Wisdom teeth, also known as third molars, are the last teeth to erupt in your mouth. This generally occurs between the ages of 17 and 25, a time of life that has been called the “Age of Wisdom.”
A tooth becomes impacted when there is a lack of space in the dental arch and its growth and eruption are prevented by overlying gum, bone, or another tooth. A tooth may be partially impacted, which means a portion of it has broken through the gum, or totally impacted and unable to break through the gum at all.
The early humans lived off the land and ate a rough diet resulting in the excessive wear of their teeth. Drifting of the teeth to compensate for this wear ensured that space was available for most wisdom teeth to erupt by adolescence. The presence of the third molars also provided much needed chewing and grinding surface. The modern diet is much more refined and softer and, along with orthodontic tooth straightening procedures, produces a much fuller dental arch which commonly does not leave room for the wisdom teeth to erupt, thereby setting the stage for the various problems associated with impacted wisdom teeth.
Impacted and partially impacted teeth can lead to difficulty with oral hygiene, food impaction, discomfort, periodontal disease, and infection. They may also crowd or damage adjacent teeth or their roots.
Cyst formation may also be a serious problem related to impacted teeth. The sac surrounding the impacted tooth can become filled with fluid and enlarged forming a cyst. As the cyst grows it may hollow out the jaw and permanently damage adjacent teeth, the surrounding bone and nerves. Rarely, if a cyst is not treated, a tumor may develop from its walls and a more serious surgical procedure may be required to remove it.
Despite the considerable concern regarding impacted third molars, a recent study sponsored by the American Association of Oral and Maxillofacial Surgeons and the Oral and Maxillofacial Surgery Foundation finds that third molars which have broken through the tissue and erupted into the mouth in a normal, upright position may be as prone to disease as those third molars that remain impacted.
Not all problems related to third molars are painful or visible. Damage can occur without your being aware of it.
As wisdom teeth grow, their roots become longer, the teeth become more difficult to remove and complications become more likely. In addition, partially or totally impacted wisdom teeth are more likely to cause problems as patients age.
No one can predict when third molar complications will occur, but when they do, the circumstances can be much more painful and the teeth more difficult to treat. It is estimated that about 85% of third molars will eventually need to be removed.
It isn’t wise to wait until your wisdom teeth start to bother you. In general, earlier removal of wisdom teeth results in a less complicated healing process. The AAOMS/OMSF study strongly recommends that wisdom teeth be removed by the time the patient is a young adult in order to prevent future problems and to ensure optimal healing. The researchers found that older patients may be at greater risk for disease, including periodontitis, in the tissues surrounding the third molars and adjacent teeth. Periodontal infections, such as those observed in this study, may affect your general health.
Before surgery, Dr. Bamonte will discuss with you what to expect. This is a good time to ask questions or express your concerns. It is especially important to let the doctor know about any illness you have and medications you are taking.
The relative ease with which a wisdom tooth may be removed depends on several conditions, including the position of the tooth and root development. Partially or totally impacted wisdom teeth may require a more involved surgical procedure.
Most wisdom tooth extractions are performed in the oral and maxillofacial surgery office under local anesthesia, oral sedation or IV anesthesia. Dr. Bamonte will discuss the anesthetic option that is right for you.
Following surgery, you may experience some swelling and mild discomfort, which are part of the normal healing process. Cold compresses may help decrease the swelling, and medication prescribed by Dr. Bamonte can help manage the discomfort. You may be instructed to modify your diet following surgery and later progress to more normal foods.