Akal Daad (Wisdom Tooth): Dard, Ilaj aur Kab Nikalna Zaroori Hai

Akal daad kya hai aur kab aati hai? (What and when)

Akal daad are the third molars, the last teeth at the very back of the mouth, one in each corner. They usually come in between the ages of 17 and 25, though some appear later and some people never get all four. Because they arrive last, there is often not enough room in the jaw for them to come through straight.

Akal daad me dard kyon hota hai? (Why it hurts)

Wisdom tooth pain is most often caused by pericoronitis, an infection of the gum flap over a partly erupted tooth, where food gets trapped and a brush cannot reach. Other causes are decay in the wisdom tooth or in the molar in front of it, a tooth pushing sideways against its neighbour, or, rarely, a cyst around a buried tooth.

• Swollen, sore gum at the very back, worse when you bite: gum infection over the tooth.
• Pain spreading to the ear, throat or jaw, or difficulty opening the mouth: infection spreading into the muscles.
• Sensitivity or a hole in the molar in front: decay caused by food trapped against it.

Akal daad dard me ghar par kya karein? (What to do at home)

For wisdom tooth pain at home, rinse with warm salt water after every meal to clear trapped food, clean gently behind the last tooth with a soft brush, and take an ordinary over-the-counter painkiller exactly as directed. These settle a mild flare-up. Swelling, fever or difficulty opening the mouth need a dentist the same day.

Kya akal daad nikalna zaroori hai? (Does it have to come out?)

Removing a wisdom tooth is not always necessary. The UK's National Institute for Health and Care Excellence advises against removing healthy, symptom-free wisdom teeth as a precaution. Removal is recommended when the tooth causes repeated infection, decay, damage to the molar in front, gum disease or a cyst. An X-ray shows which applies.

• Can usually stay: fully through, upright, meeting the tooth above, easy to clean.
• Usually better out: repeated gum infections, decay in it or the next molar, a cyst, damage to the next tooth's root.
• Watch with X-rays: buried but causing no problems.

Tedi ya fasi hui akal daad (Impacted wisdom tooth)

An impacted wisdom tooth is one that cannot come through fully because it is tilted, lying sideways or blocked by the tooth in front. Impacted lower wisdom teeth are the most common cause of repeated swelling at the back of the mouth. Removing one is a surgical procedure that is best done by an oral and maxillofacial surgeon.

The lower wisdom teeth sit close to the nerve that gives feeling to the lower lip and chin. Mapping where that nerve runs before surgery, with an OPG and sometimes a 3D scan, is what keeps the risk of numbness low. Temporary numbness happens in a small percentage of cases and usually recovers; permanent numbness is rare.

Akal daad nikalne ki prakriya aur kharcha (The procedure and cost)

Wisdom tooth removal is done under local anaesthetic, so you feel pressure, not pain, and usually takes 30 to 60 minutes. A simple upper wisdom tooth comes out like any extraction; an impacted lower one may be sectioned and removed in pieces. At Pain-Off Dental Care in Jodhpur, the cost is given after the X-ray, before surgery.

Akal daad nikalne ke baad kya khaayein? (Aftercare)

After wisdom tooth removal, eat soft, lukewarm food for the first few days: khichdi, dal, curd, upma, soft idli and mashed potato. Avoid hot, spicy, crunchy and sticky food. Do not smoke, chew gutkha, use a straw or spit forcefully for at least three days, because these dislodge the blood clot and can cause a painful dry socket.

• Bite on the gauze for 30 to 45 minutes after surgery.
• Ice on the outside of the cheek, 15 minutes on and off, for the first day.
• Warm salt-water rinses from the next day, gently, after meals.
• Swelling peaks around 48 hours; most people take one to two days off work or college.
• Call the clinic if pain gets worse on day 3 or 4, bleeding will not stop, or you develop a fever.