Wisdom Teeth

Here are a few common questions regarding wisdom teeth:

What are wisdom teeth?

Also called third molars, these teeth are the last teeth in the back of the mouth to develop. Usually between the ages of 15 and 20 is when the wisdom teeth have completed development.

What does “impacted” mean?

If a tooth does not erupt, it is termed as being impacted. There are three degrees of impaction: soft tissue (not fully out of the gum), partial bony (not protruded through the gum) and complete bony (fully imbedded in the jawbone). Each has its own set of potential problems either for the patient or dentist performing the extraction. Soft tissue impactions are difficult to clean; partial bony impactions can damage adjacent teeth; and complete or fully impacted wisdom teeth are susceptible to cysts, cause crowding and damage adjacent teeth.

When do wisdom teeth need to be removed?

If it has been determined that a patient lacks room for wisdom teeth, or if the wisdom teeth are erupting off line, then third molars should be removed between the ages of 15 and 20.

What are the consequences of leaving them alone?

Risk of tooth damage, gum disease, decay/cavities, or cysts in the jaw may occur if impacted, crowded or misaligned wisdom teeth are not removed.

What’s to be expected when wisdom teeth are removed?

Obviously, the patient will be numbed with a local anesthetic prior to the procedure. The patient may elect to be fully sedated with general anesthesia by an oral surgeon. The procedure typically takes forty five minutes to an hour and a half. Afterwards, post-operative instructions will be given to the patient along with any appropriate medications. Ice packs can be used for the first 24 hours.  Everyone heals and responds differently. Initial healing takes 48-72 hours. Limited activity may resume by day three, when the worst of any swelling and soreness begins to subside. Smokers are to abstain during the initial healing phase. A dry socket is inevitable for non-compliant smokers. This is a painful condition that prolongs the healing process due to the breakdown of the blood clot, exposing bone, requiring additional treatment.

What are the risks?

As mentioned, a dry socket is possible and the most common problem patients experience following wisdom tooth surgery. A medicated packing is placed into the affected tooth socket to help relieve the radiating pain that occurs in the jaw, upwards to the ear. Infection is another risk. Prolonged swelling, drainage, and/or fever are signs that infection may be occurring. The patient is to be seen as soon as these symptoms occur to begin or change antibiotics, possibly including cleaning and drainage of the site. Upper wisdom teeth have roots that are near the maxillary sinus cavity. If an opening to the sinuses results, specific post-operative instructions will be given. A more invasive procedure may need to be performed if the sinus opening does not heal properly. Lower wisdom teeth have roots that are near the main nerve that provides feeling to the lower lip, chin and tongue. Occasionally this nerve becomes irritated from the surgery. Tingling, numbness or complete lack of feeling in the lower lip, chin or tongue may occur. This is usually a temporary condition and should correct itself over time.