Wisdom Teeth

Wisdom teeth are the last teeth to come in – and the ones least needed for good oral health. The third molars, or wisdom teeth, are called such because they develop when most individuals become adults (which is near 17 years of age).

Because our jaws are smarter than our ancestors, our wisdom teeth may not have enough room to fit in our mouths properly. Therefore, problems may result if these additional teeth attempt to emerge.

Most people have four wisdom teeth, one in each corner of the mouth, and often they are impacted (trapped in the jawbone and gums). Cramped for room, these impacted teeth grow in many different directions and removal may be recommended by your dentist to prevent potential problems.

Wisdom Teeth

Whether wisdom teeth cause your mouth harm depends on several factors, including the size of your jaw and how your wisdom teeth grow in. You may have no symptoms at all, but the other teeth in your mouth could be at risk for damage.

Help make your treatment a success by understanding why your wisdom teeth may need to be removed, what the procedure involves and what you can do to promote a successful recovery.

Potential Problems

If you learn the different ways wisdom teeth can develop and the problems that can arise, you’ll be better able to understand why you may need to have them removed.

Infection in the gum: When a wisdom tooth partially break through the gum’s surface, bacteria can get under the flap, causing an infection in the gum.

Crowning displaces next tooth: An impacted or erupting wisdom tooth can push on adjacent teeth, causing them to become crooked or even damaging them structurally.

Decayed wisdom tooth: Decay forms in a wisdom tooth that is hard to clean due to its position or because it is partially covered by the gum tissue which may collect cavity causing bacteria.

Poorly positioned wisdom tooth: A wisdom tooth that grows toward the cheek can irritate nearby tissue. If an erupted tooth is crooked it may be hard to clean or make it hard to bite down.

Cyst destroys bone: If the sac that holds the crown remains in the bone, it can fill with fluid, forming a cyst that can destroy surrounding bone.

It is best to have wisdom teeth removed around 17 years of age because that is when they usually develop. Removal will be easier as the bone may not be as dense as in older person. Also, recovery will be faster since the roots usually have not yet fully developed.

Procedure for Removal

The procedure for removal begins with an evaluation of your dental and medical histories. You may also receive two types of x-rays; a panographic x-ray which provides an overall view of your mouth and an intraoral x-ray which examines individual teeth. The removal may be done in your dentists’ or oral surgeon’s office or in a hospital. The type and length of the surgery will depend upon how developed your wisdom teeth are.

It is recommended that you do not eat or drink anything for at least 8 hours before the surgery. You may be given a sedative to help you relax or a general anesthetic so you can sleep through the procedure. You will also receive a local anesthetic to numb the area around your wisdom teeth. Once you are fully relaxed or asleep, and your mouth is numb, the surgery will begin. The surgical method used depends on whether your wisdom teeth are erupted or impacted.

Smiling Patient

If your tooth is partially or completely erupted it may be extracted, or lifted out with forceps. Occasionally, if the roots are deeply embedded in the jawbone, the tooth may have to split or bone removed.

If your tooth is impacted, an incision is made in the gum to reach your wisdom tooth. The incision creates a flap which is peeled back, exposing the jawbone. If the tooth is lodged in the jawbone, bone tissue that is covering the tooth may have to be removed. The tooth may be extracted from its socket in one piece or split for easier removal.

After Surgery

After the surgery is completed, you’ll rest for a while under close observation as you recover from the anesthetic. When the dentist or oral surgeon is satisfied with your progress, you’ll be able to go home. You should probably plan to rest and take it easy for the next few days. Since swelling and pain are likely, you will probably be given a prescription for pain medication as well as instructions for your home recovery.

The healing process begins immediately after surgery. The body sends blood to nourish the tooth socket. To control excessive bleeding, you may be instructed to bite down on a piece of gauze, applying constant, direct pressure to the area. This helps a blood clot to form in the socket. In a day or two after surgery, soft tissue begins to fill in the opening. New bone tissue also begins to grow in the socket, becoming denser over the next two to three months.

It is recommended to drink clear liquids at first and a cold compress will also help with the soreness. You should not brush or floss the area near the surgery, but continue to brush the rest of your teeth very carefully.

A follow-up visit may also be scheduled to verify that the socket is healing properly and that your mouth is returning to a normal healthy state. If you have any questions or concerns while you’re recovering from your surgery, call your dentist or oral surgeon.