Extraction of Wisdom Teeth
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?
The shape of the modern human mouth is often too small to accommodate wisdom
teeth, which make their first appearance in young adults between the ages of 15
to 25. Over the course of time, humans learned to harness fire for cooking foods
and developed bladed tools to better process food before consumption. They reduced
the need for strong jaws to chew food. According to studies of ancient skull specimens,
over time, a full set of teeth in a smaller jaw caused crowding in permanent teeth
because of lack of space.
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
What kind of problems can impacted third molars cause?
Partially erupted wisdom teeth are breeding grounds for bacteria and germs that
may cause infection, and cysts. Tumors may grow on a trapped wisdom tooth. Jaw
pain and gum disease may occur. 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 medication and doesn't solve the real problem: The tooth can't fit in your
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.
Updated July 1997 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; "Patient's 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.
This information was compiled for you by the Academy of General Dentistry. Your
dentist cares about long-term dental health for you and your family and demonstrates
that concern by belonging to the Academy of General Dentistry. As one of the 35,000
general dentists in the United States and Canada who are members of the Academy,
your dentist participates in an ongoing program of professional development and
continuing education to remain current with advances in the profession and to
provide quality patient treatment. Visit the AGD's website at www.agd.org . You have permission to photocopy this page and distribute if to your patients.
Posted 9-26-98 [TCJ]