.
Dr. James L. Johnson