Wisdom Tooth Extractions

Wisdom Tooth Extractions

Third molars are commonly referred to as wisdom teeth, they are usually the last four of 32 teeth to erupt (surface) in the mouth.  Wisdom teeth generally make their appearance between the ages of 17 to 25. They are located at the very back of the mouth (top and bottom). The term “wisdom” stems from the idea that the molars surface at a time typically associated with increased maturity or “wisdom”.

In most cases, inadequate space in the mouth does not allow the wisdom teeth to erupt properly or become fully functional. When this happens, the tooth can become impacted (stuck) in an undesirable or potentially harmful position. If left untreated, impacted wisdom teeth can become infected; damage adjacent teeth and they can also cause the development of cysts or tumors.

There are several types of wisdom tooth impactions.   The classification of impaction is based on the actual depth of the teeth within the jawbone:

Soft Tissue Impaction: The upper portion of the tooth (the crown) has penetrated through the bone, but the gingiva (gum) is covering part or the entire crown of the tooth and the gingiva has not positioned itself properly around the tooth.  Because it is difficult to keep the area clean, food can become trapped below the gum and cause an infection and/or tooth decay, resulting in pain and swelling.

Partial Bony Impaction: The tooth has partially erupted, but a portion of the crown remains submerged below the gum and surrounding jawbone. Again, because it is difficult to keep the area clean, infection will commonly occur.

Complete Bony Impaction: The tooth is completely encased by the jawbone. This type of impaction will require more complex removal techniques.

Reasons to remove wisdom teeth:

While not all wisdom teeth require removal, wisdom teeth extractions are most often performed because of an active problem such as pain, swelling, decay or infection, or as a preventative measure to avoid serious problems in the future. If impaction of one or more wisdom teeth is present, and left untreated, a number of potentially harmful outcomes can occur, including:

  • Infection: Bacteria and food can become trapped under the gum tissue, resulting in an infection. The infection can cause considerable pain and swelling.  
  • Damage to nearby teeth: Second molars (the teeth directly in front of the wisdom teeth) can be adversely affected by impacted wisdom teeth.  Tooth decay, periodontal disease and possibly tooth resorption of the second molar can occur. 
  • Disease: Although uncommon, cysts and tumors can occur in the areas surrounding impacted wisdom teeth. 
  • Tooth Crowding: It has been theorized that impacted wisdom teeth can put pressure on other teeth and cause them to become misaligned (crowded or twisted). 

Wisdom teeth examination

As with any dental procedure, your dentist will want to initially conduct a thorough examination of the wisdom and surrounding teeth.  A panoramic x-ray will be taken in order for your dentist to evaluate the position of the wisdom teeth and determine if a current problem exists, or if there is the likelihood of any potential future problems.  The x-rays can also expose additional risk factors, such as deterioration or decay of nearby teeth. Early evaluation and treatment (typically in the late-teen years) is recommended in order to identify and correct any current or potential problems. Only after a thorough examination can your dentist provide you with the best options for your particular situation.

What does the removal of wisdom teeth involve?

Wisdom teeth removal is a common procedure and can be performed under local anesthesia, intravenous (IV) sedation, or general anesthesia.  You will be given detailed post-operative instructions and medications (if necessary).  Please contact us if you have any questions or concerns.