What are Wisdom Teeth?

Wisdom teeth are the third molars, the last teeth in the dental arch and last to develop and appear in your mouth. There are typically four that are located in the back of the mouth, with two on the top and two on the bottom. These teeth usually erupt between the ages of 17 and 25, although some people do not ever develop wisdom teeth.

Are Wisdom Teeth Always Removed?

Every person is unique and the decision for wisdom teeth removal is based off of a clinical examination, x-ray or 3D x-ray (cone beam CT) consultation and a discussion between the dentist and the patient. The wisdom tooth examination ideally occurs in the late teenage years, while the teeth are still developing.

Wisdom teeth may occasionally cause pain. When they first erupt, or even beforehand, you may feel a dull pain in the back of the jaw, and this is usually normal. Dental pain should always be evaluated by a dentist to see if there is an issue with the gum tissue, the position of the teeth,  impaction, or hygiene habits.

The most common options for our patients are to extract the teeth or to pursue active surveillance.  Standard indications  for removal include evidence that predicts periodontal (gum) disease, cavities that cannot be fixed, infections, cysts or tumors, and damage to neighboring teeth. Active surveillance involves the dentist noting the current condition of the wisdom teeth and following it closely over time.  Clinical and x-ray examinations are utilized to monitor for any changes and signs of disease.  Third molars can be retained under active surveillance when they are completely erupted and functional, painless, free of cavities, disease free, and in a position that can be kept clean and healthy.

What are Impacted Wisdom Teeth?

Some wisdom teeth are unable to fully enter the mouth, and these are considered to be “impacted” teeth.  Most commonly, a tooth is impacted because there is not enough room in the mouth and the tooth is not able to fully erupt.

Complications that may arise from these impacted wisdom teeth include infection (they are very hard to clean), inflammation, damage to adjacent teeth or cysts.  An oral-systemic link related to wisdom teeth exists and has been documented.  Impacted wisdom teeth are prone to infection, and may affect overall health. The bacteria that cause the infection can enter the bloodstream and affect important organs like the heart and kidneys as well as increase systemic inflammation.

Wisdom Teeth Removal Procedure

Wisdom teeth should be carefully evaluated. If we decide that the wisdom teeth are vulnerable and should be extracted, we will discuss the procedure and tell the patient what to expect.  Many factors such as how the tooth is positioned, stage of root development, or impaction will determine how easy it will be to remove the wisdom teeth.

Most of the time third molars can be removed with little or no pain. Patients are usually given either local anesthesia or nitrous oxide (laughing gas).  After the procedure, we give the patient a full complement of natural supplements to improve the healing of the extraction sites and ensure the body fully repairs itself.

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