wisdom teeth

Wisdom teeth, also known as third molars, are usually the last teeth to develop. They are upper and lower teeth whose function is to grind food as part of the digestive process. They are located in the very back of your mouth, behind your second molars and near the entrance to your throat. They usually complete development between the ages of 15 and 20.

Why should I have my wisdom teeth removed?

Although most people develop and grow 32 permanent, adult teeth (16 in the upper and 16 in the lower jaw), many do not have enough room in their mouth for all of these teeth to completely erupt. Since the wisdom teeth are the last to develop, they often will not have enough room to adequately erupt into the mouth to become fully functional and cleanable teeth. This lack of room or space can result in a number of harmful effects on your overall dental health. When this occurs they are said to be impacted, indicating their inability to erupt into an alignment that will allow them to be able to function in the chewing process.

What are some risks of leaving wisdom teeth in?

If you do not have enough room in your mouth for your third molars to erupt and they become impacted, several detrimental results can occur:

• Infection - Without enough room for total eruption, the gum tissue around the wisdom tooth can become irritated and infected, resulting in recurrent pain, swelling and problems with chewing and swallowing.
• Damage to adjacent structures - If there is inadequate room to clean around the wisdom tooth, the tooth directly in front, the Second Molar, can be adversely affected resulting in gum disease (bone loss) or cavities (more appropriately known as dental caries or decay).
• Cysts and tumors - Cysts are fluid-filled 'balloons' inside the jawbone which are associated with impacted wisdom teeth and slowly expand destroying adjacent jawbone and occasionally teeth. They can be very difficult to treat if your wisdom teeth are not removed in your teenage years. Although rare, tumors can be associated with the delayed removal of wisdom teeth.

When is the best time to have them removed?

If it is recognized that you do not have enough room in your mouth for your third molars to erupt, it is advisable to have them removed as soon as it is recognized. In some patients it is as early as 13 or 14 whereas in others it may not be until 18 to 20 years of age. You will heal faster, with more predictable final healing, and have fewer complications than an older patient. An x-ray of the jawbone will allow us to evaluate root formation and determine the optimum time for wisdom tooth removal. As you grow older, removal of your wisdom teeth becomes more difficult and prone to complication.

What happens on the day they’re removed?

First of all, you need to decide if you want general anesthesia ("go to sleep"). Most people clearly prefer to be unaware of the experience when they have their wisdom teeth removed. You will be provided with appropriate anesthesia options at your consultation.

We ask that a parent or responsible adult accompanies you to the office on the day of surgery, and that they plan to stay with you the rest of the day. Your procedure will take about an hour and you will probably be in the office for 1 to 2 hours. Our staff will review your post-operative instructions. When you leave the office you will be comfortable, and probably a little drowsy. Most patients prefer to go home and rest with no other physical or scholastic activities planned for a few days.

All outpatient surgery is performed under appropriate anesthesia to maximize your comfort. We have the training, license, and experience to provide various types of anesthesia, and allow patients to select the most appropriate alternative. These services are provided in an environment of optimum safety, utilizing modern monitoring equipment and staff experienced in anesthesia techniques.

What are some difficulties associated with wisdom tooth removal?

Temporary problems you may experience in the postoperative period include stiffness of the jaws or jaw joints, chafing around the corners of your lips, swelling and bruising, oozing from the extraction sites, dry sockets, and inflammation at the site of your IV catheter. The postoperative instruction sheet we will provide should answer many of the questions related to these more common concerns. If not, don’t hesitate to call the office.

As with any surgical procedure there is the possibility that infection can occur postoperatively. This usually requires an office visit. Occasionally, you may experience the numbness in your lip, chin or tongue, involvement of your sinuses, or damage to an adjacent tooth. Dr. Glenn will review these in greater detail during your consultation appointment.

What are dry sockets?

Dry sockets continue to be a common problem people experience following dental surgery. They arise due to premature loss of a blood clot in the empty tooth socket. This seems to occur with greater frequency in people who smoke, those aged 25 and older, and in teeth requiring more substantial surgery. While both jaws can be affected, they usually occur in the lower jaw. They cause a dull, continuous aching on the affected side(s), typically beginning three to five days after the procedure. Patients may first notice the pain starting in the ear radiating down towards the chin. Pain medication may seem less effective than previously. Treatment involves placing a medicated dressing in the "empty" tooth socket, which delivers pain medication directly to the affected area. This dressing may need to be replaced more than once, usually at intervals of several days at a time. It should be noted that the dressing does not aid directly in healing, and is placed only for pain control. If over the counter medication (i.e. ibuprofen) is controlling the pain, the socket will heal without a dressing. An irrigation device may be given to you to help keep food particles from lodging in the extraction site following removal of the dressing.