As we age from childhood into adulthood we lose our baby teeth and our adult teeth move into position to replace them. By our mid-teens all of our teeth, with the exception of our wisdom teeth, are fully developed and visible in the mouth. Given that they usually erupt around the age of 18, it is no surprise that 3rd molars are called “wisdom teeth”. Unfortunately they are anything but wise!
See, most people have just enough room in their mouths for 28 fully functional teeth, but Mother Nature has us develop 32. This means that most of us don’t have room in our mouths for our four wisdom teeth to fully erupt,, at least not without negative effects.
Why should I have my Wisdom Teeth Removed?
If you have fully erupted wisdom teeth (meaning they are straight in the mouth with plenty of room around them), and you keep them scrupulously clean (that means brushing and flossing behind them), then they often do not have to be removed. Unfortunately this is pretty rare, for most people there is inadequate space for the wisdom teeth to properly erupt and it can be difficult keeping them well cleaned tucked all the way in the back of the mouth
If you are lucky enough to have fully erupted wisdom teeth your dentist may still recommend their removal. The reasons for this are that 3rd molars are notoriously difficult to keep clean and often compromise the periodontal health of the 2nd molars (the teeth in front of them). They also may be more prone to decay and fillings on wisdom teeth, while sometimes possible, are often fraught with problems which leads to a poor seal on the fillings – leading to recurrent cavities.
Wisdom teeth without room to erupt will still try their best to make it into the mouth. This tends to cause partial impactions – where the tooth is partially visible in the mouth and partially still under the gum and bone. This sets up a recipe for disaster ,as oral bacteria and food debris can get underneath the gums – but a toothbrush can’t reach the tooth! This situation often leads to inflammation and infections around the tooth making for a painful and possibly dangerous situation.
Even when wisdom teeth remain fully covered by gum and bone we recommend early removal. Impacted teeth that are unable to erupt can sometimes form cysts or tumors within the bone. These lesions can be completely asymptomatic and may not be discovered until they are involving a large part of the jaw.
Early removal of wisdom teeth is recommended to avoid the aforementioned problems. It is also far easier for younger people to heal and recover from surgery. Although we have taken out wisdom teeth on patients in their80’s – the ideal time is between the ages of 16 – 22 years old.
Not sure if you need your wisdom teeth removed? Come into our office and meet with Dr. Martin and Dr. Appelblatt. Drs. Martin and Appelblatt will preform a thorough examination of your dentition, including taking current x-rays to see the location of your wisdom teeth. After the evaluation they will sit down with you to explain the condition of the teeth and discuss their recommended treatment plan. Early evaluation (before problems occur) and treatment results in superior outcomes for our patients.
The Removal Process
To maximize patient comfort, the procedure to remove wisdom teeth is usually preformed under anesthesia.. Dr. Martin and Dr. Appelblatt are both fully licensed to preform various types of anesthesia, including local and IV sedation (general) anesthesia. The options of anesthesia, as well as the risks and benefits of anesthesia and the surgery itself will be fully discussed with you before your surgery.
On the day of surgery, if you have chosen to have IV sedation anesthesia, you will arrive at the office with an empty stomach and someone to drive you home. Our wonderful oral surgery assistants will set you up with all of the specialized equipment we use to monitor you while you are asleep. Once fully set up, Dr. Martin or Dr. Appelblatt will place a small IV and administer the sedation. The next thing you know, the procedure is over and you are waking up with gauze in your mouth. You are monitored in our office after the procedure until it is safe for you to be discharged. We will send you home with a postoperative packet which will contain extra gauze, written postoperative instructions, “Sockit” (a medication to help with postop pain), and any prescriptions you require.
Our office will call you in the days following your procedure to check in and make sure you are healing as expected. We find that, in general, patients don’t need to return to see us for a post-op appointment after their wisdom teeth extractions. But if you would like to be seen, just let us know and we would be happy to make that appointment for you. If you have any questions after your surgery – please don’t hesitate to give us a call. We are always happy to answer any questions you may have!
Having Third Molar Surgery from AAOMS.org on Vimeo.