| WISDOM
TEETH
The average
adult has thirty-two teeth by age eighteen: sixteen teeth on the
top and sixteen teeth on the bottom. Each tooth in the mouth has
a specific name and function. The teeth in the front of the mouth
(incisors, canine and bicuspid teeth) are ideal for grasping and
biting food into smaller pieces while the back teeth, or molar teeth,
are used to grind food up into a consistency suitable for swallowing.
However, 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 four
other teeth are your Third Molars, also known as "wisdom teeth."
Why Should
I Remove My Wisdom Teeth?
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 erupt successfully.
These poorly
positioned impacted teeth can cause many problems. When they are
partially erupted, the opening around the tooth allows bacteria
to grow and will eventually cause an infection. The result: swelling,
stiffness, pain and illness. The pressure from the erupting wisdom
tooth 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 tooth, resulting in the
destruction of the jawbone and healthy teeth. Removal of the offending
impacted tooth or teeth usually resolves these problems. Early removal
is recommended to avoid such future problems and to decrease the
surgical risk involved with the procedure.
Oral Examination
With an oral
examination and x-rays of the mouth, our doctors can evaluate the
position of the wisdom teeth and predict if there may be present
or future problems. Studies have shown that early evaluation and
treatment result in a superior outcome for the patient. Patients
are generally first evaluated in the mid- teenage years by their
dentist, orthodontist or by an oral and maxillofacial surgeon.
All outpatient
surgery is performed under appropriate anesthesia to maximize patient
comfort. Our doctors have the training, license and experience to
provide various types of anesthesia to allow patients to select
the best alternative. These services are provided in an environment
of optimum safety, utilizing modern monitoring equipment and staff
experienced in anesthesia techniques.
Facts About
Wisdom Teeth and Impacted Teeth
 What
Are Wisdom Teeth?
Wisdom teeth are the third molars, the teeth in the upper and lower
jaws that are furthest back in the mouth. They start to form at
age 12 and can come into the mouth in the late teens. Before they
come into the mouth they are called unerupted.
What Are Impacted Teeth?
All teeth are formed deep within the jaw bones. As the root develops,
most teeth travel toward their future place in the dental arch.
This movement is called eruption. If a tooth travels in the wrong
directions, or it is blocked by another tooth or dense bone, it
is said to be impacted. Wisdom teeth that have not erupted by the
age of 17 to 20 may be impacted.
What Problems Can Wisdom & Impacted Teeth Cause?
Since it is not normal for a tooth to remain beneath the surface
after the age of 18 to 21, it is easy to understand why difficulties
develop. Some of the common difficulties are:
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1.
Infections: Many wisdom teeth and impacted teeth cannot
erupt into the mouth because the size of the jaw is too small.
The wisdom tooth stays partly buried in the bone and gum tissue
forming a gum pocket. This pocket cannot be cleaned; it is warm
and moist and food particles from the mouth can collect there.
Bacteria which are normally in the mouth then have perfect surroundings
in which to multiply. As the tissue gets swollen from the infection,
the upper wisdom tooth can bite down into this swollen tissue
making the infection worse. This may go on to cause the usual
signs of infection which are swelling, pain, temperature and
redness. This may be accompanied by inability to open the mouth,
difficulty in swallowing and a feeling of tiredness.
2. Cysts: A cyst is a sac of fluid that can develop around
impacted teeth. The cyst may destroy a great deal of jaw bone
as it gets larger. Unlike the infected wisdom tooth, there is
usually no pain or swelling until it is quite large.
3. Tumors: Tumors of different kinds can develop around
the crown of impacted teeth.
4. Cavities: Food is easily trapped between the impacted
tooth and the tooth in front of it. A cavity can form on the
tooth in front which is difficult to fill.
5. Overlapping Front Teeth: Wisdom teeth can push front
teeth as they erupt causing a crowded appearance. Therefore,
many orthodontists do not consider orthodontic treatment complete
until the wisdom teeth are removed. |
Should All Impacted Or Wisdom Teeth Be Removed?
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1.
Impacted Teeth: While it is true that not all impacted teeth
may cause the complications that have been described, no one
can tell by an X-ray which ones are going to give difficulty;
trouble usually comes unexpectedly and at inconvenient times.
Because older individuals do not tolerate the operation for
removal as well as younger people and the operation is more
difficult with advancing age, adults with impacted teeth are
advised to have them removed as early as possible. If a patient
waits until an impacted tooth causes trouble, he will first
have to be treated for the infection, or other complications,
before the operation can be done. This means additional loss
of time and expense, as well as added risk.
2. Wisdom Teeth: Not all wisdom teeth should be removed.
Third molars in normal position can be used to chew and are
not extracted except for obvious dental reasons, such as cavities
that cannot be filled, or otherwise untreatable gum disease.
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When Should Impacted Or Wisdom Teeth Be Removed?
Impacted wisdom teeth should be removed before they become infected.
(Healing will be better after surgery if the tissues are not diseased)
the best time to remove the wisdom tooth is when the root is half
to three-quarters formed. This usually occurs by the late teens.
At this stage of development, the tooth is easiest to remove and
healing is best. Other impacted teeth should be removed when they
are discovered, depending on the circumstances.
What Is It Like To Have An Impacted Tooth Removed?
Many ordinary teeth can be extracted simply by grasping the tooth
with a forceps and manipulating it carefully from the socket. That
is not possible with impacted teeth since they are partially or
completely beneath the surface. The removal of an impacted tooth
is an operation in every sense of the word. In many cases, the extensiveness
is similar to that of a tonsillectomy, or appendectomy. This is
not said to frighten the prospective patient, but to give a better
understanding about certain features regarding the cost, careful
preparations, and especially the need for good post-operative care.
The actual removal
of the tooth is done in keeping with surgical principles, meticulously
sterile instruments, good light, a dry operative field, and gentle
handling of the soft tissue and bone. Depending on the difficulty
of the procedure, it may last from 20 to 60 minutes. The wound may
be closed with stitches. Instructions will be furnished for home
care.
Are There Any Complications?
Any operation
carries some risk. This is reduced by adequate pre-operative appraisal
of your physical condition, by careful preparation of instruments
and all facilities, and by the skill of the operator. Lower impacted
teeth often rest on the main nerve to the lower jaw. Sometimes,
in spite of all precautions, this nerve may be bruised. If the nerve
is bruised, this may result in numbness of the lower lip on that
side. Usually this numbness is temporary. The effect does not last
more than a few weeks, in most cases, improving as the nerve repairs
itself and regenerates. The nerve involved is associated with feeling
only and has no effect on eating, talking or your appearance.
Upper impacted teeth may lie adjacent to the wall of the maxillary
sinus. These teeth are sometimes difficult to remove, but all precautions
will be used to see that no unnecessary injury occurs to this area.
If you would like to learn more about Wisdom Teeth, you may download
a printable document format (PDF) file at the following link:
http://www.aaoms.org/public/Pamphlets/WisdomTeeth.pdf
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