Wisdom teeth, also known as third molars, are the last teeth to erupt in your mouth. This generally occurs between the ages of 17 and 25, a time of life that has been called the “Age of Wisdom.”
A tooth becomes impacted when there is a lack of space in the dental arch and its growth and eruption are prevented by overlying gum, bone or another tooth. Anthropologists have noted that the diet of early humans resulted in the excessive wear of teeth. Normal drifting of the teeth to compensate for this wear ensured that space was available for most wisdom teeth to erupt by adolescence. The modern diet, which is much softer, and the popularity of orthodontic straightening procedures produce a fuller dental arch, which quite commonly doesn’t leave the room for the wisdom teeth to erupt, thereby setting the stage for problems when the final four molars enter the mouth.
WHAT IS AN IMPACTED TOOTH?
(A) INFECTION (B) CROWDING, DAMAGE (C) CYST
A tooth becomes impacted when there is a lack of space in the dental arch and its growth and eruption are prevention by overlying gum, bone or another tooth.
HOW SERIOUS IS AN IMPACTED TOOTH?
Impacted teeth can be painful and may lead to infection. They may also crowd or damage adjacent teeth or roots. More serious problems may occur if the sac surrounding the impacted tooth becomes filled with fluid and enlarges to form a cyst. As the cyst grows it may hollow out the jaw and permanently damage the adjacent teeth, surrounding bone and nerves. Rarely, if a cyst is not treated, a tumour may develop from its walls and a more serious surgical procedure may be required to remove it.
MUST THE TOOTH COME OUT IF IT HASN’T CAUSED ANY PROBLEMS YET?
Not all problems are related to third molars are painful or visible. Damage can occur without being aware of it. As wisdom teeth grow, their roots become longer, the teeth become more difficult to remove and complications become more likely. In addition, impacted teeth become more difficult to remove and complications become more likely to cause more problems as patient’s age.
Despite the considerable concern regarding impacted third molars, a recent study sponsored by the American Association of Oral and Maxillofacial Surgeons and the Oral and Maxillofacial Surgery Foundation finds that third molars which have broken through the tissue and erupted into the mouth in a normal, upright position may be as prone to disease as those third molars that remain impacted.
WHEN SHOULD I HAVE MY WISDOM TEETH REMOVED?
Wisdom teeth are easier to remove when the patient is younger, since their roots are not completely formed, the surrounding bone is softer, and there is less chance of damaging nearby nerves or other structures. Removal of wisdom teeth at a later age becomes more complicated as the roots have fully developed (may involve the nerve), and the jawbone is denser. It isn’t wise to wait until your wisdom teeth start to bother you .
In general, earlier removal of wisdom teeth results in a less complicated healing process. The AAOMS/OMSF study strongly recommends that wisdom teeth be removed by the time patient is a young adult in order to prevent future 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. Periodontal infections, such as those observed in this study, may affect your general health.
WHAT HAPPENS DURING SURGERY?
Before surgery, your oral and maxillofacial surgeon will discuss with you what to expect. This is a good time to ask questions and express your concerns. It is especially important to let the doctor know about any illness you have and any medications you are taking. The relative ease with which a wisdom may be removed depends on several conditions, including the position of the tooth and root development.
Impacted wisdom teeth may require a more involved surgical procedure. Most wisdom tooth extractions are performed in the oral and maxillofacial surgery office under local anaesthesia. Your oral and maxillofacial surgeon will discuss the anaesthetic 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 compress 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. Oral and maxillofacial surgery is the specialty of dentistry that includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and aesthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
An oral and maxillofacial surgeon is a graduate of an accredited dental school who has completed additional four or more years of training in an accredited, hospital-based oral and maxillofacial surgery residency program. Oral and maxillofacial surgeons are an important link in the referral network for care providers. Through appropriate referrals, patients can be provided with expedient and cost-effective health care conditions relating to the specialty of oral and maxillofacial surgery.