Wisdom teeth are the third molars and usually erupt in the late teens to early twenties. When positioned correctly, they will appear just behind the second molars. Commonly, wisdom teeth are misaligned or there is not enough room in the mouth for the teeth. Wisdom teeth may remain partially or entirely within the jawbone and soft tissue, in a condition called “impacted.”
Misaligned teeth may damage adjacent teeth or trap debris. Impacted teeth are prone to gum disease, infection and decay. When wisdom teeth are misaligned, the mouth is over crowded or when the teeth are impacted, an extraction is usually recommended.
The ease of the extraction is based on the condition and position of the tooth. A fully erupted, non-decayed tooth is easily extracted. Impacted and misaligned teeth may require oral surgery. It is sometime necessary to remove the tooth in small sections in an effort to decrease the amount of bone requiring removal to access the tooth.
A local anesthetic will be administered prior to the extraction. This is the same numbing agent used when a cavity is filled. Additional medications may be utilized to reduce the anxiety of the patient. Nitrous oxide, oral sedation and intravenous sedatives will provide varying levels of sedation.
The healing process is heavily dependent on the type of surgery required to remove the tooth. Generally, the following can be expected: bleeding, facial swelling, pain medications and antibiotics. Signs to watch for following the extraction are dry sockets and parasthesia. Dry sockets occur when the blood clot is pulled from the extraction site. This usually occurs when the patient engages in an activity that requires a sucking motion (drinking from a straw, smoking a cigarette). Dry sockets are extremely painful and must be treated by a dentist. Wisdom teeth are often near facial and oral nerves. Parasthesia occurs when the nerve is disrupted by the extraction. The patient may experience numbness of the tongue, chin or lip. The numbness can last a few days or may, in rare cases, be permanent.
The decision to remove wisdom teeth should be made only if keeping them is detrimental to the health of the patient. When wisdom teeth are healthy and fully erupted, only careful oral hygiene is needed to ensure that complications do not occur.