Wisdom teeth—also known as third molars—are the final permanent adult teeth to form and ascend into the mouth. The teeth will usually come in the late teenage years and should be fully developed by about 23 years of age. This was assumed in the past to be the “age of wisdom,” which is where the name wisdom teeth came from.
In most cases, an adult jaw is not big enough to accommodate wisdom teeth and they remain under the gums. These “impacted” teeth are not fully exposed in the mouth because they are covered by tissue or bone. As humans evolved and our cranial size grew, our jaw size grew smaller and limited the space to accommodate wisdom teeth.
X-rays can frequently predict if impacted teeth will become a problem later in life. Extraction surgery is easier for younger patients because the roots of the wisdom teeth are not yet fully developed and bone is less dense. Younger patients also tend to heal quicker, and healing potential is highest in patients under 30 years old.
Teeth that partially erupt are still considered impacted. Mouth bacteria can easily work down into the impacted teeth and cause infection in the surrounding bone and gum tissue. Soreness around the wisdom teeth is often interpreted as the teeth trying to breach the gum but this could be a sign of infection and if left untreated, can damage tooth roots or surrounding teeth and bone.
Impacted wisdom teeth can produce near constant pressure that can also cause damage to adjacent teeth and a patient may not feel anything until damage has developed. Pressure can push other teeth out of alignment and may require orthodontic treatment.
Headaches, earaches, and general pain in the face, neck, throat, and mouth can all occur if impacted wisdom teeth are not removed. Cysts can also form around impacted teeth and the cysts will destroy bone surrounding adjacent molars. In some extremely rare cases of untreated cysts, tumors can develop and may require extensive surgery to remove.
The early removal of wisdom teeth is usually a less involved process than if a patient waits until they experience pain or other complications. It is recommended that the teeth are removed before the roots are fully formed. Roots will grow and anchor to the jaw bone as you age making them more difficult to remove. If you wait until your wisdom teeth are causing problems, the chances of complications with the extraction are higher, and your recovery time may take significantly longer.
The administration of various medications provides the patient with a completely pain-free, anxiety-free and comfortable surgical experience. Oral surgery procedures can now be accomplished free of pain and apprehension by utilizing sedation in combination with local anaesthesia. Very often, this procedure can be accomplished in an office environment. The utilization of new narcotics, tranquilizers, and ultra-short-acting drugs, combined with local anaesthesia, allows patients to experience a state of sleep or sedation in complete comfort and safety. More complex or severely impacted teeth will be extracted under general anaesthesia in a hospital environment.
As with any surgical procedure, there are some risks with removal of wisdom teeth such as bruising, pain, and post-operative swelling. Patients should carefully apply ice packs for the first 24 to 48 hours to help relieve these symptoms. Occasionally, the roots of the wisdom teeth contact are in close proximity to the neurovascular bundle of the mandibular nerve (to the nerve that supplies the lower jaw). The nerve can sometimes be disturbed and can cause numbness in the tongue, gums, or lower lip. Many times, this may be a temporary situation. However, some people never fully recover from this lack of sensation. There is no impairment of motor function (movement).
Appropriate narcotic and non-narcotic medications may be prescribed to minimize discomfort. The use of intravenous general anaesthesia tends to minimize preoperative and postoperative anxiety which consequently helps decrease post-operative pain. Narcotic medications and anaesthetic agents can impair your reflexes and judgment. Please take precautions to ensure you do not drive, operate machinery, or use power tools while taking these medications. It is also recommended that you do not make any important financial decisions.
The recovery period varies from patient to patient depending on several factors including the degree of tooth impaction, age of patient, overall medical health and other risk factors. Maintaining good hygiene and avoiding the use of tobacco products will promote healing. Following post-surgical instructions will help speed up overall recovery time. Our doctors and staff are available for any questions or concerns you might have after the completion of your surgery. Please feel free to contact us if you have any concerns or questions about your postoperative care.
Postoperative infection is also a concern and your chances of a postoperative infection can be reduced by a combination of good post-operative oral hygiene and avoiding foods which have seeds, kernels or are hard and crunchy during the first few postoperative weeks. Occasionally antibiotic therapy will be prescribed by the doctor.
Dental and medical insurance plans will cover all or most of the removal of a tooth. Our office staff will confirm your coverage with your insurance provider and make all attempts to assist in the arrangement of your extraction. We can also help process a written request if required by your insurance provider.
Our practice is dedicated to providing our patients with the best possible care. Our main concern is to make our patients’ surgical experience as comfortable and pleasant as possible and to ensure the best possible result from treatment.