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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.

Oral Surgeons and Wisdom Tooth FAQ

Q. What is an oral surgeon?

A. An oral surgeon is a dentist that performs many aspects of surgery in and about the head area including wisdom tooth removal. They can perform simple to extremely difficult extractions, such as wisdom teeth extraction. They also perform dental biopsies and remove tumors in the head and neck region. Most place implants in the jaw for future restorations and do complex jaw realignment surgeries. They usually have four or more years of continuing education after graduating dental school, and most limit their practice to only oral surgery.

Q. What is oral surgery?

A. Oral and maxillofacial surgery is the specialty of dentistry that includes diagnosis, surgical, and adjunctive treatment of diseases, injuries, and defects involving both the functional and esthetic aspects of the head, face, mouth, teeth, gums, jaws, and neck. An example of oral surgery would be extracting an impacted wisdom tooth or even extracting multiple impacted wisdom teeth.

Q. What are wisdom teeth?

A. Wisdom teeth are third molars. Normally people have three permanent molars that develop in each quadrant of the mouth; upper, lower, right and left. The first molars usually grow into the mouth at around six years of age. The second molars grow in at around age 12.

The third molars, wisdom teeth, usually will try to grow in at around age 18 to 20 years. Since that is considered to be the age when people become wiser, third molars gained the nickname, "wisdom teeth".

Actually, wisdom teeth are no different than any other tooth except that they are the last teeth to erupt, or grow into the mouth. Wisdom teeth are just as useful as any other tooth if they grow in properly, have a proper bite relationship, and have healthy gum tissue around them.

Q. Why do wisdom teeth cause problems?

A. Wisdom teeth cause problems because the shape of the modern human mouth may be too small to accommodate these teeth. As a result, they become impacted, or unable to come in or move into their proper place.

When wisdom teeth are prevented from erupting into the mouth properly, they are referred to as impacted. Teeth that have not erupted are not necessarily impacted. It may be that it is still too early in someone's dental development, and if time passes they might grow in properly. A dentist must examine a patient's mouth and his or her x-rays to determine if the teeth are impacted or will not grow in properly.

Impacted wisdom teeth may cause problems. Impacted wisdom teeth can result in infection, decay of adjacent teeth, gum disease or formation of a cyst or tumor from the follicle, which is the tissue which formed the crown of the tooth. Many dentists recommend removal of impacted wisdom teeth to prevent potential problems.

Q. What problems occur from partially erupted wisdom teeth?

A. Partially erupted wisdom teeth are breeding grounds for bacteria and germs that may cause infection, and cysts and tumors may grow on a trapped wisdom tooth. Jaw pain and gum disease may occur.

Partially erupted wisdom teeth can cause problems with the teeth in front of them, such as decay, bone loss, or root resorption. Any soft tissue which may is partially covering them is subject to infection. Again, if any of your wisdom teeth are partially erupted, you may want to carefully consider extraction. Not all wisdom teeth cause problems.

+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.