The 3 W’s of Wisdom Teeth “Why, When and Who”

What are “wisdom teeth”?  They are a third set of molar teeth that develop and erupt into the mouth much later than other teeth, when the patient is older and “wiser”.   The theme of this article is to explain why wisdom teeth can be a problem, the optimal time to remove them as well as who the most qualified dental provider is to perform the surgery.

Why do we recommend removing the third molars?  There are two major reasons that wisdom teeth can become problematic:

1. Dental crowding can develop in the mouth. Since the third molars begin to develop so late there usually is not enough room in your mouth for them to come in or erupt properly.  As a result, the third molar teeth can push against the neighboring teeth leading to crowding of, and damage to these teeth. 

2. The risk of infection, gum disease and tooth decay is high. Due to the lack of adequate space in your mouth for the wisdom teeth they typically only emerge partially through the gum tissue.  The incomplete or partial eruption of the wisdom teeth makes the area very difficult to see and properly clean.  As a result, you become susceptible to oral infection, gum disease and tooth decay.  Typically the tooth decay is untreatable and can lead to the loss of neighboring teeth.

Large cavity noted in the wisdom tooth and the 2nd molar. This adult patient will have to have both teeth removed because the decay is not treatable.

Large cavity noted in the wisdom tooth and the 2nd molar. This adult patient will have to have both teeth removed because the decay is not treatable.

When is the best time to remove wisdom teeth?

There are a number of factors that we take into effect when making the recommendation to remove the wisdom teeth.  Age, does the patient have symptoms (pain and swelling) as well as the time of year.

Generally, the likelihood you will have problems with your wisdom teeth is high so we recommend they be removed before problems arise.  The ideal time to have the procedure performed is during the mid to late teenage years.  At this point, the jawbone and tooth roots have partially developed making the surgery less complicated.  In addition, we find that the recovery for a teenage patient is generally faster than for an adult.

If someone has symptoms (pain or swelling) in the area we consider the wisdom teeth to be pathologic and recommend removal at that time.  If the symptoms are acute we can treat them with a round of antibiotic therapy before having the teeth removed. 

Teenage patient with partially developed roots

Teenage patient with partially developed roots

Adult patient with an oral infection and full root development of the wisdom tooth. The surgery will be quite complicated to remove this tooth.

Adult patient with an oral infection and full root development of the wisdom tooth. The surgery will be quite complicated to remove this tooth.

For the teenage patient the recovery from surgery is typically 3-4 days.  Scheduling your surgery can then be determined by what time of year is best suited for you.  The typical recovery consists of 48 hours of manageable discomfort and swelling followed by another 24-48 hours of a transition back to a normal diet and normal activity.  We suggest that most teenagers allow for 4 days of recuperation (including the surgery day) before returning to school or work.  As you can imagine, long weekends and big breaks (winter, spring and summer) make for ideal times to have your wisdom teeth removed.

Who is best suited to perform your surgery?  Oral and Maxillofacial Surgeons are Dr’s who spend an additional 4-6 years of surgical training after graduating from dental school.  We are experts in the anatomy of the jaw, face, skull and neck.  Oral and Maxillofacial surgeons are among the most skilled dentists and doctors.  They can treat numerous conditions of the head and neck, including injury, disease and skeletal malformations.  Most importantly, we are recognized as the specialists in Dentistry for wisdom tooth removal.

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James Ellis