Wisdom teeth or third molars are the final set of molars to erupt, typically between the ages of 17 and 25. They are named for the increasing maturity or “wisdom” associated with the same period of young adulthood.
Anthropologists believe that the rough diet of early humans resulted in the excessive wear of their teeth. The shifting of teeth to compensate for this wear provided space for most wisdom teeth to erupt by adolescence. Our softer modern diet and the popularity of orthodontic tooth straightening procedures produces a fuller dental arch, which commonly doesn’t leave room for the wisdom teeth to erupt properly. When growth and eruption are prevented by overlying gum, bone or another tooth, a tooth can become stuck or impacted in an undesirable position.
There are several types, or degrees, of impaction based on the actual depth of the teeth within the jaw:
Soft Tissue Impaction: The crown (upper portion) of the tooth has penetrated through the bone, but the gingiva (gum) is covering part or all of the tooth’s crown and is not positioned properly around the tooth. With soft tissue impaction it becomes more difficult to keep the area clean and prevent food from becoming trapped below the gum line. This may result in painful infection and/or tooth decay.
Partial Bony Impaction: The tooth has partially emerged, but a portion of the crown remains submerged below the gum and surrounding jawbone. Again, proper hygiene becomes more difficult and infection will commonly occur.
Complete Bony Impaction: The tooth is completely covered by bone and soft tissue and has not begun to emerge. Complete impaction will require more complex surgical techniques.
Reasons to remove wisdom teeth
Wisdom teeth extractions may be 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. It is estimated that about 85% of third molars will eventually need to be removed.
It isn’t wise to wait until your wisdom teeth start to bother you. In general, earlier removal of wisdom teeth results in a less complicated healing process. In addition, as patients age their impacted wisdom teeth are more likely to cause problems. A recent study by the American Association of Oral and Maxillofacial Surgeons and the Oral and Maxillofacial Surgery Foundation supports our recommendation 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.
The risks of untreated impacted wisdom teeth include:
- Crowding, damage to nearby teeth: Adjacent teeth can be adversely affected by impacted wisdom teeth, resulting in tooth decay, periodontal disease (gum disease) and possible bone loss.. It has been theorized that impacted wisdom teeth put pressure on other teeth and may cause them to become misaligned.
- Disease: Cysts and rarely, tumors can occur in the areas surrounding impacted teeth.
- Infection: Bacteria and food trapped under the gum tissue can result in an infection. Infections can cause both pain and danger.
Wisdom teeth examination
Your surgeon will initially conduct a thorough examination of the wisdom and surrounding teeth. Panorex or peri apical X-rays will be taken in order to evaluate the position of the wisdom teeth and determine if a current problem exists, as well as the likelihood of future problems. The X-rays can also expose additional problems such as deterioration or decay of nearby teeth. We recommend early evaluation in the mid-teen years to identify potential problems and to improve the results for patients requiring wisdom teeth extractions. After a thorough examination, your surgeon will provide you with the best options for your particular case.
If surgery is recommended, your oral and maxillofacial surgeon will discuss with you what to expect. This is a good time to ask questions or express your concerns. It is especially important to let the doctor know about any illness you have and medications you are taking.
What does the removal of wisdom teeth involve?
Wisdom teeth removal is a common procedure, generally performed under local anesthesia, intravenous (IV) sedation, or general anesthesia in the oral and maxillofacial surgery office. Your oral and maxillofacial surgeon will discuss the anesthetic option that is right for you. After a recovery period in the office, you will be released with post-operative instructions and any necessary medication to help manage swelling or discomfort.