Wisdom Teeth

By the age of 18, the average adult has 32 teeth; 16 teeth on the top and 16 teeth on the bottom. Each tooth in the mouth has a specific name and function. The teeth in the front of the mouth (incisors, canine, and bicuspid teeth) are ideal for grasping and biting food into smaller pieces. The back teeth (molar teeth) are used to grind food up into a consistency suitable for swallowing.
However, the average mouth is made to hold only 28 teeth. It can be painful when 32 teeth try to fit in a mouth that holds only 28 teeth. These four other teeth are your third molars, also known as “wisdom teeth.”

Why Should I Have My Wisdom Teeth Removed?

Wisdom teeth are generally the last teeth to erupt within the mouth. Unfortunately, there is not enough room for them and they are prevented from properly erupting. They may grow sideways, partially emerge from the gum, and even remain trapped beneath the gum and bone. Impacted teeth can take many positions in the bone as they attempt to find a pathway that will allow them to successfully erupt.

These poorly positioned impacted teeth can cause many problems. When they are partially erupted, the opening around the teeth allows bacteria to grow and will eventually cause an infection. The result: swelling, stiffness, pain, and illness. The pressure from the erupting wisdom teeth may move other teeth and disrupt the orthodontic or natural alignment of teeth. The most serious problem occurs when tumors or cysts form around the impacted wisdom teeth, resulting in the destruction of the jawbone and healthy teeth. Removal of the offending impacted teeth usually resolves these problems.

Even when wisdom teeth align properly and gum tissue is healthy, one should consider their removal. This is because they are very difficult to keep clean all the way in the back of the mouth, and in most cases, develop decay and periodontal pocketing. Infections develop and your good chewing teeth can also be affected. Unfortunately, one often assumes that these properly aligned wisdom teeth should not come out, but waiting until later in life when these problems start makes their removal significantly harder for both the doctor and the patient, and the removal of these teeth later on in life has many more potential serious complications. Early removal is recommended to avoid such future problems and to decrease the surgical risk involved with the procedure.

Oral Examination

With an oral examination and x-rays of the mouth, Drs. Rothman and Kim can evaluate the position of the wisdom teeth and predict if they are present and may create future problems. Studies have shown that early evaluation and treatment result in a superior outcome for the patient. Patients are generally first evaluated in the mid-teenage years by their dentist, orthodontist or by an oral and maxillofacial surgeon.

All outpatient surgery is performed under appropriate anesthesia to maximize patient comfort.

Removal

In most cases, the removal of wisdom teeth is performed under local anesthesia, light conscious sedation, or moderate/deep sedation. If necessary, Drs. Rothman and Kim will use the services of a hospital or surgery center for the general anesthesia. These options, as well as the surgical risks (i.e., sensory nerve damage, sinus complications), will be discussed with you before the procedure is performed. Once the teeth are removed, the gum is sutured. You will rest under our supervision in the office until you are ready to be taken home. Upon discharge, your postoperative kit will include postoperative home care instructions, a prescription for pain medication, antibiotics, and a follow-up appointment in one week for suture removal. If you have any questions, please do not hesitate to call us.