The third molars, called “wisdom teeth” because they usually become visible when a person is 17 to 25 — supposedly the time we achieve wisdom, may have adverse effects on adjacent teeth. Most adults have four wisdom teeth, although some people have more; and some, none at all. The wisest thing to do about wisdom teeth may be to have them removed if they are poorly positioned.

What is an impacted wisdom tooth?

If a wisdom tooth is pushing against gums, other soft tissues, or adjacent teeth at an awkward angle, it is referred to as “impacted.” Usually this occurs when there is not have enough room in the jaws for these last molars to fit next to their adjacent teeth. They can disrupt the gum tissue attachment of their neighboring teeth and the surrounding bone leading to periodontal disease and, ultimately, their loss.

In many cases, impacted teeth are painless, and those who have them have no warning of the problem. Thus it is important to have routine dental exams during the time when the third molars are coming in.

When should wisdom teeth be removed?

It is better to remove wisdom teeth early rather than waiting until periodontal (gum) disease has set in. As individuals age, keeping their wisdom teeth may lead to more serious problems. Periodontal defects tend to get worse in the presence of retained third molars. Furthermore, there is a higher incidence of postoperative symptoms in people over 25.

What are the pros and cons?

Removing impacted third molars can have a negative influence on the periodontal tissues of adjacent second molars. A number of techniques, such as scaling, root planing, and bacterial plaque control, can be used to minimize periodontal problems and promote healthy healing.

Surgical removal of wisdom teeth will involve some mild to moderate post-operative discomfort. Use of aspirin or ibuprofen for a few days after surgery will provide pain relief and control most swelling and symptoms. Antibiotics may be prescribed to ensure infection-free healing. It is important to keep the socket area clean by washing and rinsing with saline or antibacterial rinses. Careful surgery will promote good healing with minimal periodontal consequences to adjacent second molar teeth.

To decide whether your wisdom teeth should be removed, you will need an evaluation to assess the clinical health of the wisdom teeth, the neighboring teeth, and other vital structures. X-ray and digital imaging techniques play an important role in determining the exact position of the wisdom teeth in the jaw. A full assessment and consultation will include all the risks, benefits, likely consequences, and alternative treatment options. This will provide you with the wisdom you need to determine what is best for your wisdom teeth.

To learn more about wisdom teeth, read “To Be or Not to Be: What are the consequences of an impacted wisdom tooth?” Or contact us today to discuss your questions or to schedule an appointment.

Wisdom teeth are the third set of molars that erupt in the late teens or early twenties — so-called because they come in around the age of maturity or “wisdom.” While teeth are designed to last a lifetime, wisdom teeth are often problematic requiring early removal because they frequently become impacted, meaning they are not able to erupt fully through the gums to become healthy functioning teeth. However, not all wisdom teeth need to be removed if they are fully erupted and functional.

Prevention: Having a tooth submerged below the gum, pressing on the roots of neighboring teeth can cause damage and decay even though you may not be feeling any discomfort. By the time the tooth becomes painful, significant damage may already have occurred. In addition, the ability of the body to heal following oral surgery tends to decrease with age. A recent study sponsored by the American Association of Oral and Maxillofacial Surgeons and the Oral and Maxillofacial Surgery Foundation strongly recommends that wisdom teeth be removed in young adulthood in order to prevent future problems and to ensure optimal healing.

Reasons for Removal: If your wisdom teeth are impacted against (pressing on) the roots of other teeth, damage can occur. To prevent infections, gum disease, decay, or damage to other permanent teeth, our office may recommend removal of your wisdom teeth.

What to Expect: If wisdom teeth removal is recommended, it can generally be done in the dental office as a surgical procedure with local anesthesia and conscious sedation (twilight sleep). After the surgery, you may experience some moderate discomfort and swelling depending on the degree of impaction and difficulty. Taking non-steroidal anti-inflammatory medication like ibuprofen, or prescription medication for several days after surgery will provide pain relief and control swelling.

Contact us today to schedule an appointment to discuss any questions you may have regarding removal of your wisdom teeth. Read more about this topic in the Dear Doctor magazine article “Wisdom Teeth: To Be Or Not to Be?”