Wisdom Teeth: The good, bad, and ugly
Though wisdom teeth, also known as third molars, may not cause problems for everyone, these teeth are often removed to prevent more serious issues like an abscess or periodontal problems. Wisdom teeth typically begin to surface in the late teens to early 20s, often times staying impacted (submerged under the gums/bone) as they develop, growing sideways into the other teeth or angled forward.
Wisdom teeth may erupt from the gumline or may stay impacted in the jaw. Partially erupted wisdom teeth may present several issues as these teeth are difficult to clean and care for. Common complications of partially impacted wisdom teeth include pericoronitis (gum infection), which causes on-and-off pain, or localized periodontitis (bone and gum disease), where bone and possibly tooth structure of adjacent teeth become affected by the partially impacted wisdom tooth. Extractions are typically handled by a more experienced dentist or specialist, such as Dr. Parsi, since there are many vital structures and nerves that require a thorough understanding of the anatomy.
Do I Need My Wisdom Teeth Removed?
Most dental professionals will recommend having your wisdom teeth removed if you experience any of the following scenarios:
- You’ve experienced chronic pain in your gums around your wisdom teeth. Pain in your gums can indicate an infection. Often, foul-smelling odors accompany these infections and add to the problem. Partially erupted wisdom teeth are prone to infections because food and bacteria get trapped in the envelope created between the wisdom tooth and its overlying gum tissue. Having your wisdom teeth removed can prevent further infection. Another option, which will be discussed at your planning appointment, is an operculectomy. Operculectomies remove just the tissue above the wisdom tooth, leaving the wisdom tooth intact and much more hygienic.
- Your wisdom teeth don’t fit in your mouth. On average, a total of 28 teeth are in the oral cavity by age 17. Many do not have enough room in their jaw for 32 teeth, therefore creating a potential for wisdom teeth to become impacted. Impacted means the wisdom teeth cannot fully erupt or they may become misaligned. It’s important to remember that not all impacted wisdom teeth become problematic. However, if there’s a tooth-size vs available space discrepancy, your dentist may recommend removing them before wisdom teeth problems occur in the first place.
- Your wisdom teeth are causing tooth decay to adjacent teeth. Wisdom teeth can be difficult to keep clean because of their location in the mouth. Flossing and brushing can be challenging and without good oral care, gum disease and tooth decay can develop. Removing your wisdom teeth can prevent tooth decay issues in surrounding teeth as well as the wisdom teeth. This is another reason why early detection and treatment is absolutely essential.
- Your wisdom teeth aren’t coming in straight. Often, wisdom teeth will not grow in straight and can cause your teeth to shift and move over time. Additionally, this angulated eruption of the wisdom teeth can provide an excellent plaque/food trap for bacteria. To prevent your teeth from moving, or becoming food traps, removing your wisdom teeth is highly recommended.
What Happens During Wisdom Teeth Extraction/Surgery?
Prior to the surgery date, Dr. Parsi will discuss the procedure with you and let you know what to expect (pre-op instructions) before, during, and after the extraction. On the day of your wisdom tooth extraction, you will be given a local anesthetic to numb the area. You may also be given oral, nitrous, or IV sedation especially if all of your wisdom teeth will be removed at one time (preferred). The local anesthetic alone will prevent pain and sedation will give you the illusion of having slept through the entire procedure.
To remove the wisdom teeth, Dr. Parsi will open the gum tissue over the tooth and remove any bone that is over the tooth (if it’s impacted). The whole tooth is then either extracted or cut into smaller pieces to make it easier to remove. After the tooth is removed, dissolvable stitches may be placed.
How Long Does Wisdom Teeth Extraction Take?
There are several factors that will affect how easy it is to remove the wisdom teeth. If the tooth has fully erupted, it is a similar procedure to a typical tooth extraction. However, if the tooth is fully impacted or if the teeth have not erupted through the gums the surgery may be more complicated, and hence, lengthier. Typically extractions range anywhere between a few minutes to a few hours. Your specific case will be discussed at the initial consult appointment.
No matter how complicated the procedure, Dr. Parsi will make sure he and his staff take care of you and hold your hand every step of the way. A common phrase we hear is “Is that it?” Or our other favorite, “did you already do it?”