Wisdom Teeth
Wisdom Teeth
Wisdom teeth, also known as third molars, are the last teeth to erupt in your mouth. This generally occurs between the ages of 17 and 25, a time of life that has been called the "Age of Wisdom."
Anthropologists note that the rough diet of early humans resulted in the excessive wear of their teeth. Normal drifting of the teeth to compensate for this wear ensured that space was available for most wisdom teeth to erupt by adolescence. The modern diet, which is much softer, and the popularity of orthodontic tooth straightening procedures produce a fuller dental arch, which quite commonly doesn't leave room for the wisdom teeth to erupt, thereby setting the stage for problems when the final four molars enter the mouth.
What is an Impacted Tooth?
A tooth becomes impacted when there is a lack of space in the dental arch and its growth and eruption are prevented by overlying gum, bone or another tooth.
How Serious is an Impacted Tooth?
Impacted teeth can be painful and lead to infection. They may also crowd or damage adjacent teeth or roots. Wisdom teeth present potential problems when they are misaligned - they can position themselves horizontally, be angled toward or away from the second molars or be angled inward or outward. Poor alignment of wisdom teeth can crowd or damage adjacent teeth, the jawbone, or nerves. Wisdom teeth that lean toward the second molars make those teeth more vulnerable to decay by entrapping plaque and debris. In addition, wisdom teeth can be entrapped completely within the soft tissue and/or the jawbone or only partially break through or erupt through the gum.
Teeth that remain partially or completely entrapped within the soft tissue and /or the jawbone are termed "impacted." Wisdom teeth that only partially erupt allows for an opening for bacteria to enter around the tooth and cause an infection, which results in pain, swelling, jaw stiffness, and general illness. Partially erupted teeth are also more prone to tooth decay and gum disease because their hard-to-reach location and awkward positioning makes brushing and flossing difficult.
More serious problems may occur if the sac surrounding the impacted tooth becomes filled with fluid and enlarges to form a cyst. As the cyst grows it may hollow out the jaw and permanently damage adjacent teeth, the surrounding bone and nerves. Rarely, if a cyst is not treated, a tumor may develop from its walls and a more serious surgical procedure may be required to remove it.
Must the Tooth Come Out if it Hasn't Caused Any Problems Yet?
Not all problems related to third molars are painful or visible. Damage can occur without your being aware of it. Despite the considerable concern regarding impacted third molars, a recent study finds that third molars which have broken through the tissue and erupted into the mouth in a normal, upright position may be as prone to disease as those third molars that remain impacted. Many people don't have the ability to keep the areas clean and free of plaque and Calculus. The act of placing the brush on the tooth is too difficult, due to lack of space.
As wisdom teeth grow, their roots become longer and the teeth become more difficult to remove. In addition, impacted wisdom teeth are more likely to cause problems as patients age. No one can predict when third molar complications will occur, but when they do, the circumstances can be much more painful and the teeth more difficult to treat. It is estimated that about 85% of third molars will eventually need to be removed.
When Should I Have My Wisdom Teeth Removed?
It isn't wise to wait until your wisdom teeth start to bother you. Dr. Denny may recommend that your wisdom teeth be extracted even before problems develop. This is done to avoid a more painful or more complicated extraction that might have to be done a few years later. Removal is easier in young people, when the wisdom teeth roots are not yet fully developed and the bone is less dense. In general, earlier removal of wisdom teeth results in a less complicated healing process. Removal of the teeth is usually optimal when the tooth is 2/3 formed, as early as the mid teens to early twenties. Studies strongly recommend that wisdom teeth be removed by the time the patient is a young adult in order to prevent future problems and to ensure optimal healing.
How Are Wisdom Teeth Removed?
Dr. Denny may take a special type of X-ray named a panoramic x-ray (PANO), periodically to evaluate for the presence and alignment of your wisdom teeth.
The difficulty of extracting your wisdom teeth depends on their position. Dr. Denny will be able to give you an idea of what to expect during your pre-extraction exam. A wisdom tooth that is fully erupted through the gum can be extracted as easily as any other tooth. However, a wisdom tooth that is underneath the gums and embedded in the jawbone will require an incision into the gums and then removal of the portion of bone that lies over the tooth. Oftentimes, for a tooth in this situation, the tooth will be extracted in small sections rather than removed in one piece to minimize the amount of bone that needs to be removed to get the tooth out.
What Happens after Surgery?
Following surgery, you may experience some swelling and mild discomfort, which are part of the normal healing process. Cold compresses may help decrease the swelling, and medication prescribed by Dr. Denny can help manage the discomfort. You may be instructed to modify your diet following surgery and later progress to more normal foods.