Wisdom Teeth

By the age of 18, the average adult has 32 teeth; 16 teeth on the top and 16 teeth on the bottom. The back teeth (molar teeth) are used to grind food up into a consistency suitable for swallowing. The average mouth is made to hold only 28 teeth. It can be painful when 32 teeth try to fit in a mouth that holds only 28 teeth. These last teeth in each arch are your third molars, also known as “wisdom teeth”.

Why should I have my wisdom teeth removed?

Wisdom teeth are the last teeth to erupt within the mouth. When they align properly and gum tissue is healthy, wisdom teeth do not have to be removed. Unfortunately, this does not generally happen. The extraction of wisdom teeth is necessary when they are prevented from properly erupting within the mouth. They may grow sideways, partially emerge from the gum, and even remain trapped beneath the gum and bone. Impacted teeth can take many positions in the bone as they attempt to find a pathway that will allow them to successfully erupt.

These poorly positioned impacted teeth can cause many problems. When they are partially erupted, the opening around the teeth allows bacteria to grow and will eventually cause an infection. The result: swelling, stiffness, pain, and illness. The pressure from the erupting wisdom teeth may move other teeth and disrupt the orthodontic or natural alignment of teeth. The most serious problem occurs when tumors or cysts form around the impacted wisdom teeth, resulting in the destruction of the jawbone and healthy teeth. Removal of the offending impacted teeth usually resolves these problems. Early removal is recommended (before the age of 20) to avoid such future problems and to decrease the surgical risk involved with the procedure. As we age the roots of these teeth enlarge and encase a nerve passing below them (inferior alveolar nerve) and the risks of a jaw fracture and nerve damage increase.

With an oral examination and x–rays of the mouth, the oral and maxillofacial surgeon can evaluate the position of the wisdom teeth and predict if there are present or may be future problems. Studies have shown that early evaluation and treatment result in a superior outcome for the patient.

How is the surgery performed?

The surgery can be performed under local anesthesia, laughing gas (nitrous oxide/oxygen analgesia), intravenous sedation or general anesthesia. These options, as well as the surgical risks will be discussed with you before the procedure is performed. Once the teeth are removed, the gum is sutured. To help control bleeding, bite down on the gauze placed in your mouth. You will rest under our supervision in the office until you are ready to be taken home. Upon discharge, your postoperative kit will include postoperative instructions, a prescription for pain medication, antibiotics, and a follow up appointment in one week or two weeks. Most patients can return to normal activities 3-5 days after the surgery.