Wisdom Teeth

Third molars, commonly referred to as wisdom teeth, are usually the last four teeth to erupt (surface) in the mouth, generally between the ages of 17 to 25.

A tooth that fails to emerge or fully break through the gum tissue is an impacted tooth. This is a common problem associated with third molars or wisdom teeth, as they are the last teeth to develop and erupt into the mouth. 

Wisdom Teeth

In most cases, inadequate space in the mouth does not allow the wisdom teeth to erupt properly and become fully functional. When this happens, the tooth can become impacted (stuck) in an undesirable or potentially harmful position.

  • The usual symptoms associated with impacted teeth are pain, swelling, and signs of infection in the surrounding tissues.

  • An impacted tooth has the potential to cause permanent damage to adjacent teeth, gum tissue, and bone structure.

  • Impacted teeth are also associated with the development of cysts and tumours that can destroy large portions of the jaw.

  • When they are partially erupted, maintaining good hygiene and keeping the gum tissue healthy becomes difficult and that becomes a recurring problem which only can be resolved by removing the impacted teeth.

 

Do all wisdom teeth have to be removed?

Not all wisdom teeth have to be removed. When they erupt properly, and are kept healthy, wisdom teeth do not have to be removed. Unfortunately, this does not generally happen.

Extractions can be necessary for a variety of reasons. Teeth may be non-restorable, painful, or abscessed. Sometimes extractions are recommended by Pediatric Dentists and Orthodontists to facilitate favourable eruption and alignment of other teeth. Other times extractions are necessary as part of comprehensive dental reconstructions.

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 like:

Damage to nearby teeth:

Second molars (the teeth directly in front of the wisdom teeth) can be adversely affected by impacted wisdom teeth, resulting in tooth decay (cavities), periodontal disease (gum disease) and possible bone and other teeth loss.

Disease:

Although uncommon, cysts and tumours can occur in the areas surrounding impacted wisdom teeth

Wisdom TeethInfection:

The opening around the tooth allows bacteria and food to become trapped under the gum tissue, resulting in an infection and tooth decay and will eventually cause an infection. The infection can cause considerable pain and danger. 


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).

The most serious problem occurs when tumours or cysts form around the impacted wisdom tooth, resulting in the destruction of the jawbone and the healthy teeth. Removal of the offending impacted tooth or teeth usually resolves these problems. Timely removal is recommended to avoid such future problems and to decrease the surgical risk involved with the procedure.

Do I need to have my wisdom teeth removed?

Your dentist can evaluate the position of the wisdom teeth with an oral examination and X-rays and can determine if there may be present or future problems. Studies have shown that early evaluation and treatment result in a superior outcome for the patient.

Your dentist may decide to remove your wisdom teeth themselves, but more often you would be referred to an Oral and Maxillofacial Surgeon. Typically dental extractions referred to an Oral and Maxillofacial surgeon involve higher levels of difficulty, health and safety concerns, or desirable anaesthesia choices that are not available at the referring dentist’s surgery.

Wisdom teeth examination

As with any dental procedure, your dentist will want to initially conduct a thorough examination of the wisdom and surrounding teeth. Panoramic or digital x-rays will be taken in order for your dentist to evaluate the position of the wisdom teeth and determine if a current problem exists, or the likelihood of any potential future problems.

What does the removal of wisdom teeth involve?

The removal of wisdom teeth is performed under local anaesthesia (injections and being aware in the dental chair), or general anaesthesia (being asleep-in hospital).

Either option is completely painless.

These options, as well as the surgical risks (i.e., the possibility of sensory nerve damage, sinus complications), will be discussed with you before the procedure is performed. Once the teeth are removed, the gum is sutured. 

Wisdom Teeth

Upon discharge, your postoperative kit will include postoperative instructions, a prescription for pain medication (if necessary), antibiotics, and a follow-up appointment. 

Postoperatively, you will need some days off work or other activities, and these circumstances will be discussed with you at the time of your appointment. 

 

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