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Wisdom Teeth

Wisdom teeth, also known as third molars, are the last teeth to erupt in your mouth. This generally occurs between the ages of 17 and 25, a time of life when we are accumulating our “wisdom”.  Anthropologists postulate that the rough diet of early humans resulted in the excessive wear of their teeth. The excessive wear led to drifting of the teeth forward, which ensured that there was enough space available for most wisdom teeth to erupt by adolescence. The modern diet, which is much softer, and the popularity of orthodontic tooth straightening procedures have resulted in a fuller dental arch, which often does not leave enough space for the wisdom teeth to erupt.

What is an Impacted Tooth?

A tooth is considered to be impacted when there is a lack of space in the dental arch and its eruption is prevented by overlying gum, bone, or another tooth.

Complications such as infection, damage to adjacent teeth, and the formation of cysts may arise from impacted teeth.

How serious is an Impacted Tooth?

Impacted teeth can be painful and lead to infection. They can also cause crowding or damage to adjacent teeth.  More serious problems may occur if the sac surrounding the impacted tooth becomes filled with fluid and enlarges to form a cyst. As the cyst grows, it may lead to bone resorption and permanent damage to the adjacent teeth. Rarely, if a cyst is not treated, a tumor may develop from its walls.  As the cyst enlarges, the surgical procedure to remove it becomes more extensive.

Despite the considerable concern regarding impacted third molars, a recent study sponsored by the American Association of Oral and Maxillofacial Surgeons and the Oral and Maxillofacial Surgery Foundation found that erupted third molars may be just as prone to gum disease as those third molars that remain impacted.

Must the Tooth come out if it has not caused Any Problems Yet?

Not all third molars need to be removed.  Third molars that have erupted into occlusion and are functional do not need to be extracted.  However, not all problems related to third molars are painful or visible. Damage can occur without any symptoms.  If third molars are causing damage or have the potential to cause damage, then it is better to remove them sooner rather than later.  As wisdom teeth grow, their roots become longer, the teeth become more difficult to remove and are more likely to lead to postoperative complications. In addition, recovery after removal of impacted wisdom teeth is more difficult as we age.  It is estimated that about 85% of third molars will eventually need to be removed.

When Should I Have My Wisdom Teeth Removed?

Wisdom teeth are easier to remove when a patient is younger.  The roots of the impacted teeth are not completely formed, the surrounding bone is softer, and there is less chance of damaging nearby nerves or other structures. Removal of wisdom teeth at a later age becomes more complicated as the roots complete development and the bone calcifies.

In general, earlier removal of wisdom teeth results in a quicker and less painful recovery process.  The AAOMS/OMSF study strongly supports the extraction of wisdom teeth before the age of 24.  The researchers found that older patients may be at greater risk for disease, including periodontitis, in the tissues surrounding the third molars and adjacent teeth. Periodontal infections, such as those observed in this study, may affect your general health.

What Happens During Surgery?

Prior to surgery, Dr. Clark, Dr. Cole, or Dr. Patel will consult with you regarding what to expect during and after surgery.  This is a good time to ask questions or express your concerns. It is especially important to let the doctors know about any illness you may have or any medications you may be taking.

The relative ease with which a wisdom tooth may be removed depends on several factors, including the position of the tooth and the development of the tooth’s roots.  Most wisdom tooth extractions are performed in our office under local anesthesia, intravenous sedation, or general anesthesia.  We will discuss your anesthetic options at your consultation visit.

What Happens after Surgery?

Following surgery, you may experience some swelling and discomfort, which are part of the normal healing process. We will provide you with medications and written instructions to help reduce the postoperative pain and swelling.

Dr. Clark, Dr. Cole, and Dr. Patel are very experienced in removing wisdom teeth.  They will do everything they can to make your experience as pleasant as possible.