What causes wisdom teeth to need removal? Wisdom teeth are also called third molars. They usually don’t come in until a person is around 18 years or older, when they are becoming “older and wiser”, they’re called wisdom teeth. They are the final teeth to develop in the mouth, and are trying to come into an already crowded mouth. Many times they become impacted into the jawbone. They often grow in at a horizontal angle into the other teeth, resulting in what’s called an impaction. As a result, they put pressure on the other teeth in the mouth. They can cause enough pressure to actually move two premolars and a canine tooth, creating anterior tooth crowding. They can come in sideways, or only partially come through the gum, or get trapped beneath the gum and the bone, all in an effort to erupt like a normal tooth. It can be very painful when 32 teeth try to fit into a mouth that only has room for 28! Not only that, it’s very hard to clean around wisdom teeth, which can result in tooth decay around the tooth. Bacteria can infect the tissue around partially erupted molars, and cause gum disease, stiffness, pain and illness. The most serious effect is that they can also cause the formation of cysts or tumors from the follicle in the tissue formed around the tooth, which can actually cause destruction to the jaw bone. This happens when the sac that surrounds the impacted tooth fills with fluid and enlarges to form a cyst, causing an enlargement that hollows out the jaw and results in permanent damage to the adjacent teeth, jawbone and nerves. Left untreated, a tumor may develop from the walls of these cysts and a more complicated surgical procedure would be required for removal. In some cases, the wisdom teeth come in just fine, but, in many cases, they come in at the wrong angle and cause discomfort and crowding of teeth.
What can be done about them? The doctor will give you an oral examination and x-rays, and evaluate the position of your teeth and determine if there are any complications that will arise as they come in. Early evaluation and treatment can head off future problems. In most cases, it’s recommended that impacted wisdom teeth that are extracted. A typical procedure is that an incision is made and overlying bone removed, exposing the crown, the tooth is extracted whole or surgically sectioned, and the site sutured closed. Depending on the position of the tooth and your medical history, extraction can be done in our offices or the outpatient surgery at the hospital.
What do I need to do to prepare?
• Ask any questions you may have prior to surgery to alleviate any anxieties you have.
• Have nothing to eat or drink 8 hours prior to surgery if you are having IV sedation.
What do I need to do after the surgery?
• Use ice packs on the cheek for swelling, alternating on and off every thirty minutes for 48 hours.
• Apply biting pressure with clean gauze to stop bleeding.
• Eat soft foods and drink extra liquids. DO NOT USE A STRAW the day of the surgery.
• Avoid hard or crunchy foods in the tender area.
• Brush carefully the day after surgery.
• DO NOT SMOKE for at least 48 hours.
• Do NO spitting until bleeding has stopped.
• Take prescribed medications and follow all instructions as directed.
• Do warm salt water rinses the day after surgery.