What are Wisdom Teeth?

Wisdom teeth are the 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 usually will try to grow in at around age 17 to 21 years. Since that is considered to be the age when people become wiser, third molars gained the nickname, "wisdom teeth." Actually, they are no different than any other tooth except that they are the last teeth to erupt, or grow into the mouth. They 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. Unfortunately, this does not always happen.

What is an impaction?

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 teeth may cause problems, such as infection, decay of adjacent teeth, gum disease or formation of a cyst (fluid-filled sac) or tumor from the follicle, which is the tissue that formed the crown of the tooth. Many dentists recommend removal of impacted wisdom teeth to prevent potential problems.

What about wisdom teeth that have already erupted?

Erupted wisdom teeth may also need to be removed. The dentist may recommend this if the tooth is nonfunctional, interfering with the bite, badly decayed, involved with or at risk for periodontal disease, or interfering with restoration of an adjacent tooth. Once again, every case is different, and only your dentist can determine if there is a reason for you to have a tooth removed.

When should wisdom teeth be removed?

The following symptoms may indicate that the wisdom teeth have erupted and surfaced, and should be removed before they become impacted, in other words, the teeth have surfaced and have no room in the mouth to grow. However, each individual may experience symptoms differently.

Symptoms may include:

• Pain
• Infection in the mouth
• Facial swelling
• Swelling of the gum line in the back of the mouth

Many oral health specialists will recommend removal of the wisdom teeth before they are fully developed, usually in the adolescent years, as early removal will help to eliminate problems, such as an impacted tooth that destroys the second molar.

What is involved in the extraction procedure?

Wisdom tooth extraction involves accessing the tooth through the soft and hard tissue, gently detaching the connective tissue between the tooth and the bone and removing the tooth. Extractions can be performed under local anesthesia.

What can I expect after the extraction procedure?

Following the extraction, you may experience some swelling and discomfort, which is a normal part of the healing process. Cold compresses can help decrease the swelling, and your dentist may prescribe medication to help relieve discomfort.

What is dry socket?

Dry socket, the most common postoperative complication from tooth extractions, delays the normal healing process and results when the newly formed blood clot in the extraction site does not form correctly or is prematurely lost. The blood clot lays the foundation for new tissue and bone to develop over a two-month healing process. Women who take oral contraceptives are at a higher risk of developing dry socket after wisdom teeth extraction due to high levels of estrogen.

Tips for preventing dry socket

• Schedule extractions during the last week of the menstrual cycle, when estrogen levels are lower.
• Avoid drinking through a straw, as the suction may interfere with clotting.
• Avoid smoking, which can irritate the extraction site.
• Avoid excessive mouth rinsing, which may interfere with clotting.