The discovery that a wisdom tooth is severely decayed, often described as “rotting,” can be concerning. These teeth, technically known as third molars, are the last to emerge, typically appearing between the ages of 17 and 25. While their late arrival often causes no trouble, their position makes them highly susceptible to deterioration and infection. This article explains why third molars are prone to decay and outlines the necessary steps for intervention.
Why Wisdom Teeth Are Vulnerable to Decay
The primary reason wisdom teeth are susceptible to decay relates directly to their anatomical location at the very back of the jaw. This positioning severely limits the access required for effective brushing and flossing, allowing plaque and food debris to accumulate easily and undisturbed. Even with meticulous oral hygiene efforts, the distal surface of the third molar often remains insufficiently cleaned, setting the stage for bacterial proliferation and enamel erosion.
A significant contributing factor is incomplete or angled emergence, often resulting in impaction. A partially erupted tooth frequently retains a flap of gum tissue, known as an operculum, covering part of the crown. This gum flap creates a sheltered, warm, and dark pocket that acts as a perfect trap for bacteria and food particles. The resulting inflammation and infection in this space is called pericoronitis, which rapidly accelerates the decay process.
The angle of eruption can also pose a direct threat to the adjacent second molar. When a wisdom tooth grows against its neighbor, it creates an abnormal contact point that is impossible to clean effectively. This crowding allows bacteria and acid to erode the enamel of both teeth, leading to decay in the second molar as well. Therefore, the decay process in a third molar is rarely an isolated problem.
Recognizing the Signs of Advanced Decay and Infection
The symptoms associated with advanced decay and infection in a third molar can escalate quickly. One of the most common signs is visible physical changes, such as dark spots, brown discoloration, or a hole in the tooth surface. However, because these teeth are at the back of the mouth, the decay is often only detected by a dentist during an examination or on an X-ray.
A persistent, unpleasant odor or taste frequently signals an active infection. This halitosis is caused by the accumulation of bacteria and the discharge of pus from an infection site, such as a developing abscess or the pocket beneath the gum flap. The pain can range from a dull, chronic ache to sharp, intense throbbing, especially when biting down or applying pressure to the area.
Physical inflammation is another indicator that the decay has progressed. The gum tissue surrounding the affected area may appear red, swollen, and tender to the touch. The infection can cause swelling that extends into the soft tissues of the cheek and jaw. A concerning symptom is trismus, which is muscular stiffness that makes it difficult to open the mouth fully, indicating the infection is spreading to deeper tissues.
Urgent Dental Intervention and Treatment Options
If you suspect advanced decay or infection in a wisdom tooth, seek professional dental consultation immediately. The dentist will perform a thorough visual examination and use dental radiographs (X-rays) to accurately assess the extent of the decay, the tooth’s position, and the condition of the surrounding bone. Diagnostic imaging is important for determining if the infection has reached the pulp chamber or if an abscess has formed at the root tip.
For a wisdom tooth affected by severe decay, restoration options like fillings or root canals are seldom recommended. This is primarily due to the tooth’s non-functional position and high risk of re-infection. The standard treatment for a deeply infected third molar is extraction, which removes the source of the problem. The procedure chosen depends on whether the tooth is fully erupted or impacted beneath the gum line or bone.
A simple extraction is possible if the tooth has fully emerged. If the wisdom tooth is impacted, a surgical extraction is required, which involves making an incision in the gum tissue and sometimes removing a small amount of surrounding bone to access and remove the tooth. If an acute infection is present, the dentist may prescribe a course of antibiotics to control the spread of bacteria and reduce swelling before scheduling the extraction.
Consequences of Leaving Rotting Wisdom Teeth Untreated
Ignoring a severely decayed or infected wisdom tooth carries significant risks. One danger is damage to the adjacent second molar, which can develop decay or bone loss due to chronic pressure and infection. The infection can also erode the surrounding jawbone, weakening the area’s integrity.
As the bacterial infection progresses, it can spread into the deeper fascial spaces of the head and neck, leading to conditions like cellulitis or Ludwig’s angina. Ludwig’s angina is a rapidly progressing infection of the floor of the mouth that can compromise the airway, requiring emergency medical attention. Bacteria from the dental abscess can also enter the bloodstream (bacteremia), potentially leading to systemic issues or sepsis. Timely removal of the infected tooth prevents these complications.