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
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. If left untreated, impacted
wisdom teeth can contribute to infection, damage to other teeth, and
possibly cysts or tumors.
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. If impaction of one or more
wisdom teeth is present, and 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: Although uncommon, 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: It has been theorized
that impacted wisdom teeth can put pressure on other teeth and cause
them to become misaligned (crowded or twisted). This theory isn’t
universally accepted by all dental professionals, and it has never been
validated by any scientific studies.
Wisdom teeth examination
As with any dental procedure, Dr. Stephen Fitch will want
to initially conduct a thorough examination of the wisdom and
surrounding teeth. Panoramic or digital x-rays will be taken in order
for Dr. Stephen Fitch to evaluate the position of the wisdom teeth and
determine if a current problem exists, or the likelihood of any
potential future problems. The x-rays can also expose additional risk
factors, such as deterioration or decay of nearby teeth. Early
evaluation and treatment (typically in the mid-teen years) is
recommended in order to identify potential problems and to improve the
results for patients requiring wisdom teeth extractions. Only after a
thorough examination can your dentist 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 local anesthesia, intravenous (IV) sedation, or general
anesthesia by a specially trained dentist in an office surgery suite.
The surgery does not require an overnight stay, and you will be released
with post-operative instructions and medication (if necessary), to help
manage any swelling or discomfort.