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Wisdom Teeth Removal

Wisdom Teeth, Their Benefits and Problems

Wisdom teeth, also known as third molars, are the last teeth to erupt in your mouth. This generally occurs between the ages of 17 and 25, a time of life that has been called the “Age of Wisdom,” thus the name!

Anthropologists note that the rough diet of early humans resulted in the excessive wear of their teeth. Normal drifting of the teeth to compensate for this wear ensured that space was available for most wisdom teeth to erupt by adolescence.

The modern diet, which is much softer, and the popularity of orthodontic tooth straightening procedures produce a fuller dental arch, which quite commonly doesn’t leave room for the wisdom teeth to erupt, thereby setting the stage for problems when the final four molars enter the mouth.

Growth ofWisdom Teeth at ages of 12, 14, 17 and 25

Wisdom Teeth  Wisdom Teeth  Wisdom Teeth  Wisdom Teeth

What is an Impacted Tooth?

A tooth becomes impacted when there is a lack of space in the dental arch and its growth and eruption are prevented by overlying gum, bone or another tooth.

  Impacted Tooth  

How Serious is an Impacted Tooth?

Impacted teeth can be painful and lead to infection. They may also crowd or damage adjacent teeth or roots. More serious problems may occur if the sac surrounding the impacted tooth becomes filled with fluid and enlarges to form a cyst. As the cyst grows it may hollow out the jaw and permanently damage adjacent teeth, the surrounding bone and nerves. Rarely, if a cyst is not treated, a tumor may develop from its walls and a more serious surgical procedure may be required to remove it.

Despite the considerable concern regarding impacted third molars, a recent study sponsored by the American Association of Oral and Maxillofacial Surgeons and the Oral and Maxillofacial Surgery Foundation finds that third molars which have broken through the tissue and erupted into the mouth in a normal, upright position may be as prone to disease as those third molars that remain impacted.

Complications such as infection (fig. a), damage to adjacent teeth (fig. b) and the formation of cysts (fig. c) may arise from impacted teeth.

Wisdom Teeth Infection

Fig a

Wisdom Teeth Crowding

Fig b

Wisdom Tooth Cyst

Fig c

Must the tooth come out if it hasn't caused any problems yet?

Many people believe that as long as they are not in pain, they do not have to worry about their wisdom teeth. However, pain free does not mean disease or problem free. In fact, wisdom teeth that come in normally may still be prone to disease, according to a study by the American Association of Oral and Maxillofacial Surgeons and the Oral and Maxillofacial Surgery Foundation. AAOMS strongly recommends that third molars be evaluated by an oral and maxillofacial surgeon by the time a patient is a young adult in order to assess the presence of third molars, disease status, and to suggest management options ranging from removal to a monitored retention plan to ensure optimal patient-specific outcomes.

In general, dental and medical professionals agree that wisdom teeth should be removed in the following instances:

  • Infections and/or periodontal disease
  • Cavities that cannot be restored
  • Pathologies such as cysts, and tumors
  • Damage to neighboring teeth.

Wisdom teeth that are completely erupted and functional, painless, cavity-free, in a hygienic environment with healthy gum tissue, and are disease-free may not require extraction. They do, however, require regular, professional cleaning, annual check-ups and periodic radiographs to monitor for any changes.

What Happens During Surgery?

Before surgery, Dr. Fatemi will discuss the procedure with you and tell you what to expect. This is a good time to ask questions. Also talk to him about any concerns you have. Be sure to let him know about any illness you have and medications you are taking.

There are several conditions that affect how easy it will be to remove a wisdom tooth. These conditions include how the tooth is positioned and the stage of root development. If the wisdom teeth are impacted the surgery might be more complicated.

Most of the time third molars can be removed with little or no pain. Patients are given either local anesthesia, intravenous sedation or general anesthesia. Dr. Fatemi will recommend the option that is right for you.

What Happens after Surgery?

Following surgery, you may experience some swelling and mild discomfort, which are part of the normal healing process. Cold compresses may help decrease the swelling, and medication prescribed can help manage the discomfort. You may be instructed to modify your diet following surgery and later progress to more normal foods.

What if I decide to keep my wisdom teeth?

If after discussing your situation with Dr. Fatemi, you decide to keep your wisdom teeth, be sure to take particular care in cleaning and flossing your teeth, especially the molars. Your third molars must be professionally examined regularly and x-rays of your wisdom teeth should be taken every year to make sure that the health of your teeth and gum tissue does not change.

For your convenience, Dr. Fatemi offers flexible hours, including Saturday hours, to accommodate your dental needs.

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