You may still not want to call your last molar (especially the lower ones) wisdom tooth if you ever have to go through the pains it may sometimes bring.

I haven’t asked those who had experienced it, and subsequently done a surgical extraction of it if they really feel the lower last molar that caused them so much pain could be considered wise or imparted them with some wisdom. Conversely, it will be interesting to know, if by removing one or all of their last molars (wisdom teeth), they had grown less wise.

I wish to talk about the last molars, frequently referred to as WISDOM TEETH and how they’ve continued to constitute a source of discomfort to the harmony of the oral cavity for many.

The wisdom teeth are so far placed behind in people who haven’t lost any teeth to be involved in chewing, in many people it is even too far placed to be effectively and adequately brushed. The implications of this is germaine to the discomfort it may cause hereafter.

Because the last molar is hardly involved in chewing it tends to accommodate food debris, and when these aren’t removed during the brushing exercise, or with the tongue, or following rinsing, microorganisms in the mouth feed on these remnants, releasing products which break down the surface of teeth, breeching it’s integrity to give rise to a hole or cavity in the tooth.

People who fail to visit a dentist soonest to have such cavities filled stand the risk of the cavity deepening till it touches the third layer of the tooth, known as the pulp.

The pulp is a chamber within the tooth housing the nerves and blood supply to the tooth, which if breached either by a cavity or fracture of the tooth could cause so much pain requiring that a Root Canal Treatment/Therapy (involving the cleaning out of the pulp and it’s extensions aka root canals of nerves and blood vessels, effectively ‘killing’ the tooth but leaving it in a mummified state in the mouth, such that it can still be used to chew and do whatever else you’d like to do to and with the tooth, though the tooth may not remain as strong as it used to be, as well as also begin to turn darker in shade, hence requiring a crown) which because of poor access owing to its location isn’t a favourite for most dentist, especially when the other two molars before it are present, leaving the dentist no sensible choice but to have the last molar aka WISDOM TOOTH extracted.

Now, the last molars, especially the lower ones erupt or come up very late, much later than other sets, usually arriving when there’s little or no space to accommodate it. Many see it as an evolutionary trend resulting even in the absence of wisdom teeth with some people as there’s increasingly less of a need for it because of today’s diet which is softer than what our ancestors were used to.

When lower last molars erupt as late as they do in the late teen and adolescent years, most find they are in restricted space making them IMPACTED, or lodged into the little space available in unusual position, making the situation more precarious in that food packs into the space between the second and last molar. This may further be complicated by a cavity on same tooth and/or even the one before it by reason of food packing and inaccessibility while brushing.

You may also find that due to the lack of space situation and consequent impaction of tooth, the gum that should ideally surround tooth, begins to overlie it, seeing that the tooth couldn’t reach the normal height. In some cases these gum tissue become inflamed because the opposing fully erupted upper last molar bites on the gum rather than on the tooth. Also, food packs into the space between the gum and tooth, causing discomfort, unpleasant odour and in the worst of cases restricted mouth opening. Palliative measures include the administration of pain medication and antibiotics. Pain medication is usually of the Non Steroidal Anti-Inflammatory Drugs, NSAID’s like Ibuprofen or Cataflam. Cutting off the overlying gum may also provide some relief, but ultimately the extraction of the Lower last molar will suffice.

Some school of thought support the extraction of all Wisdom Teeth to prevent Future Kasala.

Most Lower Last Molars appear impacted and cannot be extracted normally hence the need to Surgically Extract them. Surgical Extractions aren’t painful, not because they shouldn’t be painful but because the jaw of the affected side is usually ‘numbed’ or adequately locally anaesthetized before the procedure is embarked upon, and afterwards the patient is placed on the necessary analgesic and antibiotic regimen. Some school of thought support pre-surgery medication regimen mainly of antibiotics some hours before the extraction especially when a case of infection is established.

The Surgical Extraction involves, raising a flap of gum to expose the bone in which the tooth is lodged.
This is followed by drilling of the bone, usually of the cheek side to expose the buried tooth, then extracting such teeth after separating it from bone, either in one whole or divided in two major parts, depending on which the dentist finds easier to do.

In most patients, you may find post-extraction swelling of the cheek of the affected side, which is usually a reaction of the tissue to the assault of such an invasive procedure which may peter out within a few days. Also restricted mouth opening isn’t an unusual occurrence, this is also taken care of with jaw exercises (which includes chewing gum for the period).

A major complication, is nerve damage especially when the roots of the tooth lie close to the Inferior Dental Nerve Canal (near the Angle of Mandible/Lower Jaw) and enough care wasn’t taken during the extraction of mostly vertically impacted lower last molars. Sometimes, damaging a nerve may not be avoidable, hence the patient is placed on medication that will help regenerate nerve endings.

Removing a lower last molar will cause the opposing upper molar to Supra-Erupt/grow longer over time, leading to dental disharmony and a large interdental space with the Upper Second molar, which may serve as nidus for food to pack there, leading to discomfort, even pain when a hole or cavity develops in the neck of any of the affected tooth. It’s therefore best to extract these too.

A dentist will assess a tooth that will need to be Surgically Removed, if a tooth needs to go like that, then it must. If your last molar is acting in ways unbecoming of the wisdom it’s thought to possess, you now know exactly what to do.

I hope you find this useful.





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