YOUR WISDOM TEETH

Long after our primary (baby) teeth have been replaced by perManent teeth, we get third molars -   Third molars are called "wisdom" teeth because they generally erupt between 17 and 21 years of age, when we reach adulthood.

Why Do Wisdom Teeth Cause Problems?

Wisdom teeth that are healthy and properly positioned can be a valuable asset to the mouth.  Unfortunately,  this is not often the case, and problems develop that require their removal.  For example, when the jaw is not large enough to accommodate these teeth, they can become impacted - unable to come in or move into their proper place.  They may grow sideways, emerge only part way from the gum, or remain trapped beneath the gum and bone.

Impaction occurs most often in the third molars of the lower jaw.  After examining your mouth and taking X-rays, your dentist will discuss whether your wisdom teeth should be removed.

Why Are Wisdom Teeth Removed?

Extraction of third molars can protect the overall health of the mouth.  It is generally recommended when the following conditions occur:

•  Wisdom teeth only partially erupt.  This leaves an opening for bacteria to enter around the tooth and  cause an infection.  Pain, swelling, jaw stiffness and general illness can result.
•  Impacted wisdom teeth may continue growing without enough room, damaging adjacent teeth.
•  A fluid-filled sac (cyst) or tumor forms, destroying surrounding structures such as bone or tooth roots.

Why Remove the Teeth Early?

People between the ages of 16 and 19 should have their wisdom teeth evaluated.  If they need to be removed, it should be considered before age 20 when generally fewer complications occur.  At a younger age, tooth roots are not fully developed, the surrounding bone is softer, and there is less chance of damaging nearby nerves or other structures.  There is also less surgical risk and healing is generally faster.
   Extractions of wisdom teeth may be performed by a general dentist.  If your dentist anticipates any special care will be needed he, or she, may refer you to an oral and maxillofacial surgeon.

Why Remove Wisdom Teeth? Wisdom teeth that are not painful seem harmless enough. But if they are not removed early, they often cause problems such as:

1. INFECTION (PERIOCORONTIS): The mouth is full of bacteria that normally do not get past the protective layer of gums. But when an impacted tooth breaks through the gum surface, bacteria can get in causing an infection in the gums around the crown of the tooth. This infection can cause severe pain, swelling, jaw stiffness, and even general illness.
2. DESTRUCTION OF THE NEXT TOOTH: An impacted tooth may still try to grow where it has no room, eroding the tooth next to it. This is called RESORBTION. Eventually, this could lead to the loss of both teeth.
3. PAIN: Infection in a decayed wisdom tooth or in the gum around an impacted tooth can cause pain. If a decayed wisdom tooth is not situated in a healthy position, or if it is not restorable, we may recommend its removal. An impacted tooth can also cause pain if it presses against a nerve or the next tooth.
4. CROWDING: An impacted tooth can crowd nearby molars out of alignment. If you are undergoing orthodontic care, we may recommend that your impacted wisdom teeth be removed.
5. CYSTS: When a tooth is impacted, the sac of tissue around the crown remains in the bone. Occasionally, the sac fills with fluid forming a cyst that can readily destroy or enlarge the bone and endanger surrounding structures.

What to Expect of the Procedure

Before surgery, your dentist will explain what to expect, have you sign a consent form and give you personalized instructions to follow.  Keep in mind these general items to help your surgery go smoothly.

Wear  comfortable clothing and arrange to have someone be with you after surgery.  Extractions can be performed under local anesthesia .  Following surgery, you may experience some swelling and mild discomfort, which is part of the normal healing process.  Cold compresses can help decrease the swelling and medication prescribed by your dentist can help decrease the pain.  You may be instructed to drink only clear liquids following surgery and later progress to soft foods.

Some patients experience numbness or tingling following surgery.  Normal sensation usually returns in a period of time.

  Occasionally, a dry socket occurs when the blood clot breaks down earlier than normal.  A dressing placed in the socket protects it until the socket heals.

Talk with your dentist about any questions that you have.  It is especially important to let your dentist know, before surgery, of any illness that you have and medications that you are taking.  If your general dentist has referred you to a specialist, they will both work together to provide you with  efficient care.