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Oral Surgery: The Wisdom Teeth Removal Procedure

Wisdom teeth, those third molars at the very back of our mouths, are so named because they generally erupt during late adolescence and early adulthood. When properly positioned they can be a valuable asset to us. When the jaw is not large enough to accommodate these wisdom teeth, they can cause dental problems, such as infection, requiring wisdom tooth removal.

Wisdom Teeth in Teens

Wisdom teeth usually appear in young adults between the ages of 15 and 25. Some wisdom teeth will grow in normally; others are "impacted." An impacted wisdom tooth allows no room for the rest of your teeth to grow. Dentists use X-rays to evaluate whether your wisdom teeth have any chance of coming in properly and can advise you on the best time to have wisdom tooth removal.

Why Are Wisdom Teeth Removed?

When there is no room for wisdom teeth to come in properly or when the teeth haven't reached their permanent location by age 25, then they're considered to be impacted wisdom teeth. Dentists recommend removing the tooth early, before wisdom tooth and other dental complications can develop.

Partially visible wisdom teeth are susceptible to bacteria that can cause wisdom tooth infection. Cysts and tumors can grow on a trapped wisdom tooth, causing irritation and some pain as well as diseases of the gums. Another problem occurs when the second molar, the last tooth before the wisdom tooth, is damaged as the wisdom tooth grows in without enough room.

The younger the patient, the easier the healing will be, which is another reason not to wait before removing impacted wisdom teeth. This oral surgery will be performed in the office of either a dentist or an oral surgeon, under anesthesia, providing patients with maximum comfort while keeping the procedure efficient and cost-effective. Local anesthetic (such as Novocain) is always used, but you may opt for additional comfort with nitrous oxide ("laughing gas"), IV sedation (twilight sleep) or deep sedation (general anesthesia.)

Wisdom Tooth Removal

An oral surgeon or your dentist can provide guidance whether you're a candidate for wisdom teeth removal (extraction). The bottom line is that wisdom teeth most often don't fit well in our mouths and they can cause other teeth to move or lead to gum disease or bone problems. Ask the dentist to make an evaluation and suggest the best course of action!

by Brian J. Gray, DDS, MAGD, FICO

+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.

Does a Dental Biopsy In My Mouth Mean I Have Oral Cancer?

The short answer is no.

A dental biopsy is a technique of removing some tissue in order to examine it under a microscope. Most biopsies are done by administering some local anesthetic and then removing a segment of tissue with a scalpel. The indication for a biopsy is for any lesion or entity that is not normal.

Many conditions that affect the skin, for example, psoriasis, can also affect the mouth. Without a biopsy, one cannot be certain of the diagnosis. Sometimes there are patches on the tongue or lip that become rather thick and white, or parts of the skin of the mouth (mucous membrane) can break away, leaving raw and painful areas.

In order to determine the exact nature of the condition, a biopsy is necessary. Once the diagnosis is made, the appropriate therapy is administered.

Sometimes a biopsy is required because a small lump appears on the lips, cheeks, or tongue. It can be a nuisance in that it may cause concern or it may be traumatized by inadvertently being chewed on.

Some children (and adults) have a habit of chewing their lips and this can traumatize the small salivary glands in those areas. The glands can swell and form mucoceles. Mucoceles are areas of saliva ballooning up in the tissues after the duct has been partially obstructed. They usually are a painless, blue-domed, raised structure that almost always appears in the lower lip. Often, the only way to eliminate them is to excise them by performing a biopsy.

A recent development is the OralScan CD, in which a pipe-stem-like brush is swept across abnormal tissue (without use of a local anesthetic) and then the brush is drawn over a glass slide and a fixative solution is added. The slide is then examined by an advanced computer system for the presence of abnormal cells. This later technique is not similar to a Pap smear because it does not examine superficial cells, but instead examines the deeper or basal cells in the lesion.

Just as in the rest of the body, any lump, ulcer, sore or odd-appearing tissue should have a biopsy done on it if is still present two weeks after whatever is thought to have caused it is removed. Again, a dental biopsy does not mean you have oral cancer.

by Myer Leonard, DDS, MD

+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.