Wisdom Tooth Extractions

The short answer is no.  Some people may develop less than four, or none at all.  Whereas others may develop more than four!  The answer rests with the genetics of the individual.

Wisdom teeth become a cause for discussion when they become problematic.  Problems with wisdom teeth typically occur with Impacted Wisdom teeth.

You may become aware of your wisdom teeth by experiencing pain, soreness or swelling when they are erupting into your mouth.  The “teething” process involved with wisdom teeth eruption usually occurs between the age of 16 to 24 depending on the individual.   

Or you may become aware of your wisdom teeth as a result of pain or swelling associated with an impacted wisdom tooth.

Impacted wisdom tooth (or teeth) is a dental condition whereby the third molar is prevented from erupting into the mouth fully or at all.  This is caused by a physical barrier such as other teeth in the way, by reduced space due to a small mouth and big teeth, and by poor angulation during eruption.  These conditions can result in a partially erupted wisdom tooth.

Complete Impaction is when the wisdom tooth (or teeth) is present in the jaw but unerupted in the mouth.  Indication of this is confirmed by a physical exam and an x-ray such as a Panorex.   

The answer to this question depends on a few factors:

• The nature of the impaction (fully or partial) and the impact of this condition on the adjacent teeth and supporting bone.
• The potential of future problems.
• The personal philosophies of you and your Dental Health Care Professional (your dentist!).

If your wisdom teeth fit well in your mouth, are easy to clean, and contribute to good function, then you really do not have a problem.  However, if these conditions do not exist you may develop associated problems.

Fully or partially impacted wisdom teeth could result in:

• The development of dental cysts affecting health of the surrounding bone, teeth and soft tissue such as your dental nerves.
• Dental caries on the partially erupted wisdom tooth leading to the development of caries on the adjacent tooth, or a dental abscess on the impacted tooth itself.
• Is affecting the periodontal (gum) health of adjacent teeth.
• Repeated soft tissue infections of the tissue around the erupting tooth (called Pericoronitis).

Pericoronitis is the most common problem associated with impacted wisdom teeth.  Pericoronitis is an infection of the soft tissue (gums) around a partially erupted wisdom tooth. It is commonly caused by either a bacterial infection from food impaction, or by repeated trauma to the tissue through chewing.  

Antibiotics will address the immediate infection and soft tissue surgeries may temporized the situation, however pericoronitis will reoccur if the source of the problem remains untreated.  Typically, the most common treatment of pericoronitis is the extraction of the partially erupted wisdom tooth.

Depending on the presentation of your particular situation, there are a few ways to approach wisdom tooth extraction.

• Simple extractions could require an in-office visit with Dr Tina and nothing more than local anesthetic prior to extracting the tooth.
• A more involved situation – a potentially more difficult extraction, and/or high patient anxiety about the surgery – could require an in-office visit using oral sedation in conjunction with local anesthetic.
• Difficult extractions could require a referral to an oral surgeon for consultation and discussion of treatment options that include IV sedation or General Anesthetic.

Typical post-operative expectations include:

• Some swelling, bleeding, and pain lasting approximately two to three days. Post-op bruising is dependent on the difficulty of the extraction and on the physical response of the individual.  Some people bruise easily. . . some people don’t.
•  A post-op appointment to remove any sutures usually occur around day seven.
• Verbal and written post-op instructions are given on the day of surgery.  However, it is wise to plan to take a few days off from regular activities to rest, ice your face and to relax.
• If you have any questions once you arrive home following your surgery, or during your post-op course, please call the office or email Dr. Tina directly.