Wisdom teeth are the upper and lower third molars , located at the very corner / back of the mouth. They are called wisdom teeth because they come in usually when a person is between 17 & 25 years older , old enough to have gained some wisdom. Wisdom teeth that are healthy and properly grown, do not cause problems.

Frequently, there is not enough space for normal eruption for them as by the time that they have to come, other teeth would have occupied the space in the dental arch, which results in their growth in unusual direction like towards the cheek, horizontally towards the neighbouring tooth, towards tongue causing pressure pain. Many a times, they would have grown completely, but being corner most teeth, they are not easily cleansable leading to food collection in them and consequent dental decay / dental infection / dental pain in them.

Wisdom teeth are like accessory 15th or 16th player of a cricket team which are not of any functional help to the mouth. They may not contribute to chewing, biting, swallowing or speaking in an evident manner. It has been documented by scientific research that their removal or non-existence does not cause any loss or deficiency in the functions of mouth. Dr Shah at ivories dental clinic in ahmedabad can explain further with the help of animation videos during consultation.

What happens in some cases is that tartar (solidified food debris) would have accumulated (occupied) for a long time where gums would have gone down and patient's tongue is adapted (used) to it. After cleaning, the tartar is removed and all the areas where tartar (solidified food debris) has been cleaned, the patient would initially feel the spacing or gaps between the teeth. In due course of time ,the gums will now get a chance to come back again to their original position from where they had moved down due to bacterial irritation of tartar.

Here are the signals of the problem :

• Dental Pain in opening the mouth
• Dental Pain in the surrounding gums of wisdom tooth
• Pain in the ear and headache
• Dental Pain on chewing on the affected side of wisdom tooth
• Swelling on the affected side of the wisdom tooth
• Ulcers on the skin around wisdom tooth
• Sensitivity to hot and cold in the wisdom tooth

Whenever there is dental pain due to decay or pressure of wisdom tooth, it needs to be checked with a dental / digital x-ray first. If the mouth opening is wide and decay is treatable with a dental root canal treatment ,then the tooth may be saved. Most of the times, removal by a minor dental surgical procedure is preferable as a permanent solution of the problem of wisdom teeth. Medicines without any sort of dental treatment may partially serve the purpose of treating dental pain but only temporarily.

What if I don�t get it removed?

Removal is the last choice for any patient or a dentist. The mere thought of the procedure is scary for a patient. Nobody likes to go for it at the first place. As wisdom teeth are of no functional value,

there are certain unavoidable situations where removal is completely helpful in preserving other teeth and structures and preventing further damage due to dental infection and undue pressure

Impacted / infected wisdom teeth can cause:

• Dental infection of neighbouring skin-gum tissue
• Dental decay in wisdom tooth with posing threat of spreading to neighbouring teeth
• crowding of front teeth due to pressure on front teeth
• possible spread spread of dental infection upwards to side of the face , ear and surrounding areas.

Wisdom tooth removal in ahmedabad at ivories dental clinic in vastrapur area is carried out usually under local anesthesia by making the tooth and surrounding areas numb. This will reduce the dental pain during the procedure drastically. Medicines given before and after the dental procedure will help too. They have been reviewed by patients as best painless dentist in ahmedabad on justdial.com , burrp.com and various open forum.

Generally, the day that the dental procedure is carried out, one needs to take a half day leave. He/ she may resume work / schedule the next day in most of the cases.

First 24 hours after the dental procedure, soft and cold room temperature ( semi-solid) food / liquids are to be consumed. No spitting / gargling is to be done for first 24 hours. Brushing is to be avoided on that part. Most importantly , ice application with a handkerchief is to be done on the side of the face (from outside) where tooth has been removed. This will reduce the postoperative pain and swelling. Mild swelling / pain for 2-3 days may happen but is taken care of with the medicines. One may resume normal food /other activites from the 3rd day in most of the situations.

There are no side effects of the procedure. It is pretty much safe and preventive in nature.

The cost of wisdom tooth surgery depends on whether its an upper 3rd molar or lower and how complex the wisdom tooth surgery is anticipated from the xray analysis. it is usually higher than the normal tooth removal of other teeth in the mouth. the instruments and medication are specialized for the painless wisdom tooth removal in ahmedabad at ivories dental clinic in vastrapur ahmedabad. hence it may be any where in between Rs. 500 to 3000 depending on the complexity of the case.

Most people find that cleanings are painless, and find the sensations described above - tickling vibrations, the cooling mist of water, and the feeling of pressure during "scraping" - do not cause discomfort. A lot of people even report that they enjoy cleanings and the lovely smooth feel of their teeth afterwards! There may be odd zingy sensations, but many people don't mind as they only last a nanosecond.

WHAT CARE DO I NEED TO TAKE FOR THE INITIAL DAYS AFTER GETTING PROFESSIONAL CLEANING?

In some cases for the initial 24-48 hours, one may have to avoid extreme temperature food and liquids like ice-creams and cold-drinks. Thereafter, one may resume to their day to day food habits.

How many times a day should we brush the teeth?

You must brush your teeth after every meal ideally. Brushing at night is more important than in the morning. When we have food in late evening and we don't brush before going to sleep then the bacteria have a full 8-10 hours to attack the enamel and cause cavities. Brushing before going to bed is a must.

How often must you change the brush?

The brush must be changed as soon as its bristles become distorted in shape. Usually it takes 3-4 months. A toothbrush with frayed bristles has reduced cleaning efficiency and it also acts as a source of germs. Change the brush as soon as its bristles start spreading. Some brushes come with a colour indicator too for the same purpose.

How to prevent toothbrush abrasion

• Toothbrush damage is known in the trade as toothbrush abrasion and is the damage to teeth and gums that results from the use of excessive force in brushing, usually using a hard toothbrush.
• In a way this is the condition of people who care too much. Somehow they get to think that unless they really go at it with gusto they won't do a good job. This is a kind of over-zealous enthusiasm where the excess energy actually becomes destructive. The genuine desire to do the best is pushed over the top to become over-zealousness.

The problem is the way in which a person thinks about what is required in brushing. Plaque is a very soft material, which builds up on the teeth. It is very soft and very easy to remove.

The problem is therefore very simply a wrong notion or idea which leads to an 'aggressive' approach to cleaning, resulting in damage or wear (abrasion) to tooth and gum tissues.

Toothbrush abrasion affects both teeth and gums. Often the earliest sign of the problem is what people describe as a 'little ledge' in the tooth at the very margin of the gum. The person often feels this with a fingernail and sometimes there is an 'electric shock sensation' when the area is touched with the fingernail or a toothbrush bristle. Very often there are no shocking symptoms although sensitivity to cold is a quite common feature.

The damage to the tooth eventually manifests as a v-shaped notch at the gum margin which increases over time both in width and depth.

• We simply need to change the way we think about brushing.
• Instead of thinking -
• This job is difficult to do -
• I need an aggressive approach -
• There is harsh action needed -
• I need a good hard brush -
• Think instead -
• This job is EASY -
• I will be GENTLE with a SOFT brush -
• I will TAKE MY TIME -
• I will be THOROUGH -
• I will NEVER use a HARD brush.
• This change of mind coupled with the change of behaviour and a soft brush is all you need to prevent toothbrush damage.
• The solution could not be easier!!

More Tips

• Many if not most of the rechargeable electric toothbrushes (such as Oral-B) nowadays come with an indicator which lights up or shuts off the toothbrush when you brush too hard.
• Many people also find these easier to use than manual toothbrushes.
• Although their initial purchase price is higher and the replacement brush heads are more expensive, they can save you money in the long run.

Toothbrush and/or toothpaste damage may be the most frequent cause of sensitive teeth. By brushing too hard and/or using abrasive toothpaste, you may be removing tooth structure at the necks of your teeth. This can result in pain, especially to cold drinks, food, and air, but also to physical pressure, hot, sweet and sour. The reason for the pain is lost outer cover leading to exposed dentine - the inner substance of the tooth that link to the nerves on the inside of the tooth, and when dentine is exposed, these nerves are easily stimulated, resulting in pain.

Other things which can cause sensitive teeth include:

• acidity erosion
• gum disease,
• tobacco (paan-masala) chewing
• tooth grinding,, and
• a cracked tooth or filling.

To prevent further damage, brush your teeth gently as described on our toothbrush abrasion page and avoid abrasive toothpaste or use a non-alcohol mouthwash to wet your toothbrush instead.

Desensitizing agents such as Sensodyne rapid relief (there are different options in the market now) work by blocking off the dentinal tubules, so that the nerves don't get stimulated.

They work a lot better by gently massaging the paste or gel into the sore spot with a finger for a minute or so.

You may to try a non-alcohol mouthwash with a high fluoride content for further relief . Some of them are specifically designed to reduce sensitivity. They should be used twice a day after brushing - one of those times should be just before you go to bed, so the mouthwash does not get rinsed away when you drink or eat something.

Swish / swirl the mouthwash back and forth between the teeth for at least 60 seconds, and do not rinse with water or eat afterwards for 30 minutes.

Some people also find that GC Tooth Mousse cream helps.

• Depending on the cause of the sensitivity, Dr Alaap Shah may be able to paint special fluoride gels, rinses or varnishes onto the affected teeth ,advise desensitizing toothpastes, treat the cause of sensitivity like decay or V - shaped notch in the tooth by fillings, and so on and so forth.
• If you have a habit of grinding your teeth, especially at night during sleep, ask Dr Alaap Shah about the possibility of having a rubber plate (mouthguard) made to wear at night.