Third molars, commonly known as wisdom teeth, typically emerge as the final set of four out of a total of 32 teeth in the mouth. They usually make their appearance between the ages of 17 and 25 and are situated at the posterior end of the mouth, both on the upper and lower jaws, near the entrance to the throat. The term "wisdom" is associated with these molars because they typically surface during a period that is often associated with increased maturity or "wisdom."
In many cases, the limited space in the mouth does not allow the wisdom teeth to erupt properly and attain full functionality. Consequently, the tooth can become impacted, meaning it gets stuck in an undesirable or potentially harmful position. If left untreated, impacted wisdom teeth can lead to infections, damage to adjacent teeth, and even the development of cysts or tumors.
There are different types or degrees of impaction depending on how deeply the teeth are embedded in the jaw:
Soft Tissue Impaction: In this case, the upper part of the tooth, known as the crown, has emerged through the bone, but the gum tissue (gingiva) is covering part or all of the crown, and it has not positioned properly around the tooth. Due to the difficulty in keeping the area clean, food particles can get trapped beneath the gum, leading to infection, tooth decay, pain, and swelling.
Partial Bony Impaction: Here, the tooth has partially erupted, but a section of the crown remains submerged beneath the gum and the surrounding jawbone. Similar to soft tissue impaction, this condition makes it challenging to maintain oral hygiene, resulting in frequent infections.
Complete Bony Impaction: In this scenario, the tooth is fully encased within the jawbone. Removing such impacted teeth necessitates more complex extraction techniques.
Reasons to remove wisdom teeth
There are several reasons why a wisdom tooth may need to be removed:
Impaction: One of the most common reasons for wisdom tooth extraction is impaction. When there is not enough space in the mouth for the wisdom teeth to fully erupt, they can become impacted, meaning they are trapped below the gum line or partially emerged. Impacted wisdom teeth can cause pain, swelling, and increase the risk of infection.
Crowding: Wisdom teeth can exert pressure on the surrounding teeth as they try to emerge, leading to crowding or shifting of the other teeth. This can disrupt the alignment of the existing teeth and affect the bite.
Infection: Wisdom teeth that are partially erupted or impacted are more prone to infection. The gum tissue around the partially erupted tooth can become irritated and infected, resulting in symptoms like pain, swelling, redness, and difficulty in maintaining oral hygiene in that area.
Decay or Gum Disease: Wisdom teeth are located at the back of the mouth, making them difficult to clean properly. This can make them more susceptible to tooth decay and gum disease. The position and angulation of wisdom teeth can make brushing and flossing challenging, leading to plaque accumulation and subsequent dental problems.
Cysts or Tumors: In some cases, a sac called a cyst may develop around an impacted wisdom tooth. If left untreated, the cyst can damage the surrounding teeth, bone, and nerves. Rarely, tumors can also develop around impacted wisdom teeth.
Orthodontic Treatment: If a person is undergoing orthodontic treatment, the presence of wisdom teeth can interfere with the alignment of the teeth. Removing the wisdom teeth may be necessary to maintain the results of orthodontic treatment.
Preemptive Removal: Some dentists or oral surgeons may recommend removing wisdom teeth before they cause problems as a preventive measure. This is often done in cases where the risk of future complications is high, such as when the mouth is too small to accommodate the wisdom teeth or if the teeth are at an unusual angle.
Ultimately, the decision to remove wisdom teeth depends on various factors, including the individual's oral health, the position and condition of the wisdom teeth, and the recommendations of the dentist or oral surgeon. It is important to consult with a dental professional for a thorough evaluation and personalized advice.
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. The X-rays can also expose additional risk factors, such as deterioration or decay of nearby teeth. Early evaluation and treatment (typically in the mid-teen years) is recommended in order to identify potential problems and to improve the results for patients requiring wisdom teeth extractions. Only after a thorough examination can your dentist provide you with the best options for your particular case.
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 by a specially trained dentist in an office surgery suite. The surgery does not require an overnight stay, and you will be released with post-operative instructions and medication (if necessary), to help manage any swelling or discomfort.