Wisdom teeth are our third set of molars, furthest in the back of our mouths. If they erupt, they do so later in life; typically between the ages of 17 and 21. This period often marks a transition from childhood to adulthood, or when a person has reached maturity. With maturity comes wisdom, hence why these teeth have been nicknamed ‘wisdom’ teeth.
There are multiple reasons it may be suggested to have wisdom teeth removed. Most commonly, it is because insufficient spaces exists in your mouth. If there is not enough room for the tooth to come through in your mouth, it can cause inflammation and swelling of your gums. This can be painful to close or chew. Furthermore, if the tooth is coming through at an odd angle because of the lack of space, pressure is exerted on the tooth in front, which can cause damage, such as resorption. If only a portion of the wisdom tooth breaks through, this can be a potentially risky situation as well. The opening in the gum tissue allows food, saliva and bacteria access down to the wisdom tooth, but you don’t have any access to keep it clean. If you’re not able to clean it, you could have cysts, infections, or decay start to form.
The word impacted means deeply entrenched or wedged in, not easily dislodged. As we previously discussed, often wisdom teeth don’t have sufficient room to erupt into your mouth. They are prevented from doing so either due to lack of room in the bone – referred to as a bony impaction. Or due to lack of room in the gum tissue – called soft tissue impaction. Many times, the impaction can be a combination of those two. Basically the wisdom tooth gets stuck where it is because it’s blocked from traveling any further.
If you suspect that you may need your wisdom teeth out, scheduling an assessment would be a good idea. Likewise, if during a routine exam, the dentist notices that there may be some space limitations in regards to your wisdom teeth, an assessment will be done. A panoramic x-ray that rotates around your head and images all the pathology and anatomy of your mouth will be taken. Since this shows your entire jaw bone, the dentist can clearly see if there will be enough room for your tooth to come in and be functional or whether it will be best to have it removed.
Sometimes a wisdom tooth can be removed at our office. However most often wisdom teeth are removed by oral surgeons. Wisdom teeth have multiple roots, are very far in the back, sometimes their roots can be close to nerves or sinuses, etc. For all these reasons and more, once your situation has been assessed, if needed, we will refer you to an oral surgeon for the extractions to be done. They will discuss any potential risks and go over various levels of sedation that can be done; from wide awake but completely numb, to put to sleep. Then they will remove the tooth/teeth. Typically this requires them to section the tooth into several smaller pieces to get it out. Next, they will pack the extraction site and place sutures if needed. Lastly they will cover the post-operative patient instructions. It is normal to experience some minor bleeding, isolated swelling and generalized tenderness in the extraction site. You may be given antibiotics or pain medications, as well as instructions on diet, and keeping the area clean. All of these will help prevent complications and promote good healing of the socket.