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Oral surgery

What are wisdom teeth?

Wisdom teeth are another name for any one of four third molars found in the permanent dentition. These teeth are the last or most posterior teeth in the dental arch. Although most people have wisdom teeth, it is possible for the third molar to never develop or become impacted (not normally erupted through the gums) under the gingival tissue.

How do I know if I have wisdom teeth?

You know if you have wisdom teeth by examining your mouth and finding three permanent molars in each dental quadrant. However, if the tooth is impacted under the tissue, presence of the tooth needs to be verified by a radiograph. A panoramic X-ray is usually preferred to help assess the angle of eruption and state of development of the tooth. Most wisdom teeth can be visualized erupting through the gingiva in early adulthood, between the ages of 16 to 23. Your general dentist will often inform you of the condition of these teeth.

Do all wisdom teeth need to be extracted?

Not all wisdom teeth need to be extracted. When a wisdom tooth erupts cleanly through the tissue without compromising the adjacent tooth, the wisdom tooth can be retained in the mouth with little concern. wisdom tooth However, removal of the wisdom tooth is indicated if the tooth has partially erupted through the gingival tissue causing inflammation and at times infection. A soft tissue growth over a partially erupted wisdom tooth is referred to as an operculum. If bacteria are trapped under the operculum, swelling with an associated bad taste can occur; this is called a pericoronitis. The wisdom tooth can also erupt at an angle such that the adjacent molar can become difficult to keep clean and free of dental caries. If the third molar has erupted through the tissue but is without opposing occlusion (contact with other teeth), extraction should still be considered. Considering the posterior position of an erupted wisdom tooth, these teeth are often difficult to keep clean.

How is wisdom teeth extraction performed?

Once a wisdom tooth is deemed problematic, extraction by an oral surgeon or qualified general dentist is usually indicated. Local anesthesia is administered to ensure the tooth can be pulled out without any discomfort. A minor surgery is performed where the tissue and bone around the wisdom tooth are removed so that the tooth can be cleanly extracted from the socket. Several stitches may be needed to close the surgical site and promote healing of the overlying tissue.

extraction cartoon
What is the recovery like after wisdom teeth extraction?

The recovery and healing from wisdom tooth extraction usually occurs over a 48 to 72 hour period. It is normal to have slight bleeding (oozing) from the site considering the surgical procedure performed. The bleeding should start to ease after the first 24 hours. Pain medication is often prescribed to help with any postoperative symptoms and discomfort. Adhering to the postoperative instructions of the surgeon is important to minimize any complications.

What are the potential risks and complications of wisdom teeth extraction?

Although the postoperative recovery is usually uneventful, problems can occur. The most common adverse occurrence of a wisdom tooth extraction is a dry socket or alveolar osteitis. This condition is created when the blood clot in the surgical site accidentally dislodges. Once this occurs the bone along the extraction socket can become inflamed and painful. If a dry socket occurs the surgeon should be contacted. This complication is easily treated and often resolves quickly with a packing medication or stimulation of a new blood clot. More serious complications are rare but can include injury to the adjacent inferior alveolar nerve or problems with the temporomandibular joint as a result of trauma to the area. The potential risks of wisdom tooth extraction should be reviewed with your dentist. If a wisdom tooth is deemed compromised, removal of the tooth in adolescence is advantageous to extracting the tooth in late adulthood. Discussion with your dentist about the condition of the wisdom teeth and timeline for the extractions is important and will help minimize complications.