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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.

Corrective Oral Surgery

Corrective oral surgery (orthognathic surgery) moves teeth and jaws into a more balanced, functional and healthier position. Unequal growth of the jaws, birth defects or injury can create problems. Orthognathic means "straight jaws" and corrects a wide range of facial and jaw fractures and irregularities.

Its benefits include an improved ability to:

• chew
• breathe
• speak
• enhances appearance

When only the teeth are involved, orthodontics can correct many "bite" problems but it cannot reposition jaws. Corrective oral surgery is usually performed when needed in connection with orthodontics corrections. The orthodontist and oral surgeon work together in developing your specific treatment program. A complete evaluation of the patient's condition through X-rays, photographs, facial measurements and dental impressions help them determine the best course of therapy.

What Conditions May Indicate a Need for Corrective Oral Surgery?

• Difficulty in chewing or swallowing
• Speech problems
• Chronic jaw pain
• Excessive wearing of teeth
• Facial injury or birth defects
• Unbalanced facial appearance
• Receding chin or protruding jaw
• "Open bite" (a space remains between the upper and lower teeth when the mouth is closed)
• Chronic mouth breathing with dry mouth
• Sleep apnea (breathing problems when sleeping)

What Are Preparations for the Oral Surgery?

Your orthodontist and oral surgeon will work closely together in preparation for your complete treatment program. First, pre-surgical orthodontics will move your teeth into a new position to fit together better after surgery. This means you'll be wearing braces for 6 to 18 months prior to the surgery. Your teeth will be carefully evaluated during orthodontic visits. When your dental correction team determines that your teeth are properly positioned, the surgery will be scheduled.

Where Is the Oral Surgery Performed? How Long Does It Last?

The surgery is performed in either a hospital or outpatient surgical center under general anesthesia which "puts you to sleep" during the operation. The length of surgery will depend upon the amount and type of surgery needed.

What About Any Facial Surgical Scars?

Since most incisions are made inside the mouth, no external scars are usually visible. If incisions are needed externally, the surgeon carefully conceals them in natural skin creases.

What Happens After Oral Surgery?

After surgery, you will experience some discomfort that is usually not significant; the pain can be controlled with medications. Your healing will take some time. Normally you can return to work or school within two weeks.

After four to eight weeks following surgery, your orthodontics treatment will continue to complete the proper positioning of your teeth. Usually your braces are removed within 6 to 12 months after surgery.

Following the removal of your braces, schedule an appointment with your dentist for a check-up. You'll have plenty to celebrate with all the benefits gained as a result of the corrective oral surgery.

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.