Remove Wisdom Teeth

Wisdom teeth cause more problems than any other tooth in the mouth.  They will either partially break the gum tissue and grow in crooked, or remain completely underneath the gum.  In nine out of ten people, at least one tooth remains underneath the gum – referred to as an impacted wisdom tooth – causing future problems of varying degrees.

Why it is Recommended

Even if there are no problems initially, headaches, earaches, pain in the face, neck, throat and upper and lower teeth can occur if impacted wisdom teeth are not removed.  Impacted wisdom teeth (particularly the lower wisdom teeth) are almost certain to cause problems if left in place.

The most common reasons for removing wisdom teeth are:

• Decay. Saliva, bacteria and food particles can collect around impacted wisdom teeth, causing themselves or neighboring teeth to decay.  It is very difficult to remove such decay, so whole tooth removal is often the preferred choice.
• Gum Infection. When a wisdom tooth is partially erupted, food and bacteria can collect under the gum and cause a local infection.  This may result in bad breath, pain, swelling and trismus (inability to open the mouth fully).  The infection can spread to involve the cheek and neck.  Once the initial episode occurs, each subsequent attack becomes more frequent and more severe.
• Pressure Pain. Pain may result from the pressure of the erupting wisdom tooth against other teeth.  In some cases this pressure may also cause erosion of these teeth.
• Orthodontic Reasons. Many younger patients have had prolonged orthodontic treatment (such as braces) to straighten teeth.  Wisdom teeth may cause movement of teeth (particularly the front teeth) when they try to erupt and this will compromise the orthodontic result.
• Prosthetic Reasons. Patients who are to have dentures constructed should have any wisdom teeth removed.  If a wisdom tooth erupts beneath a denture it will cause severe irritation and if removed, the patient will need to have a new denture constructed as the shape of the gum will have changed.
• Cyst Formation. A cyst can develop in the soft tissue around an impacted wisdom tooth.  Cysts can cause bone destruction, jaw expansion and displacement or damage to nearby teeth.  The removal of the tooth and cyst is necessary to prevent further bone loss.  Rarely, tumors may develop within these cysts or the jaw may fracture spontaneously if the cyst grows very large.
• Hygiene. Due to the difficulty of keeping these teeth clean through brushing and flossing, bacteria and food debris remaining on the wisdom teeth may present a foul smelling bad breath.

Instructions

It is recommended by specialists that impacted wisdom teeth be removed between the ages of 14 and 22 years, whether they are causing problems or not.  Surgery is technically easier and patients recover much more quickly when they are younger.  What is a relatively minor operation at 20 can become quite difficult in patients over 40 because as we get older, the bone surrounding the tooth becomes more dense, making the tooth more difficult to remove.  In addition, the risk of complications increases with age, and the healing process is slower.

Side-Effects

Depending on the size, shape and position of the tooth, removal can vary from a simple extraction to a more complex operation.  With a simple extraction, there is usually little swelling, bruising and/or bleeding.  More complex extraction will require special treatment which may result in more bruising, swelling and bleeding.  However, post-treatment measures can minimize these side-effects.

Following an extraction, a condition called "dry socket" may occur: If the blood clot that formed in the extraction area becomes dislodged, it exposes the underlying bone.  This condition is very painful, but resolves after a few days.  It is preventable by following the post-treatment recommendations provided by a dental professional.