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Wisdom Teeth Extractions
Wisdom teeth, or third molars, do
not always erupt properly when
they decide to make an appearance.
It's wise to get an early opinion
from your dentist on getting
wisdom teeth pulled before they
become impacted, causing pain,
swelling, infection, cavities or gum
disease.
Why don't wisdom teeth grow in
right?
Although we have seen a reduction
in the size of the human jaw during
the course of human evolution, we
still retain the same number of
teeth. The change in jaw size of
modern humans is related to the
discovery and use of fire to prepare
food, and the development of
crude tools, such as blades, to
process food. These advances not
only enhanced the culinary skills
and diet of early humans, they
significantly lightened the
workload of the jaw. The result?
As the need for a powerful jaw
vanished, the jaw became smaller,
and the teeth became crowded, the
space required for the proper
growth of wisdom teeth, no longer
available. (The modern, human
mouth is too small to
accommodate wisdom teeth, which
make their appearance in young
adults between the ages of 15-25.)
What does "impacted"
mean? When wisdom teeth
don't have room to grow or they
haven't reached their final
position by age 25, they are
considered impacted-no place to go
and no plans to grow. Third molar
impaction is the most prevalent
medical developmental disorder. A
full set of healthy teeth sometimes
doesn't leave much room for
wisdom teeth to erupt.
What kind of problems can
impacted third molars cause?
Partially erupted wisdom teeth are
breeding grounds for bacteria and
germs and may lead to infection.
In addition to jaw pain and gum
disease, which may also develop,
impacted third molars are ripe
sites for the growth of tumors and
cysts. Not all wisdom teeth cause
problems, however.
Can't I just use an antibiotic?
Antibiotics only soothe infected
wisdom teeth for a short time.
Since people frequently use a wide
variety of antibiotics, the infection
may be resistant to such medica-
tion and doesn't solve the real
problem: The tooth can't fit in your
mouth.
When is removal necessary?
It isn't wise to wait until wisdom
teeth bother you. Early removal, as
advised by your dentist, is
generally recommended to avoid
problems, such as an impacted
tooth that destroys the second
molar. People younger than 16
heal easier too. At an early age,
people should be
evaluated by their dentist who can
track third molar development with
the help of X-rays. Second molars
should be visible to lessen the
chance of damaging them during
surgery. This occurs at age 11 or
12, so wisdom teeth should be
removed when the decision has
been made that they cannot erupt
into an acceptable position.
What if I don't have any
symptoms?
People with symptoms of
impaction, such as pain, swelling
and infection should have their
wisdom teeth removed
immediately. However, those with
no symptoms can avoid the
chance of ever suffering from the
pain of impacted wisdom teeth or
achieve better orthodontic
treatment results by
having them removed.
Asymptomatic impacted wisdom
teeth also should be removed to
reduce the chance of unexplained
pain, accommodate prosthetic
appliances, or avoid cavities,
periodontal disease, bone
shrinkage and tumor development.
How is the tooth removed?
Surgery for impacted wisdom
teeth consists of removing of the
gum tissue over the tooth, gently
stripping connective tissue away
from the tooth and bone, removing
the tooth and sewing the gum back
up.
Sources: William Howard, DMD, MAGD;
"The management of third molar teeth,"
Dentoalveolar Surgery, February 1993;
"Impacted lower wisdom tooth: To remove
or to leave alone," Dental Update,
July/August 1994; "Surgical removal of third
molars," British Medical Journal, September
1994; "Impactations: Observe or Treat?"
West Virginia Dental Journal, October
1994;
"Diseases and lesions associated with third
molars," Oral Surgery Oral Medicine Oral
Pathology; February 1995; "Early removal
of wisdom teeth can prevent an array of
problems," Georgia Dental Association
Action, March 1994; "Patients anxieties with
third molar surgery, " British Journal of Oral
and Maxillofacial Surgery, October 1994;
"Symptoms from impacted wisdom teeth,"
British Journal of Oral and Maxillofacial
Surgery, December 1994; "Infections in
elderly patients associated with impacted
third molars," Oral Surgery Oral Medicine
Oral Pathology, February
1995.
