Wisdom teeth are the third and final set of molars that most people get in their late teens or early twenties. Sometimes these teeth can be a valuable asset to the mouth when healthy and properly aligned, but more often, they require removal. Wisdom teeth present potential problems when they are misaligned - they can position themselves horizontally, be angled toward or away from the second molars or be angled inward or outward. In addition, they can be entrapped completely within the soft tissue and/or the jawbone or only partially break through or erupt through the gum. Teeth that remain partially or completely entrapped within the soft tissue and/or the jawbone are termed "impacted."
The removal, or extraction, of wisdom teeth is generally recommended when:
- The jaw isn't large enough to allow all the wisdom teeth to fully erupt in an alignment that is useful for chewing and crushing food;
- Wisdom teeth only partially erupt. This allows an opening for bacteria to enter around the tooth and cause an infection, which results in pain, swelling, jaw stiffness, and general illness. Partially erupted teeth are also more prone to tooth decay and gum disease because their hard-to-reach location and awkward positioning makes brushing and flossing difficult.
- Poor alignment of wisdom teeth crowds or damages adjacent teeth, the jawbone, or nerves. Wisdom teeth that lean toward the second molars make those teeth more vulnerable to decay by entrapping plaque and debris.
- Cysts (fluid-filled sacs) form or to minimize their potential for forming. Cysts destroy surrounding teeth, jawbone, and nerves. If untreated, a tumor could develop from the walls of the cysts, requiring a more complicated surgical procedure for removal.
How Do I Know if I Have Wisdom Teeth?
Ask your dentist about the positioning of your wisdom teeth. He or she may take an X-ray periodically to evaluate for the presence and alignment of your wisdom teeth. Your dentist may also decide to send you to an oral surgeon for further evaluation.
Your dentist or oral surgeon may recommend that your wisdom teeth be extracted even before problems develop. This is done to avoid a more painful or more complicated extraction that might have to be done a few years later. Removal is easier in young people, when the wisdom teeth roots are not yet fully developed and the bone is less dense. In older people, recovery and healing time tend to be longer.
How is a Wisdom Tooth Removed?
The relative ease at which your dentist or oral surgeon can extract your wisdom teeth depends on the position of the impacted teeth. Your oral health care provider will be able to give you an idea of what to expect during your pre-extraction examination. A wisdom tooth that is fully erupted through the gum can be extracted as easily as any other tooth. However, a wisdom tooth that is underneath the gums and embedded in the jawbone, requires an incision into the gums and then removal of the portion of bone that lies over the tooth. Oftentimes for a tooth in this situation, the tooth will be extracted in small sections rather than removed in one piece to minimize the amount of bone that needs to be removed to get the tooth out.
What Medications Might be Needed During Extraction?
Before your wisdom tooth is extracted, the tooth and the surrounding tissue will be numbed with a local anesthetic - the same injection with the same medication you receive to numb a tooth prior to having a cavity filled. In addition to the local anesthetic to numb the pain, you and your dentist or oral surgeon may decide that a sedative - in addition to the local anesthetic - is desired to control your anxiety. Sedating medications that could be selected include: nitrous oxide (otherwise known as "laughing gas"), an oral sedative (for example, Valium), or an intravenous sedative (administered via an injection into your veins). If nitrous oxide is given, you will be able to drive yourself home. If any of the other medications is selected, you will need someone to drive you both to and from the appointment in which your tooth will be extracted.
Although many procedures on your wisdom teeth can be performed by our dentists at our state of the art dental office, there are cases when we may refer you to an oral surgeon.Go Back