Wisdom teeth, or third molars, are the last teeth to develop and appear in your mouth. They come in between the ages of 17 and 25, a time of life that has been called the "Age of Wisdom."
What is an Impacted Tooth?
When a tooth is unable to fully enter the mouth, it is said to be "impacted." In general, impacted teeth are unable to break through the gums because there is not enough room. Nine out of ten people have at least one impacted wisdom tooth.
How Serious is an Impacted Wisdom Tooth?
If left in the mouth, impacted wisdom teeth may damage neighboring teeth, or become infected. Because the third molar area of the mouth is difficult to clean, it is a site that invites the bacteria that leads to gum disease. Furthermore oral bacteria may travel from your mouth through the bloodstream, where it may lead to possible systemic infections and illnesses that affect the heart, kidneys and other organs.
Research has shown that once periodontal disease is established in the third molar areas, the problem is persistent and progressive, but may improve following extraction of the teeth.
In some cases a fluid-filled cyst or tumor may form around the base of the untreated wisdom tooth. As the cyst grows it may lead to more serious problems as it hollows out the jaw and damages surrounding nerves, teeth and other structures.
Must the Tooth Come Out if it Hasn't Caused any Problems Yet?
Many people believe that as long as they are not in pain, they do not have to worry about their wisdom teeth. However, "asymptomatic," or "pain free," does not mean the absence of disease or pathology.
Bacterial that cause gum disease may exist in clinically significant numbers in and around asymptomatic third molars and cause damage before symptoms let you know that something is wrong. Impacted wisdom teeth can contribute to a variety of problems, including infection, damage to neighboring teeth, tooth decay, receding gums, loosened teeth, bone loss and tooth loss. Research suggests the bacteria surrounding wisdom teeth may contribute to systematic health problems, including diabetes, heart disease, kidney disease and other health problems. Other studies have found that gum disease in expectant mothers is strongly associated with a greater likelihood of preterm and low birth weight babies.
A young adult's wisdom teeth generally have incomplete root systems, making the surgery to remove the teeth relatively uncomplicated. As wisdom teeth grow, their roots lengthen and may become entangled with the sensory nerves that run through the lower jaw, or the sinus area. In these cases, the wisdom teeth are more difficult to remove and complications are more likely to occur. 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.
When Should I Have My Wisdom Teeth Removed?
It isn't wise to wait until your wisdom teeth stat to bother you. In general, earlier removal of wisdom teeth results in an easier and quicker 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 further 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.
What Happens During Surgery?
Before surgery, your oral surgeon will discuss the procedure with you and tell you what to expect. This is a good time to ask questions. Also talk to your surgeon about any concerns you have. Be sure to let your 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. Impacted wisdom teeth may require a more complicated surgical procedure.
Most wisdom tooth extractions are routinely performed with little or no discomfort in the oral and maxillofacial surgery office under local anesthesia, intravenous sedation or general anesthesia. Your surgeon will recommend the anesthetic option that is right for you.
What Happens after Surgery?
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 your Oral and Maxillofacial Surgeon can help manage the discomfort. You may be instructed to modify your diet following surgery and later progress to more normal foods.
What if I decide to keep my wisdom teeth?
If after discussing your situation with your family dentist or oral and maxillofacial surgeon, you decide to keep your wisdom teeth, be sure to take particular care in cleaning and flossing your teeth, especially the molars. Your third molars must be professionally examined regularly and x-rays of your wisdom teeth should be taken every year to make sure that the health of your teeth and gum tissue does not change.
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