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FAQ Wisdom Teeth

Frequently Asked Questions About Wisdom Teeth

What are "impacted wisdom teeth"?

In dental terminology "impacted" means that a tooth has failed to emerge fully into its expected position. This may occur either because there is not room enough in the jaw for the tooth, or else because the angulation of the tooth is improper.

Why do impacted wisdom teeth need to be extracted?

Wisdom Teeth PeopleThe precise reasons why an individual's wisdom teeth should be extracted should be explained to them by their dentist, because each person's situation is different. Some of the more common reasons are:

  • Wisdom teeth, either partially or fully erupted, can often be very difficult to clean effectively ("erupted" means that the wisdom tooth has, to some degree, penetrated through the gums). This increases the risk of developing dental problems such as tooth decay ("cavities"), periodontal disease ("gum disease"), or reoccurring infections.
  • Tooth crowding. Wisdom teeth, as part of their efforts to come fully into place, can put pressure on a person's other teeth and cause them to become misaligned (crowded and shifted). The misalignment of a person's lower front teeth, especially, is frequently blamed on pressure created by a person's wisdom teeth.
  • While not a common occurrence, cysts and tumors can develop in the tissues associated with impacted wisdom teeth.
  • The attempted eruption of a misdirected impacted wisdom tooth can cause damage to a person's 2nd molar (the next tooth forward of the wisdom tooth).
  • At what age should wisdom teeth be extracted?

    If a dentist can clearly tell that there are good reasons to remove a wisdom tooth, it is usually best to go ahead and have it removed as soon as possible. While there is no specific age by which a person's wisdom teeth should be extracted, as a rule of thumb, the younger a person is when they have their wisdom teeth extracted the fewer complications they experience. Usually, a person's wisdom teeth should be removed in their later teens or early twenties.

    What are Dry Sockets?

    College StudentsDry sockets are one of the most common problems people experience following dental surgery. They are caused by the premature loss of a blood clot in the empty tooth socket and affect approximately one out of five patients. This seems to occur with greater frequency in people who smoke or are taking birth control pills. While both jaws can be affected, they usually occur in the lower jaw on the third to fifth day. They cause a deep, dull, continuous aching on the affected side(s). Patients may first notice the pain starting in the ear radiating down towards the chin. It frequently begins in the middle of the night, and the Motrin medication usually doesn't help. Treatment involves placing a medicated dressing in the "empty" tooth socket. This will help decrease the pain and protect the socket from food particles. The effectiveness in alleviating the pain lasts for 24-48 hours and usually will require dressing changes every day or two for five to seven days. The dressings are usually removed when you have been pain free for 2-3 days. The dressing doesn't aid in healing. The only reason to place a dressing is for pain control. If Motrin is controlling the pain, the socket will heal without a dressing. An irrigation device will be given to you to help keep food particles from lodging in the extraction site following removal of the dressing.

    What types of medications are administered?

    During dental and oral surgical procedures, local anesthesia (Novocain) is administered to block sensations. However, the anxiety that some people have can be controlled by administering sedative drugs, such as Valium-type medications. A sedated patient may remember the procedures, but will be more relaxed. Additional medications such as agents similar to pentothal are sometimes used to cause anesthesia, which places the patient more deeply asleep.

    How is the medication administered?

    The sedative and anesthetic medications are typically given intravenously (IV). Since the effects are so rapid by this means of administration, your doctor can precisely give the correct amounts of the medications to make you relaxed and comfortable. Also, if more medications are needed during the procedure, the IV allows easy administration of additional medications.

    Is anesthesia safe?

    Wisdom Teeth SmileThe use of sedation and anesthesia in dentistry has a commendable record of safety. This is due to the advanced training your doctor has and his/her commitment to your overall health. It is important to advise your doctor of all medications that you take as well as any changes in your health since your last visit.

    In most states a special permit is required to administer intravenous medications. In order to qualify, your doctor had to provide evidence of advanced training in anesthesia and often a site visit is required. The ability to handle emergency situations as well as having specific emergency medications and equipment is also mandatory.

    How am I monitored during the procedure?

    Depending on the depth of the sedation and anesthetic being used, as well as your own medical condition, various monitors are used. These vary from automatic blood pressure cuffs, to the use of pulse oximeters which through a light sensor measure the oxygen concentration in your blood. Sometimes an EKG may be used as well.The doctor along with at least one trained member of the staff will always be with you and closely observe you throughout your treatment.

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    If I Don’t Have My Wisdom Teeth Removed,What’s The Worst That Can Happen?

    For young adults, wisdom tooth removal can be scheduled at a convenient time for patients and their families. While this may seem like a gift of time, it is unwise to delay surgery indefinitely. To do so may invite a variety of problems including damage to adjacent structures, such as sensory nerves, the maxillary sinus, and neighboring jawbones.

    Postponed surgery may be more complicated and require a lengthier recovery. Further, damage caused by wisdom teeth to adjacent teeth may not be easily repaired.

    Tooth Decay

    Keeping the back of your mouth clean with daily brushing and flossing is difficult in the best of circumstances. When wisdom teeth are present, good oral hygiene in this area is virtually impossible; a situation that often leads to cavities and tooth loss. Research has shown that more young adults have decay in the wisdom tooth area than previously thought. Of those studied between 23 and 34 years of age, over 40% had experienced cavities in their wisdom teeth, a condition difficult to treat.

    Gum Disease and Bacterial Infection

    Wisdom teeth are not like other teeth in that they generally do not have adequate space to erupt. This is due not only to limited space, but also to the fact that gum tissues in the area are not designed to attach to the tooth in a normal manner like other teeth. No matter how well you brush or floss, it is virtually impossible to keep the wisdom tooth area clean and bacteria free. Bacterial infection and inflammation often results in gum recession, bone loss and the possibility of loosened teeth. Of additional concern is the possibility that oral inflammation may extend to other parts of the body either directly or indirectly.

    This Girl Sure Likes Her Cell Phone Involvement of Adjacent Structures

    A young adult's wisdom teeth generally have incomplete root systems, making surgery relatively uncomplicated. As wisdom teeth mature, their roots lengthen and may become involved with the surrounding structures such as sensory nerves and/or the maxillary sinus. In such cases, surgery may be more involved with a greater chance of complications.

    Cyst and Tumor Formation

    A fully impacted wisdom tooth sits in the jawbone surrounded by the sac in which teeth develop. Over time, however, this sac may enlarge and even develop unhealthy changes in the cells from which it is made. Problems occur when the sac surrounding the impacted tooth becomes filled with fluid and enlarges to form a cyst. As the cyst grows it may damage the jaw, neighboring teeth and other surrounding structures. Occasionally, tumors develop from the same tissues that surround an impacted tooth, requiring extensive surgery and reconstructions.

    What If I Decide To Keep My Wisdom Teeth?

    If after discussing your situation with your family dentist or one of our doctors, you decide to keep your wisdom teeth for the time being, it is important to agree on a long-term plan for monitoring the health and condition of the teeth and gum tissue in the third molar area. While an accepted protocol for monitoring retained wisdom teeth is still being investigated, researchers believe that, at a minimum, x-rays to see the wisdom tooth and surrounding bone and a clinical examination to determine whether an impacted wisdom tooth can be probed should be performed every two years. For your part, it is critical that you take particular care in cleaning and flossing the area as part of your oral healthcare regimen.

    In the case of wisdom teeth, good things don't come to those who wait. A lot of bad things can happen in that time. Why wait for bigger problems later on?

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