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WHAT
ARE WISDOM TEETH?
Wisdom
teeth, or third molars, are the last teeth to develop and appear in the
mouth. They are called
“wisdom teeth” because they usually appear during a person’s late
teens or early twenties, which has been called the “age of wisdom.”
The normal position of wisdom teeth is behind the upper and lower
second, or 12-year, molars. Many
times the jaws of modern humans are not normally large enough to accommodate
the four wisdom teeth. This is
why wisdom teeth cause more problems than any other teeth in the mouth.
In fact, for nine out of ten people at least one wisdom tooth remains
underneath the gum due to lack of space in the mouth.
| A
wisdom tooth usually appears as the last tooth behind the upper and lower
second molars during a person’s late teens or early twenties.
When a wisdom tooth is blocked from erupting or coming into the mouth
normally it is termed “impacted.” |
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| Pictured
here is the normal position of wisdom teeth. |
IMPACTED WISDOM
TEETH
When a wisdom tooth is blocked from erupting or coming into the mouth normally, it is termed “impacted.” A tooth may be only partially impacted; meaning it grows in crooked and breaks through the gum only partially, or it may fail to break through at all and thus remains totally impacted. Serious problems can develop from partially impacted teeth, such as pain, infection, and crowding of, or damage to, adjacent teeth. For totally impacted teeth, more serious problems can occur if the sac that surrounds the impacted tooth fills with fluid and enlarges to form a cyst. This enlargement can hollow out the jaw and result in permanent damage to the adjacent teeth, jawbone and nerves. If the cyst is not treated, a tumor may develop from the walls of the cyst and a more involved surgical procedure may be required for removal.
| Many
problems with wisdom teeth can occur with few or no symptoms, so there can
be damage without your knowing it. It
is important to know that as wisdom teeth develop, their roots become longer
and the jawbone more dense.
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Mesioangular Impaction |
Thus,
as a person grows older, it becomes more difficult to remove wisdom teeth
and complications can become more severe.
In addition, as people age there is an increased chance of the
symptoms mentioned above. For
these reasons, the surgeon may recommend the removal of wisdom teeth even if
they are not yet causing obvious problems, particularly for young adults.
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Click
on the image to enlarge. Close that window when you are done. Impacted
wisdom teeth often grow at an awkward angle making their removal more
difficult. As a person grows
older the tooth roots become longer and the jawbone denser.
Partially or fully impacted wisdom teeth are more likely to pose
serious problems in older individuals.
Distoangular impaction |
Horizontal
impaction |
Vertical
impaction |
HOW
WISDOM TEETH ARE TREATED
Treatment
of impacted wisdom teeth involves their removal using special surgical
techniques appropriate for each individual case.
A dentist who has specialized training in the removal of wisdom teeth
is called an oral and maxillofacial surgeon, or OMS.
If the wisdom teeth have fully erupted in normal position, they may
be observed by your dentist during your regular visits to ensure that you
are properly cleaning them and no problems are developing, such as decay.
Minor abnormalities in the position of an erupted wisdom tooth may be
taken care of by your dentist, or removal might still be best.
The
removal of wisdom teeth can be performed on an outpatient basis, either in
the dental office, or in certain cases, in a hospital setting.
If the tooth is impacted, an incision is made in the gum tissue and
the tissue is turned back so the tooth can be seen.
If bone is covering the tooth, it may need to be removed in order to
expose and extract the tooth. The
tooth may be removed whole, or in some cases it may be cut into sections,
and each section is then individually removed.
Usually the surgical procedure will take up to one hour, although
this varies according to each case. After
surgery you will spend some time “in recovery” before going home.
In most cases normal activities can be resumed within a few days
depending on the degree of impaction and the number of teeth removed.
X-rays
will show the presence of impacted teeth and will reveal important surgical
information like curved roots and the proximity of the tooth roots to
nerves.
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