Wisdom teeth, or third molars, are the last teeth that may develop in your mouth. If these teeth do develop, you can expect them to grow just behind the second molars at the very back of the mouth. Wisdom teeth usually begin to erupt into the mouth between the ages of 17 and 25, a time of life that has been called the age of wisdom.
Some individuals don’t develop wisdom teeth at all and, therefore, never need to have them removed. Others can develop just one or two wisdom teeth, all four wisdom teeth, or in some special circumstances, more than four wisdom teeth.
Why do we have wisdom teeth?
When early humans were still developing, they consumed a much different diet than we have today. This rough diet caused teeth to drift naturally into an arch which could accommodate a third molar in the back of the mouth. In fact, the wisdom teeth can prove to be a valuable asset and assist in everyday function as their broad surfaces and surplus of four or five cusps can assist in grinding food and chewing.
Our modern diet consisting of softer foods and the growing prevalence of orthodontic straightening treatments do not allow our teeth to shift and develop in the same way as our early ancestors. The fuller dental arch created by our modern cosmetic technologies often doesn’t allow the proper space necessary for wisdom teeth to erupt into the mouth, and rather than providing value, they often create oral health problems.
What is an impacted wisdom tooth, and how serious is it?
Often times, it is difficult for people to know if they have wisdom teeth because they have not yet erupted into the mouth and are living beneath the surface of the gums. When a single wisdom tooth or multiple wisdom teeth are beneath the surface of the gums, these teeth are said to be impacted. If you visit your general dentist regularly for cleaning or checkups, it is likely that he/she will be able to detect the presence of incoming wisdom teeth early on through conventional X-ray technology. Impacted or partially impacted wisdom teeth generally do not grow with proper alignment, leading to pain and infection, which is why an oral surgeon will remove them from the mouth.
When teeth only partially emerge from beneath the gums or do not fully erupt, they are extremely difficult to keep clean. The partial opening in the gums creates room for bacteria to enter the tooth and the gums and create a wide range of unpleasant side effects. When infection from the bacteria begins to formulate, many individuals experience pain, jaw stiffness, swelling, or even bodily illness.
Impacted wisdom teeth are also at risk for developing cysts, which occurs when the sac surrounding the impacted tooth becomes filled with fluid and enlarges. The growth of a cyst may result in the hollowing out of the jaw and the permanent damage to adjacent teeth, surrounding bone, and nerves. Rarely, if a cyst is not treated, a tumor may develop from its walls, and a more serious surgical procedure may be required to remove it.
It is not uncommon for wisdom teeth to show horizontal growth beneath or above the gum line. When wisdom teeth grow horizontally, they may grow toward or away from the second molar or even inward toward the tongue or outward toward the cheek. This abnormal growth pattern has the potential to push the rest of the teeth out of alignment or to damage the adjacent teeth, jaw bone, or nerves in the mouth.
Must the tooth come out if it hasn’t caused any problems yet?
Not all problems related to third molars are painful or visible, which means that damage can occur without being aware of it. Despite the considerable concern regarding impacted third molars, a recent study sponsored by the American Association of Oral and Maxillofacial Surgeons and the Oral and Maxillofacial Surgery Foundation finds that third molars which have broken through the tissue and erupted into the mouth in a normal, upright position may be as prone to disease as those third molars that remain impacted.
The longer the wisdom teeth are allowed to grow into the mouth, the longer their roots become. These roots can make extraction extremely difficult when not removed early enough and increase the risk for complication as patients age. No one can predict when third molar complications will occur, which is why it is best to have wisdom teeth removed to avoid additional pain and more difficult treatment.
When should I have my wisdom teeth removed?
It is not recommended to wait until your wisdom teeth start to bother you to seek treatment and removal. In general, it is best to get wisdom teeth removed early in order to ensure a less complicated healing process.
The American Association of Oral and Maxillofacial Surgeons strongly recommends that wisdom teeth be removed by the time the patient is a young adult in order to prevent future problems and to ensure optimal healing. Research has also found that older patients may be at greater risk for disease, including periodontitis, in the tissues surrounding the third molars and adjacent teeth, which can affect general health in addition to oral health.
What happens during surgery?
You may have been referred to Dr. Marashi or Dr. Haghighi directly from your general dentist when X-rays showed the presence and misalignment of wisdom teeth, or you may be experiencing pain in the mouth and have sought out treatment on your own.
During your initial consultation, Dr. Marashi or Dr. Haghighi will explain what to expect during the wisdom tooth removal procedure and develop the best plan of action for extraction. He will develop an individualized treatment plan to ensure that all of your questions or concerns have been addressed and that your medical history has been taken into consideration.
Many patients are nervous when they hear that they need to have their wisdom teeth removed. To ease pain and anxiety during treatment, Greater Charlotte Oral & Facial Surgery offers a range of anesthetic and sedative options including
- Local Anesthesia – an anesthetic applied directly to the area of removal
- Nitrous Oxide – also known as laughing gas, an anesthetic option used in congruence with other anesthetic options to calm anxiety during the procedure
- Sedation Anesthesia – administered through an intravenous (IV) line which suppresses your consciousness during the procedure
- General Anesthesia – an anesthetic administered intravenously which causes you to lose total consciousness during the procedure
Your doctor will review these options with you and choose the anesthetic that is right for you. You may be given specific instructions not to eat or drink anything prior to the procedure based on the anesthetic option you choose.
The length of the procedure is dependent on the number and position of the wisdom teeth to be removed and the age of the patient. During the procedure, your surgeon will gently open the gum tissue, separate the tooth from the bone and remove it from the mouth. Sometimes, small stitches will be made in the gum tissue to assist in healing. Most stitches will dissolve on their own after a few days.
What happens after surgery?
You may experience some swelling and mild discomfort following surgery as part of the normal healing process. Cold compresses may help decrease the swelling, and your doctor may prescribe medication to help manage the discomfort. You may be instructed to modify your diet following surgery and later progress to more normal foods. You will be given a full overview of proper post-operative care instructions prior to your procedure.