Wisdom Teeth

Picture1When Should They Come Out?

Wisdom teeth are the last teeth to come in, and the ones least needed for good oral health. The third morals, or wisdom teeth, are called such because they develop when most individuals become adults (which is near 17 years of age).

Because our jaws are smaller than our ancestors, (our ancestors needed large jaws and more teeth for their tougher diet. Since our lifestyle has changed and we eat softer foods, we no longer require that extra chewing power.) our wisdom teeth may not have enough room to fit in our mouths properly. Therefore, problems may result if these additional teeth attempt to emerge.

Most people have four wisdom teeth, one in each corner of the mouth, and often they are impact (trapped in the jawbone and gums). Cramped for room, these impact teeth grow in many different directions and removal may be recommended by our dentist to prevent potential problems.

Whether wisdom teeth cause your mouth harm depends on several factors, including the size of your jaw and how your wisdom teeth grow in. You may have no symptoms at all, but the other teeth in your mouth could be at risk for damage.

Picture2Help make your treatment a success by understanding why your wisdom teeth need to be removed, what the procedure involves and what you can do to promote a successful recovery.

Potential Problems
If you learn the different ways wisdom teeth can develop and the problems that can arise, you’ll be better able to understand why you may need to have them removed.

Picture3Infection in the gum – When a wisdom tooth partially breaks through the gum’s surface, bacteria can get under the flap, causing an infection in the gum.

Picture4Crowding displaces next tooth – An impacted or erupting wisdom tooth can push on adjacent teeth, causing them to become crooked or even damaging them structurally.

Picture5Decayed wisdom tooth - Decay forms in a wisdom tooth that is hard to clean due to its position or because it is partially covered by the gum issue which may collect cavity causing bacteria.

Picture5Poorly positioned wisdom tooth - A wisdom tooth that grows toward the cheek can irritate nearby tissue. If an erupted tooth is crooked it may be hard to clean or make it hard to bite down.

Picture7Cyst destroys bone - If the sac that holds the crown remains in the bone, it can fill with fluid, forming a cyst that can destroy surrounding bone.

It is best to have wisdom teeth removed around 17 years of age because that is when they usually develop. Removal will be easier as the bone may not be as dense as in an older person. Also, recovery will be faster since the roots usually have not yet fully developed.

Procedure For Removal
The procedure for removal begins with an evaluation of your dental and medical histories. You may also receive two types of X-Rays; a panographic X-Ray which provides an overall view of your mouth and an intraoral X-Ray which examines individual teeth.

It is recommended that you do not eat or drink anything for at least 8 ours before the surgery. You may be given a sedative to help you relax or a general anesthetic so you can sleep through the procedure.You will also receive a local anesthetic to numb the area around your wisdom teeth.
Once you are fully relaxed or sleep, and your mouth is numb, the surgery will begin. The surgical method depends on whether your wisdom teeth are erupted or impacted.

If your tooth is partially or completely erupted it may be extracted, or lifted out by forceps. Occasionally, if the roots are deeply embedded in the jaw bone, the tooth may have to be split or bone removed.

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Extraction of erupted tooth                          Tooth extracted in sections

If your tooth is impacted, an incision is made in the gum to reach your wisdom tooth. The incision creates a flap which is peeled back, exposing the jawbone. If the tooth is lodged in the jawbone, bone tissue that is covering the tooth may have to be removed. The tooth may be extracted from its socket in one piece or split for easier removal.

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Incision with gum flap folded back            Wisdom tooth removed & sutures closing the incision

After Surgery
After the surgery is completed, you’ll rest for a while under close observation as you recover from the anesthetic. When the dentist or oral surgeon is satisfied with your progress, you’ll be able to go home. You should probably plan to rest and take it easy for the next few days. Since swelling and pain are likely, you will probably be given a prescription for pain medication as well as instructions for your home recovery.

The healing process begins immediately after surgery. The body sends blood to nourish the tooth socket. To control excessive bleeding, you may be instructed to bite down on a piece of gauze, applying constant, direct pressure to the area. This helps a blood clot to form in the socket. In a day or two after surgery, soft tissue begins to fill in the opening. New bone tissue also begins to grow in the socket, becoming denser over the next two to three months.

Picture12A blood clot develops in the tooth socket as the area begins to heal

Picture13The socket begins to fill in with new tissue with the help of the blood nourishing the area

Picture14The bone surrlounding the socket begins to grow, eventually filling in the socket completely

It is recommended to drink clear liquids at first and a cold compress will also help with the soreness. You should not brush or floss the area near the surgery, but continue to brush the rest of your teeth very carefully. A follow-up visit may also be scheduled to verify that the socket is healing properly and that your mouth is returning to a normal healthy state. If you have any questions or concerns while you’re recovering from your surgery, call your dentist or oral surgeon.

Keep your mouth healthy by flossing and brushing daily to ward off tooth decay and gum disease. Also, be sure to visit your dentist for regular check-ups to help
diagnose and treat tooth problems.