WISDOM tooth eruption process is likened to a person who enters an already congested elevator (the jaw with teeth), when they try to fit in, they step on people’s feet (nerves) as they shove themselves against others and the door keeps closing on their arm, causing pressure and discomfort.
To clear the elevator, the process takes longer than ever as people lack the strength to walk out the elevator immediately, hence they start pushing slowly so as to avoid causing other people to fall.
They shift slightly and in that moment, they get stuck again, so they wait, to gather some more energy and try again leading to another painful episode.
Third molar or wisdom tooth eruption is one of the most painful natural processes in the mouth.
It makes it hard for you to eat, speak and interestingly, the pain is very excruciating during the night.
This tooth can steal your sleep for months or years.
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The pain is unbearable, it makes people helpless and unable to have peace that all they wish for is just to pluck it out. Why is this process so painful?
People often think that since it is just a tooth pushing through the gums, why is it taking long and being so hard to complete.
There are a lot of factors involved during this process:
Lack of space (crowding)
This is one of the most common reasons affecting wisdom tooth eruption.
Over the years, the human jaw has evolved to be smaller than our ancestors due to different reasons, for example, now families eat more processed foods than whole grains as compared to our ancestors. We have abandoned our old ways.
The modern lifestyle came with a lot of challenges and one of them include the shortening of our jaws, which have been proved by fossil records as archaeologists observed the differences in the sizes of skulls generation after generation.
Although the jaws became smaller, the number of teeth did not change as well as the size, hence as the wisdom tooth erupts between the ages of 17 and 25, it tries to force itself on a jaw that already cannot accommodate more teeth, which becomes challenging.
Impaction
Without space, the normal eruption process is disturbed, hence the tooth gets stuck or impacted.
The tooth can be trapped partially, meaning that it is under the gums covered by a flap of gum tissue called operculum, and it is partially visible.
It can also be trapped fully, meaning that it is within the jawbone, thus during eruption, the tooth is fighting its way out of the bone, which results in a significant dull pain.
Pericoronitis
This is the inflammation and infection of the soft tissues around the partially erupted tooth. It can be classified into acute and chronic.
The acute type is a single event of relatively short duration, usually three to four days, which is associated with normal eruption.
This condition can be improved by personalised dental cleaning, flossing, the use of chlorhexidine containing mouthwash.
For the reduction of pain, ibuprofen and other painkillers may be prescribed, analgesic tablets should be swallowed and not placed adjacent to the inflamed gum.
If the pain is persistent for more than three or four days or intensifies, please consult the dentist.
Chronic pericoronitis, however, presents with relatively mild episodes of recurrent infection and pain associated with the erupting tooth.
The preferred treatment is usually early extraction to avoid further complications like abscess formation in the adjacent tooth.
Pressure on the nerves
During eruption, the roots of wisdom teeth can be positioned close to or press against the major nerves of the jaw.
This will result in the pain radiating from the jaw to the ear and sometimes the neck.
Angled eruption
Due to lack of space, wisdom teeth rarely come in straight.
They are usually titled towards the adjacent tooth, which is the second molar.
This pressure is a major source of pain and can damage the roots of the adjacent healthy tooth.
Why it can take years with on-and-off pain
The process isn’t always a steady, continuous push. It happens in stages, which explains the long, intermittent pain.
- Intermittent growth: The tooth does not erupt all at once. It goes through periods of activity (where it tries to move) followed by long periods of dormancy.
During the active phases, you feel pain and pressure. When it's dormant, you might feel nothing for months or even years.
- The tooth may erupt just enough to penetrate the gum line, resulting in initial discomfort. This phenomenon is known as the “Two Steps Forward, One Step Back” effect.
Then it comes to an end. It may cause the gums to partially recover over it once more. It may later attempt to migrate once more, reopening the wound and resulting in a new round of discomfort and possible infection (pericoronitis). This cycle may recur repeatedly.
- The body’s limited “eruptive force”: A tooth erupts due to a comparatively limited natural force.
This force is frequently insufficient if the tooth is impacted against bone or another tooth. Attempting to push a boulder uphill is analogous.
The tooth exerts steady, mild pressure, which can sometimes accumulate to the point of excruciating agony before halting once more.
- An episode of pericoronitis, an infection, can occasionally induce swelling, which is followed by a reduction in gum tissue.
A little more room may be created by this cycle of swelling and healing, enabling the tooth to move somewhat before the process stalls once more.
It is imperative that you consult an oral surgeon or dentist if you are in pain from your wisdom teeth. They will take an X-ray, usually an OPG (panoramic X-ray), to evaluate:
- The teeth’s location and angle.
- The amount of available space.
- Whether there is affection of the nerves or other teeth.
Based on this information, dentists will determine the best course of action, which is frequently extraction, particularly if the teeth are impacted or creating ongoing issues.
The cycle of the pain may usually be broken by removing them.