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?
The 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”?
Dry 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?
The 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.