When your dentist recommends wisdom teeth removal, it is important to understand why this treatment is necessary for your dental and overall health. Understanding your condition, options, and risks are an important part of the decision-making process. Let’s look at some of the most common problems with wisdom teeth.
Infection of wisdom teeth (pericoronitis): Sometimes, the position of the wisdom teeth can create perfect conditions for chronic infection. Infection often occurs when a tooth is partially covered with gum tissue, leaving the area open to bacterial colonization. Over time, the chronic infection can advance into periodontal disease, which can ultimately spread to other teeth and lead to serious gum disease or loss of permanent teeth.
Patients who have undergone orthodontic treatment are often requested by their orthodontist to have their wisdom teeth removed. This is because of pressure being placed on the second and first molars, increasing the chance of orthodontic relapse.
When wisdom teeth are impacted and/or positioned at an angle, it places pressure on the tooth in front of it. Often, a bacterial trap is formed in the crevice between the two teeth. Tooth decay caused by the erosion of the adjacent tooth and/or bacterial traps can be a serious problem, and lead to the loss of both the second molar and the wisdom tooth. When wisdom teeth are positioned in such a way, they are often removed in order to help the permanent molars stay healthy.
Cysts, tumors and other pathology: Sometimes, impacted wisdom teeth can form cysts or tumors around them. Over time, they may become painful, infected, or damage the jaw bone surrounding the cyst. When pathology, such as cysts and tumors, is seen around wisdom teeth, they are most often removed in order to prevent serious damage to the jaw bone. Oftentimes, the cyst or tumor tissue will be sent to a laboratory for examination to determine whether the sample is benign, malignant, or likely to return.
People between the ages of 14-25 are at the best age for wisdom teeth removal. The goal is to remove the wisdom teeth before they begin to cause any major problems. Many patients we see are older than 25, and are beginning to develop symptoms or problems with their wisdom teeth. For these older patients, we recommend taking care of the issues right away. If you have health concerns, chronic disease, such as high blood pressure, diabetes or other problems, be sure to discuss these with your dentist prior to treatment.
Removing wisdom teeth early, before the roots have fully developed, is ideal. Early removal causes fewer complications and results in less post-operative discomfort. As we get older, fully developed roots are longer and the surrounding bone is harder. The ideal age range for wisdom teeth removal is 14-25.
Impacted wisdom teeth are trapped beneath the jawbone and gum tissue. Their position in the jaw makes it unlikely that they will ever ‘erupt’, or ‘come in’, like normal teeth. Fully impacted wisdom teeth can cause problems, such as dental crowding, damage to the roots of adjacent teeth, or even development of pathology, such as cysts and tumors. Cysts or tumors in the jaw can destroy healthy bone tissue, leading to the loss of affected teeth. Sometimes, impacted teeth place pressure on the roots of the tooth in front of it, which can cause serious damage to your second molars.
A partially impacted tooth has come partly through the gums, often leaving a small opening in the gum tissue. Bacteria can enter this area and cause a chronic infection known as pericoronitis. This infection can repeatedly flare up/resolve, causing pain and inflammation. In some cases, bacteria, entering beneath the gum tissue can cause decay of the wisdom tooth- even when the tooth is covered in gum tissue.
Even when wisdom teeth make it fully into position, they are often very difficult to keep clean. A toothbrush and floss cannot reach all the surfaces of the wisdom teeth, and over time, tooth decay can develop. In some cases, bacteria, plaque and tartar trapped around the gum line can lead to gum disease around the wisdom teeth.
Dentists and dental specialists routinely provide wisdom teeth removal surgery in the office. Once you receive the recommendation to have your wisdom teeth removed, you will have a consultation appointment in order to assess important health information, your medical history, any medications you are taking. The doctor will examine your x-rays and examine your mouth. The procedure will be planned, using the type of anesthesia you decide upon. Your vital signs, including heart rate, breathing and blood pressure will be monitored closely during surgery and recovery. In most cases, moderate IV (intravenous) sedation is used together with local anesthetic, to numbthe area. With IV sedation, an IV line is placed in the arm or hand, and medications for sedation are administered through the line. Patients who have a combination of moderate IV sedation and local anesthetic generally experience a sedated state, with no pain or discomfort during treatment, and retain little or no memory of the experience. Upon completion of the procedure, you will likely feel somewhat sedated, and your mouth will remain numb from the local anesthetic for up to several hours. Once you are recovered from the sedation, you will be able to go home and start taking any prescriptions given to you. Most people do not have significant pain after wisdom teeth surgery, although the area will be sore. Taking prescribed medications for pain, or over-the counter pain relievers (like Tylenol or Advil) will help reduce any post-operative discomfort. Some swelling is normal, and you will need to follow a special diet for up to two weeks. All patients are given specific post-operative instructions to help them take good care of their healing mouth after surgery. Following your post-operative instructions explicitly is the best way to ensure that you experience a smooth post-operative course. Most patients are able to return to work or school within 1-3 days after surgery. Your doctor will need to be consulted regarding return to sports activity, strenuous exercise, playing a wind instrument or travel by air.
We have provided general pre-operative instructions here. Be advised, your surgeon will provide you specific written and/or verbal pre-operative instructions, which you should follow. The instructions we have provided here are general in nature, and you should always follow the instructions given to you by your surgeon.
We have provided general post-operative instructions here. Be advised, your surgeon will provide you specific written and/or verbal pre and post-operative instructions, which you should follow. Patients with certain medical conditions or daily medications may need supplemental post-operative instructions, not provided here. The instructions we have provided here are general in nature, and you should always follow the instructions given to you by your surgeon.