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Home > Services > Wisdom Teeth
Wisdom teeth are the most troublesome. Either remaining beneath the gum, or breaking partially through and growing in crooked, wisdom teeth can cause a host of undesirable symptoms.
Impacted wisdom teeth remain below the gum and can cause headaches, tooth pain, earaches and pain around the neck, face or throat. Infections can also develop around impacted wisdom teeth.
Wisdom teeth that have partially erupted, or broken through the gums, can cause pressure, pain, decay or infection, and may impede any orthodontic work as they push against other teeth.
Overview
Third molars or “Wisdom teeth,” are removed for one basic reason; there is not enough room in the jaw for their proper positioning. Whether impacted or erupted, there are several disadvantages to having them. However, throughout the history of mankind, wisdom teeth were not always disadvantageous.
Wisdom teeth are the only teeth whose presence is completely absent in our jaws at birth. In theory, we evolved them at some point in history. Prehistoric skulls of humans display much larger jaws, spatially capable to afford wisdom teeth to chew more efficiently. This evolutionary advantage aided prehistoric mankind in chewing raw foods. As time progressed, the discovery of fire and cooking utensils allowed early humans to boil and cook their food, essentially softening it. These newfound capabilities ensured humanity’s immediate survival even in the absence of teeth.
In time, jaws became smaller as our skull shapes changed. The previous space available for wisdom teeth diminished. Today, 2 out of 3 Twenty-year-olds have at least one impacted 3rd molar, denoting this loss of space. Despite dentistry’s shift toward preventive dentistry, the location and positioning of 3rd molars in the dental arch make them predisposed to caries and periodontal disease. Due to their malposition, the 3rd molars are very difficult to cleanse properly. This difficulty in cleansing is the predominant indication for their removal.
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Indications for removal
- Decay: Saliva, food, and bacteria can collect around wisdom teeth causing it, or the adjacent teeth, to develop “cavities.” Difficulty for dentists to remove the decay may necessitate removal at any point in a patient’s life.
- Infection: Bacteria congregating under the gums of a partially impacted tooth may cause a local infection. Bad breath, pain, swelling, headaches, fever, or the restricted ability to open may occur.
- Pain: Headaches or pressure pain are possible with wisdom teeth and may necessitate removal.
- Cyst or Tumor formation: These problems may occur causing bone destruction, jaw expansion, movement of adjacent teeth, or damage of adjacent teeth.
- Resorption: Whether carious or pressure resorption, erosion of 2nd molars due to malpositioned 3rd molars may necessitate the removal of 2nd molars in addition to 3rd molars.
- Periodontal disease: Many times, periodontal disease begins around 3rd molars and spreads to adjacent teeth due to their malpositioning. Many times extraction of wisdom teeth is indicated to prevent the periodontal disease from spreading to adjacent teeth.
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Timing
Based on our experience and from published studies, adults in the age range of 17-22 are the ideal candidates for extraction of 3rd molars. As we age, our bone density increases. In older patients, this increased density translates to more difficulty in removing the teeth. The density also increases the risk of complications that may occur, and delays the recovery time due to the trauma involved.
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Benefits and Alternatives
The major benefits to having wisdom teeth removed are reducing pain, infection, and disease. In addition, their absence allows more thorough cleansing and a healthier oral environment. Many American adults have an incurable oral disease called periodontal disease. In fact, the American Dental Association estimates that 3 out of 4 , or 75% of American adults have some form of this disease.
The malposition of 3rd molars predisposes us to this disease by creating “pockets” behind them. These pockets are difficult to cleanse and may initiate periodontal disease which can spread to adjacent teeth. Recent studies link a protein from this disease process (C reactive protein) to heart disease, increased incidence to strokes and pre-term low-birth-weight babies. Alternatives to treatment are to not have wisdom teeth extracted.
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Sedation Options
The major benefits to having wisdom teeth removed are reducing pain, infection, and disease. In addition, their absence allows more thorough cleansing and a healthier oral environment. Many American adults have an incurable oral disease called periodontal disease. In fact, the American Dental Association estimates that 3 out of 4 , or 75% of American adults have some form of this disease.
The malposition of 3rd molars predisposes us to this disease by creating “pockets” behind them. These pockets are difficult to cleanse and may initiate periodontal disease which can spread to adjacent teeth. Recent studies link a protein from this disease process (C reactive protein) to heart disease, increased incidence to strokes and pre-term low-birth-weight babies. Alternatives to treatment are to not have wisdom teeth extracted.
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Frequently Asked Questions
How long will the procedure last?
For IV sedation and removal of 4 wisdom teeth, the procedure will be scheduled for 90 minutes. The majority of time, roughly one hour, will be devoted to sedating the patient. The actual tooth removal will be approximately 20-30 minutes.
Will the procedure hurt?
No. The IV sedation plus numbing meds will provide a comfortable appointment for the patient. Patients may experience a small “pinch” from the IV being started but nothing else.
How much pain will occur after the surgery?
Moderate pain would occur without taking the prescribed medications from the dentist. While taking the medications regularly, the patient will not be in pain. Mornings will be sore until meds may be taken. The medications prescribed will make the patient feel tired and lethargic. No driving or conducting any activities requiring alertness is recommended. In fact, these activities are strongly advised against.
How long until I heal?
Healing will be determined by a variety of factors. Age is a contributing factor. Generally, the younger you are the quicker you will heal. The type of tooth being extracted is also a factor. Impacted teeth requiring bone removal will generally be more sore than an erupted tooth. The presence of infection may also delay the healing.
Textbooks indicate the major pain will be between days 3-5. The first 2 days will be sore and the pain will actually be elevated on day 3. This is when maximum swelling occurs.
In general, the pain will last roughly one week. A general soreness or “dull” ache may linger on. Ibuprofen will usually relieve this minimal lingering soreness.
What can I eat following the surgery?
For the first several days, soft foods are recommended. Make sure nutritious foods are being ingested, for the vitamins, nutrients, and minerals will assist in healing. Replacement milk shakes such as Ensure, boost, and even slim-fast shakes have lots of vitamins and minerals. As you start having less soreness as you chew, more firm food may be integrated into your diet.
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