Most dental professionals recommend having third molars, or wisdom teeth, removed in early adulthood, preferably before they are fully formed and rooted into the jaw. Generally, this means having wisdom teeth extracted between the ages of 17 and 25. Waiting until you are older to have wisdom teeth removed can have considerable risks and complications.
Wisdom teeth that are not removed create the following risks:
- Impaction caused by wisdom teeth that do not have sufficient room to grow, causing pain and potential disease and damage to adjacent teeth.
- Tooth decay from wisdom teeth that are difficult to keep clean.
- Infection caused by bacteria that is harbored in the wisdom tooth eruption site.
- Growth of tumors and cysts caused by severely impacted wisdom teeth.
For patients who need to have wisdom teeth removed later in life, complications can include:
- More complicated removal surgery to eliminate deeply rooted or impacted wisdom teeth that results in longer surgery recovery time.
- Roots that have grown close to the nerve that affects the feeling in the lower lip might be injured in surgery, causing permanent nerve damage.
If you or your young adult have emerging wisdom teeth, schedule a consultation with your dentist to determine if and when they should be removed. While some patients will not need to have their third molars extracted, in most cases, having wisdom teeth removed as they are erupting can help to avoid a host of future problems. When wisdom tooth extraction is performed early, recovery time and risk of complications are drastically reduced for most patients.
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Wisdom teeth are really just your third molars, located in the very back of your tooth arch and are the last of your adult teeth to erupt. They most commonly erupt between the ages of 17 and 20. Most people have them, but for some people, these third molars simply do not develop. Some patients might have more than one set of wisdom teeth! Only an x-ray can reveal the complete story.
A high number of patients who possess wisdom teeth don’t know they have them because the teeth are impacted, or stuck underneath already erupted teeth, as opposed to erupting normally through the gums. This is when wisdom teeth become problematic.
The patient’s jaw may be too small to allow for the full eruption of the wisdom tooth, leading to it becoming stuck in the jaw, pushing at other teeth, causing pain and shifting of the teeth. The tooth might be able to erupt partially, triggering a flap of gum tissue to develop over the tooth, trapping bacteria and germs which can lead to serious infection.
Sometimes wisdom teeth come in at strange angles, facing sideways or backward, or they develop a serious infection and damage the surrounding teeth. They can also lead to the development of a cyst or cause damage to the jawbone.
If your dentist has told you that you need to have your wisdom teeth out, it’s a good idea to listen and to follow that advice. Removing problematic wisdom teeth can reduce crowding in the mouth, infection in the gums or tooth decay in the wisdom tooth or in the surrounding teeth.
The younger you are when you have your wisdom teeth removed, the easier it is to recover. Ask your dentist to learn more about wisdom teeth and about your particular needs as a patient.
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Wisdom teeth got their name because they are the final teeth to develop, usually in the late teens to early twenties, at a time when a person becomes fully mature or “wise.” Wisdom teeth are the third and final set of molars in the very back of the mouth. Most people have four total (two upper and two lower), but others never develop them at all. Wisdom teeth can be a valuable chewing aid, but often they are poorly aligned or don’t develop properly.
How do I know if I have them?:
Unless you start to feel them breaking through, you may not know whether you have wisdom teeth or not. Ask your dentist to examine you to see if these teeth are healthy and properly positioned. An x-ray may be required, and your dentist may refer you to an oral surgeon to be evaluated further.
Do wisdom teeth hurt?:
You don’t always feel anything with your wisdom teeth, but sometimes they are very bothersome. You may experience pain when they erupt in awkward positions, especially if the teeth rub against your mouth. Other problems include stiffness in the area, infected swelling of the gums, tooth decay, gum disease, and tooth crowding.
Why remove them?:
Your dentist or oral surgeon might suggest that your wisdom teeth be extracted. They can often predict if your wisdom teeth may crowd or damage other teeth, your jawbone, or nerves. Sometimes removal is appropriate before problems arise, in an effort to avoid more complicated or painful extractions later. Removal is usually simpler and less risky in young people. If your wisdom teeth are not extracted, it’s important for your dentist to continue monitoring them because problems may develop later.
What does impacted mean?:
Wisdom teeth may be impacted, which means they are enclosed in the soft tissue or jawbone or they only partially erupt through the gum. Impacted wisdom teeth are almost always removed to avoid risks of infection, tooth decay, and gum disease.
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Wisdom teeth are the last adult teeth to erupt into the mouth, generally emerging between the ages of seventeen and twenty-one. They are the third set of molars and are in pairs: two each on the top and bottom arch of teeth. While some patients don’t have wisdom teeth, most do. Many of those who do have them don’t have enough room for those teeth to erupt fully, causing them to be wedged under the back of another tooth, impacted in the gum.
Impacted wisdom teeth are very difficult to clean, and can negatively affect the surrounding teeth. They are highly vulnerable to disease and decay and may lead to tooth pain and damage to adjacent teeth. For these and other reasons, a dentist may recommend that the teeth be extracted through oral surgery as soon as necessary to prevent any problems.
Extraction of wisdom teeth is typically an outpatient procedure done in an oral surgeon’s office. A healthy patient can proceed with a typical surgery, but if any infection is detected, the surgery can’t move forward until the infection is cleared up through the use of a full course of antibiotics. Once the surgery is moving forward, the surgeon’s team will administer some form of anesthesia to numb the area surrounding the tooth or to possibly sedate the patient through IV sedation dentistry.
After the anesthesia has fully taken effect, the surgeon makes an incision to open the gum and to remove any bone that is blocking the tooth from extraction. The tissue connecting the bone to the tooth will be separated and the tooth will be removed. In some cases, the surgeon will have to break the tooth into smaller pieces to make it easier to remove. After thoroughly cleaning the area and removing any remaining debris, the incision will be closed, stitched and packed with sterile cotton gauze to staunch any bleeding.
The surgeon will provide aftercare instructions. Patients should follow these instructions to the letter in order to ensure the best and fastest healing of the surgical site.
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Many people are afraid of getting their wisdom teeth out based on horror stories from the internet or scary tales exaggerated by others. The best way to fight these fears is to learn more about the procedure and what you can truly expect.
The first thing to know is that wisdom teeth extractions are the most common oral surgeries. Most oral surgeons perform an average of one a day, so that experience has provided skill and expertise in the procedure. Also, you will be under some degree of anesthesia. Whether it’s general anesthesia or even just nitrous oxide (laughing gas), you won’t feel anything during the surgery and won’t remember what happened afterwards.
One common fear is the bleeding associated with wisdom teeth extractions. While there is some bleeding from the site after surgery, it is usually easily controlled by following the after-care instructions. You will be told to gently bite on gauze in that area of your mouth, and change it frequently. Propping your head up will help limit the bleeding also.
Swelling is another reason some fear this surgery, but it should be gone in just a few days. You can hold ice packs to the outside of your cheek off and on for the first 24 hours to decrease the swelling.
The recovery process should go smoothly if you follow your oral surgeon’s advice. Have someone drive you to and from the appointment, and eat soft foods at first. Do not use a straw for the first few days, and avoid touching the area with your fingers or tongue. Also, do not smoke for at least the first 24 hours following surgery.
While there are risks associated with any surgery, most wisdom teeth extractions are without complications and recovery is complete in just a few days to a week. The benefits of having the surgery outweigh the risk of ignoring your dentist’s advice to have your wisdom teeth removed.
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A wisdom tooth is often extracted to correct an existing dental problem or to prevent the possibility of problems that may arise in the future. Some problems associated with wisdom teeth are:
- Your jaw may be too small to accommodate the eruption of your wisdom teeth, leading them to become impacted (stuck in the jaw, often under the edge of an adjacent tooth) and unable to erupt through your gums.
- Your wisdom teeth may partially erupt, leaving a flap of soft gum tissue to grow over the tooth. Food, bacteria and germs can get trapped underneath this gum flap, leading to swelling, redness and pain, which are signs of infection.
- Impacted teeth can lead to a more serious problem, such as acute infection, damage to the surrounding teeth, damage to the bone or the development of a cyst.
- Wisdom teeth can present at an awkward angle, coming in with the top of the tooth facing sideways, forward or backward.
Removing your wisdom teeth can be a good method to prevent:
- crowding at the back of the mouth
- an impacted wisdom tooth stuck in the jaw and never erupting
- painful gums or infection caused by a flap of gum skin
- gum disease or tooth decay in the individual wisdom tooth or in the surrounding teeth and gums
You may want to have your wisdom teeth removed when you are younger because:
- The younger you are, the less developed your wisdom teeth roots are, and the less dense your jawbone, allowing for an easier extraction of the tooth.
- The majority of problems with wisdom teeth begin between the ages of fifteen and twenty-five.
- If you have a medical condition that is known to worsen with time, you may choose to have your wisdom teeth out early, while you are in your best health, to facilitate maximum healing.
Wisdom teeth extraction is rarely harmful, but there are risks associated with any surgery. Talk to your dentist today about any concerns you have regarding wisdom tooth extraction.
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