Wisdom teeth are an extra set of molars that develop during the late teens or early twenties. In the 19th century they were called “teeth of wisdom,” because they arrived during a time of presumed increased wisdom.
When these teeth come through in the correct position, they assist the molars in chewing food. It is normal to feel discomfort when the wisdom teeth emerge into the gum surface. However, if the new growth is painful or the tooth becomes impacted, a visit to the dentist is in order–and you may need them removed.
Common Problems With Wisdom Teeth
Most people don’t have the jaw space for the wisdom teeth to surface. Or the teeth could come through in the wrong position. In most cases, the wisdom teeth are trapped by the back molar or impacted in the jaw under the gums.
Signs of Trouble
Your dentist will look for the following oral indications that wisdom teeth could be causing trouble in your mouth:
- The teeth are out of position, allowing food to become trapped. Trapped food particles are the breeding place for bacteria and plaque growth.
- The teeth grow without the spacing needed to properly floss between the new teeth and the adjacent molars.
- Partially grown wisdom teeth allow bacteria to enter the gums, causing infection and swelling of the gums or jaw.
- Wisdom teeth can crowd or damage neighboring teeth.
- An impacted tooth can develop a cyst, which could damage roots of nearby teeth, or lead to bone loss in the root area.
You Might Need Your Wisdom Teeth Removed If…
Your dentist, after examining your mouth and taking x-rays, will recommend extraction of the wisdom teeth where there is evidence of the following:
- Gum disease.
- Tooth decay when it is not possible to restore the tooth.
- Pain and infection.
- Cysts or tumors.
- Potential or actual damage to adjacent teeth.
- The wisdom teeth are impacted—stuck below the gum surface.
Also, there are other dental treatments—fitting braces, for example—where the dentist would recommend removing wisdom teeth.
Impacted Wisdom Teeth
Sometimes the impacted wisdom tooth may partially emerge, exposing a part of its crown, or it may remain fully impacted. Impacted teeth can grow in several different positions: towards the next tooth, toward the back of the mouth, lying down within the jawbone, or straight up and down while still remaining trapped. So, impacted teeth can be a serious oral health problem. They can damage adjacent molars and crowd out healthy teeth. Like fully grown wisdom teeth, they can cause gum disease and tooth decay.
Types of Impacted Wisdom Teeth
These teeth fall into four categories:
1. Full-Bony: The wisdom tooth is completely stuck in the jaw. (This is the most difficult to remove.)
2. Partial-bony: The tooth is partly stuck into the jaw.
3. Soft-tissue: Less complicated, because the tooth is only stuck under the gum.
4. Erupted: The simplest type because the tooth has already emerged.
Removing Impacted Wisdom Teeth
The surgical procedure is performed in a dental office. The length and difficulty of the procedure depends on how the impacted tooth has developed.
How the Surgery is Done
Before the extraction begins, the patient is given an injection of local anesthetic. Patients who are particularly anxious can usually benefit from sedation dentistry as well.
If the tooth has not come through the gum, the surgeon makes an incision. The patient feels some pressure just prior to removal of the tooth while the surgeon widens the tooth socket as the tooth is rocked back and forth before removing it. Typically, a simple procedure like this takes just a few minutes. However, the more complicated wisdom tooth extractions can take 20 minutes or more.
After the tooth is removed, the surgeon uses sutures or stitches to seal the gum. Also, the patient may need to take antibiotics to fight infection, should avoid strenuous activity, and refrain from eating and drinking anything hot for 24 hours.