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Third molars, commonly referred to as wisdom teeth, are usually the last four of 32 teeth to erupt (surface) in the mouth, generally making their appearance between the ages of 17 to 25. They are located at the back of the mouth (top and bottom), near the entrance to the throat. The term “wisdom” stems from the idea that the molars surface at a time typically associated with increased maturity or “wisdom”.
In most cases, inadequate space in the mouth does not allow the wisdom teeth to erupt properly and become fully functional. When this happens, the tooth can become impacted (stuck) in an undesirable or potentially harmful position. If left untreated, impacted wisdom teeth can contribute to infection, damage to other teeth, and possibly cysts or tumours.
There are several types, or degrees, of impaction based on the actual depth of the teeth within the jaw:
- Soft Tissue Impaction: The upper portion of the tooth (the crown) has penetrated through the bone, but the gingiva (gum) is covering part or all of the tooth’s crown and has not positioned properly around the tooth. Because it is difficult to keep the area clean, food can become trapped below the gum and cause an infection and/or tooth decay, resulting in pain and swelling.
- Partial Bony Impaction: The tooth has partially erupted, but a portion of the crown remains submerged below the gum and surrounding jawbone. Again, because it is difficult to keep the area clean, infection will commonly occur.
- Complete Bony Impaction: The tooth is completely encased by jawbone. This will require more complex removal techniques.
Reasons to Remove Wisdom Teeth
While not all wisdom teeth require removal, wisdom teeth extractions are most often 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. If impaction of one or more wisdom teeth is present and left untreated, a number of potentially harmful outcomes can occur, including:
- Damage to nearby teeth: Second molars (the teeth directly in front of the wisdom teeth) can be adversely affected by impacted wisdom teeth, resulting in tooth decay (cavities), periodontal disease (gum disease) and possible bone loss.
- Disease: Although uncommon, cysts and tumors can occur in the areas surrounding impacted wisdom teeth.
- Infection: Bacteria and food can become trapped under the gum tissue, resulting in an infection. The infection can cause considerable pain and danger.
- Tooth Crowding: It has been theorized that impacted wisdom teeth can put pressure on other teeth and cause them to become misaligned (crowded or twisted). This theory isn’t universally accepted by all dental professionals, and it has never been validated by any scientific studies.
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) are 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. During your wisdom teeth extraction, your dentist or oral surgeon will make an incision in the gum tissue to expose the tooth and bone. Then the bone that blocks access to the tooth root will be removed. Next, the tooth will be divided into sections if it’s easier to remove in sections. The tooth will be removed, the site will be cleaned of any debris from the tooth or bone, and the wound will be stitched closed to promote healing (though this is not always necessary). Gauze will be placed over the extraction site to control bleeding. You will be given care instructions to take home with you, and postoperative medication to help control any swelling or pain.
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Disclaimer
Dr. Marianne Stelmaschuk is a Lloydminster General Dentist. She is not a specialist in Cosmetic or Family Dentistry. Cosmetic and Family Dentistry are not specialties recognized by the Alberta Dental Association & College of Dental Surgeons of Alberta (CDSA). She provides Cosmetic and Family Dental procedures such as Porcelain Veneers, Dental Crowns, Invisalign, and Teeth Whitening as part of her General Dentistry license. As a Lloydminster Family Dentist, she provides General Dental procedures for all ages within the family. Dr. Prabhjot Singh is a licensed Oral and Maxillofacial surgeon and can offer Oral Maxillofacial specialty services as part of his license.