Wisdom teeth are a valuable asset to the mouth when they are healthy and properly positioned. Often, however, problems that require their removal develop. When the jaw isn't large enough to accommodate wisdom teeth, they can become impacted (unable to come in or misaligned). Wisdom teeth may grow sideways, emerge only part way from the gum or remain beneath the gum and bone, trapped
Extraction of wisdom teeth is generally recommended when:
• Wisdom teeth only partially erupt. This leaves an opening for bacteria to enter around the tooth and cause an infection. Pain, swelling, jaw stiffness and general illness can result.
• There is a chance that poorly aligned wisdom teeth will damage adjacent teeth.
• A cyst (fluid-filled sac) forms, destroying surrounding structures such as bone or tooth roots. Patients should ask the dentist about the health and positioning of their wisdom teeth. The dentist may make a recommendation for removal or send the patient to an oral surgeon for further evaluation.
What should you expect when you have your wisdom teeth extracted?
A great deal of the degree of difficulty associated removing a wisdom tooth will have to do with the manner in which it is positioned in the patient's jawbone. In general, the more normal the alignment of the wisdom tooth and the further through the gums it has been able to erupt, the less involved the extraction and its subsequent healing process will be.
Another factor associated with the degree of difficulty of removing a wisdom tooth will have to do with the tooth's anatomy. Wisdom teeth are multi rooted teeth. Lower wisdom teeth typically have two roots whereas upper wisdom teeth usually have three. There can be quite a bit of variation in the way a tooth's roots have formed. In some cases each of a wisdom tooth's roots will be quite distinct and separate. In other cases the tooth's roots may have fused together or taken on an irregular shape when forming. These variations in anatomy will affect the relative degree of difficulty associated with a particular wisdom tooth extraction.
Don't necessarily expect the worst. Some wisdom teeth will be no more difficult for your dentist to extract than any other tooth. As part of your pre extraction examination your dentist should be able to give you an idea of what to expect, both during the extraction procedure and also in regards to healing.
If there is an active infection associated with a wisdom tooth (such as pericoronitis) a dentist will usually delay the timing of the extraction. In these instances your dentist will usually prescribe a course of antibiotics for you to take, typically for seven days or so. The antibiotics will diminish the amount of infection that is present at the time of the extraction, thus allowing both the extraction and the subsequent healing process to go more smoothly.
In order to extract a wisdom tooth a dentist must first gain access to it. If the tooth is underneath the gums and still totally encased in bone then the dentist will first need to create a gum tissue "flap" and then remove a portion of the bone that lies over the tooth. In order to minimize the total amount of bone that must be removed in order to get a tooth out, a dentist will often "section" a wisdom tooth into parts during the extraction process. Because each part is smaller than the tooth as a whole, each can be removed through a smaller opening in the bone.