Wisdom Teeth
Disclaimer: Not medical or professional advice. Always seek the advice of your physician.
What are Wisdom Teeth?
Wisdom teeth are often referred to as 3rd molars. The 1st molar is what we see in our kids’s mouths that comes in at around age 6. The 2nd molar right behind it usually starts to come in at age 12. Now the 3rd molar or wisdom tooth is a little more variable but usually starts to be seen between ages 15 and 19 or so. Most people have 4 wisdom teeth but some people have less or none at all. Some people have more than 4 wisdom teeth, we refer to those teeth as supernumerary wisdom teeth. See the adult tooth chart below. The teeth on the ends are wisdom teeth.
What are “Impacted” Wisdom Teeth?
Impacted wisdom teeth or 3rd molars are those that cannot come in into a functional position in the mouth. This usually means they are stuck because of little space in the back of the mouth, behind the 2nd molar teeth. It means that they cannot be used to chew with as they don’t touch their opposing wisdom tooth.
Why Remove Wisdom Teeth?
Some wisdom teeth can develop cavities as they are next to impossible to clean. By same measure many develop “gum disease” and inflammation because of bacteria that lives in that area and cannot be easily managed.
Cavities on impacted wisdom teeth cannot be repaired. These teeth that are sitting sideways can at times cause adjacent tooth roots to decay or resorb. Gum tissue can partially grow over wisdom teeth and collect food and bacteria causing infections “pericoronitis” that can cause “trismus” or inability to open mouth.
When to Remove Wisdom Teeth
Timing of removal will vary per individual. In most cases surgeons would consider the person to be ready when roots of the wisdom teeth are approximately 2/3 way formed. Usually there is no need to wait until they start to poke through the gum. If roots are fully formed or the person is already an adult, it makes the surgery more difficult. That is why many teenagers get their wisdom teeth removed even if they don’t have any discomfort or symptoms.
Should Everyone have their Wisdom Teeth Removed?
Not necessarily. Some wisdom teeth have already erupted and have enough room to function well. Those wisdom teeth should still be monitored at every recall visit with your dentist. They need to be checked for cavities and adjacent gum tissue needs to be checked for health.
It may not make much sense to remove a wisdom tooth that is easily accessible and can be fixed in an older person. In younger people many wisdom teeth are removed as a prophylactic or preventative measure as we cannot predict the future but we know many people do have problems with these teeth in the future and its usually easier to remove these teeth in younger person and with less potential complications. In any case a consultation needs to be done to see what makes sense to do and what does not.
Who Removes Wisdom Teeth?
It starts with “Surgical Judgment”. We believe an oral surgeon is best qualified to remove any tooth in the mouth, especially a wisdom tooth. Some patients may not be good candidates for wisdom tooth removal in certain situations. It takes judgment and experience from the get go to see what makes sense to do and what simply does not. Oral surgeons who do this surgery day in and day out are best to advise on this.
If surgery to remove a tooth is needed, why would one choose to go to a general dentist that may do an occasional tooth extraction and even less often a wisdom tooth?
Also, all teeth are variable. Some can be removed fairly easily, others can be very difficult. An oral surgeon is best to analyze the potential surgery. Even then difficulty or ease of surgery is unpredictable prior to surgery in many cases. Many times what looks like a difficult tooth comes out very easily and sometimes a tooth that looks easy takes real work to remove.
It always best to go to an experienced surgeon that can do the procedure as quickly and with least amount of trauma possible. The number one factor for success in any type of surgery is operator experience.
Will I Be Sedated?
This is an individual choice. Most healthy people can be sedated with IV medications in the office. Local anesthesia is also administered to so nothing is felt during the sedation. Another alternative is to use laughing gas (Nitrous Oxide) together with local anesthesia. The nitrous oxide is an anxiolytic and analgesic (relaxes and decreases discomfort) and local anesthesia such as what is used to do fillings. Either way is comfortable. With the IV sedation, there is usually no memory of the procedure.
Does it Hurt Badly to Have Wisdom Teeth Removed?
In our experience wisdom teeth removal does not hurt very much in majority of cases. It is common to have mild swelling, mild discomfort usually first few days after procedure. Pain medications and careful home instructions are usually sufficient to make post operative period comfortable. Having wisdom tooth surgery or any other mouth surgery by an experienced operator such as an oral surgeon ensures decreased pain and potential for complications than a less experienced person such as a general dentist.
Are Referrals Accepted by Oral Surgeons?
We at Dental World accept referrals that were given to patients to other oral surgeons. We will perform a consultation and give treatment options and see what makes sense to do for the individual patient.
Wisdom Teeth Extraction at Dental World of Marietta
If you are having pain, swelling, discomfort or simply want to check on any tooth in your mouth please call us to schedule a consultation. Dr. William Kapgan has over 20 years experience dealing with wisdom teeth issues.
If you have any questions about wisdom teeth or you feel wisdom teeth pain, schedule your consultation today.