Third molars, commonly referred to as wisdom teeth, are usually the last four of 32 teeth to erupt (surface) in the mouth, generally making their appearance between the ages of 17 to 25. They are located at the back of the mouth (top and bottom), near the entrance to the throat. The term “wisdom” stems from the idea that the molars surface at a time typically associated with increased maturity or “wisdom”.

There are several types, or degrees, of impaction based on the actual depth of the teeth within the jaw:

Soft Tissue Impaction: The upper portion of the tooth (the crown) has penetrated through the bone, but the gingiva (gum) is covering part or all of the tooth’s crown and has not positioned properly around the tooth. Because it is difficult to keep the area clean, food can become trapped below the gum and cause an infection and/or tooth decay, resulting in pain and swelling.

Partial Bony Impaction: The tooth has partially erupted, but a portion of the crown remains submerged below the gum and surrounding jawbone. Again, because it is difficult to keep the area clean, infection will commonly occur.

Complete Bony Impaction: The tooth is completely encased by jawbone. This will require more complex removal techniques.

Reasons to remove wisdom teeth

While not all wisdom teeth require removal, wisdom teeth extractions are most often performed because of an active problem such as pain, swelling, decay or infection, or as a preventative measure to avoid serious problems in the future.  

In most cases, inadequate space in the mouth does not allow the wisdom teeth to erupt properly and become fully functional. When this happens, the tooth can become impacted (stuck) in an undesirable or potentially harmful position. Left untreated, a number of potentially harmful outcomes can occur, including:

Damage to nearby teeth: Second molars (the teeth directly in front of the wisdom teeth) can be adversely affected by impacted wisdom teeth, resulting in tooth decay (cavities), periodontal disease (gum disease) and possible bone loss.

Disease: Cysts and tumors can occur in the areas surrounding impacted wisdom teeth.

Infection: Bacteria and food can become trapped under the gum tissue, resulting in an infection. The infection can cause considerable pain and danger.

Tooth Crowding:  Impacted wisdom teeth can put pressure on other teeth and cause them to become misaligned or crowded, disrupting the orthodontic or natural tooth alignment.

Early removal of impacted wisdom teeth is recommended to avoid such future problems and to decrease the surgical risk of the procedure.

 

Wisdom teeth examination

As with any procedure, the oral surgeon will want to first perform an examination of the wisdom and surrounding teeth. Panoramic x-ray will be taken to evaluate the position of the wisdom teeth and determine if a current problem exists, or the likelihood of any potential future problems. X-rays can also expose additional risk factors, such as deterioration or decay of nearby teeth. Early evaluation and treatment is recommended in order to identify potential problems and to improve the results if extractions are needed. Only after a thorough examination can we provide you with the best options for your particular case.

What does the removal of wisdom teeth involve?

Wisdom teeth removal is a common procedure, generally performed under intravenous (IV) sedation by an oral surgeon in an office outpatient surgery setting. For single or less complicated extractions, the procedure can be done under local anesthesia or with nitrous oxide. Surgery can be completed comfortably within an hour and you will be released with post-operative instructions and medication, to help manage any swelling or discomfort.