Third molars, more commonly known as wisdom teeth, enter the mouth between the ages of 17 and 25. They are the last teeth to develop and erupt into the mouth.
What Is an Impacted Tooth?
When a tooth is unable to fully enter the mouth, it is usually “impacted”. In general, impacted teeth are unable to break through the gums and become functional because there is not enough room. It is estimated more than 70% of adults have at least one impacted wisdom tooth¹.
What Kind of Problems are Caused by Impacted Teeth?
Impacted wisdom teeth can cause multiple problems, including pain, damage to neighboring teeth, and infection. Because these areas of the mouth are difficult to clean, wisdom teeth can develop cavities or collect bacteria leading to gum disease. Oral bacteria may travel from your mouth through the bloodstream, where it may contribute to systemic infections and illnesses affecting the heart and other organs.
Research has shown that once periodontal disease is established in the third molar areas, the problem is persistent and progressive. In general, these conditions improve following extraction of the teeth.
In some cases, a cyst or tumor can form around the impacted tooth. The cyst can lead to more serious problems, including damage to adjacent teeth or other surrounding structures.
Wisdom Teeth Growth by Age
Usually, wisdom teeth are easier to remove when the patient is younger because the roots of the teeth are not completely formed and the surrounding bone is softer. Removal of wisdom teeth at a later age often becomes more complicated as the roots will be more developed, may be closer to nerves or other anatomic structures, and the jawbone is denser.
If My Wisdom Tooth Isn’t Painful, Do I Still Need Treatment?
Many people believe as long as they are not in pain, they do not have to worry about their wisdom teeth. However, pain-free does not mean disease or problem free. In fact, wisdom teeth that erupt normally may still be prone to disease, according to a study by the American Association of Oral and Maxillofacial Surgeons and the Oral and Maxillofacial Surgery Foundation. AAOMS strongly recommends patients be evaluated in their early teenage years to assess the presence of third molars, disease status, and to suggest management options ranging from removal to active surveillance to ensure optimal patient-specific outcomes.
In general, dental and medical professionals agree wisdom teeth should be removed in the following instances:
- Dental pain
- Poor oral hygiene
- Periodontal (gum) disease
- Cysts, tumors or other pathology
- Damage to neighboring teeth
Wisdom teeth that are completely erupted and functional, painless, cavity-free, in a hygienic environment with healthy gum tissue, and are disease-free may not require extraction. They do, however, require regular professional cleaning, annual check-ups and periodic radiographs to monitor for any changes.
What Happens Before Surgery?
If your dentist recommends your wisdom teeth be removed, an oral and maxillofacial surgeon has the greatest amount of training and expertise in wisdom tooth removal. Before surgery, your oral surgeon will discuss the procedure with you and tell you what to expect. This is a good time to ask any questions. Be sure to let your OMS know about your full medical and anesthesia history, as well as any known family issues with anesthesia, and the medications you are taking.
Your OMS will discuss anesthetic options that are safe for you, which may include local anesthesia, minimal sedation (nitrous oxide), intravenous sedation, or general anesthesia. You will also receive instructions to follow on the day of the procedure, including if you cannot eat or drink anything in the hours before your surgery and if you need someone to drive you on the day of surgery.
What Happens During Surgery?
Many patients have their treatment at the oral and maxillofacial surgery office. After anesthesia is administered, the wisdom teeth are removed. Generally, third molars can be removed with little or no pain, and most procedures take less than one hour.
What Happens After Surgery?
Following surgery, you may experience some swelling and mild discomfort, which are part of the normal healing process. Cold compresses may help decrease the swelling, and medication prescribed by your oral and maxillofacial surgeon can help manage the discomfort. You may be instructed to modify your diet following surgery and later progress to more normal foods.
What if I Decide to Keep My Wisdom Teeth?
Discuss your situation with an oral and maxillofacial surgeon first. If you decide to keep your wisdom teeth, be sure to take particular care in cleaning and flossing your teeth, especially the molars. Your third molars must be professionally examined and cleaned regularly. Radiographs of your wisdom teeth should be taken every year to make sure your teeth, gum tissue, and jawbone remain healthy.
Article Courtesy of AAOMS, https://myoms.org/
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