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What Are Wisdom Teeth? Wisdom Teeth Are the Last Teeth to Develop and Appear in Your Mouth

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What Are Wisdom Teeth? Wisdom Teeth Are the Last Teeth to Develop and Appear in Your Mouth Wisdom Teeth Management | 2 What are wisdom teeth? Wisdom teeth are the last teeth to develop and appear in your mouth. They are also known as “third molars,” because they enter behind the upper and lower second molars. Wisdom teeth appear between the ages of 17 and 25. What are impacted wisdom teeth and why are they a concern? An impacted tooth is one that is unable to erupt (push up through the gum) into the mouth. Impacted teeth can cause a number of serious problems, including: • Pain • Infection • Damage to neighboring teeth and their roots • Gum disease caused by bacteria (germs) • Tooth decay • Receding gums • Loose teeth • Bone and tooth loss If the sac surrounding the impacted tooth fills with fluid it may enlarge to form a cyst. This growth may hollow out the jaw and permanently damage neighboring teeth, surrounding bone and nerves. Rarely, an untreated cyst can form a tumor, which will have to be removed surgically. WISDOM TEETH MANAGEMENT What if my wisdom teeth aren’t causing me any problems? Even if your wisdom tooth or teeth aren’t giving you any pain or discomfort, problems may occur later. Because they are so far back in the mouth, wisdom teeth are difficult to keep clean. Bacteria that can cause gum disease may still be in and around the teeth. Though you may be free of pain and other symptoms now, in time you could develop gum and tooth disease. Some studies say it’s possible this bacteria can travel through your bloodstream to cause serious health problems such as diabetes, heart disease and kidney disease. Other studies say that gum disease in expectant mothers may cause a greater chance of preterm and low birth weight babies. Complications that may arise from impacted wisdom teeth Infection Crowding Cyst | 1 When should I have my wisdom teeth removed? Waiting until your wisdom teeth start hurting to have them removed isn’t always smart. When you are young your wisdom teeth have root systems that are incomplete, as well as softer surrounding bone. This make the removal of the teeth easier, with a shorter healing time. However, as wisdom teeth grow, their roots get bigger and can become entangled with the nerves in your lower jaw. Surgery is more difficult when this happens and complications are more likely. These complications can be painful and harder to treat later in life. Our decision about wisdom teeth removal should first be considered after: • A thorough examination of your mouth • X-rays or a CT-scan • A talk with your dentist and oral and facial surgeon Wisdom teeth should be removed if there are signs of: • Periodontal (gum) disease • Cavities in the tooth or teeth that can’t be fixed • Infections • Cysts or tumors • Damage to other teeth 2 | WISDOM TEETH MANAGEMENT Wisdom teeth may not need to be removed if they are: • Fully erupted into the mouth and functional • Free of cavities • Painless • Disease-free • Are in position to be easily cleaned and kept healthy If I decide to keep my wisdom teeth, how do I care for them? You many decide, after talking with your dentist or oral and facial surgeon, to keep your wisdom teeth. If so, work with them to make a plan on how to care for the teeth and the surrounding gum tissue. You may be asked to maintain a routine to make sure you: • See your dentist at least once a year to see if any disease is developing. • Have X-rays or CT scans to check the condition of the wisdom teeth and the surrounding tissue. • Get a clinical examination every year. • Keep the wisdom teeth and the surrounding area clean with regular flossing and brushing. | 3 What if surgery is needed? Your oral surgeon may, after your examination, decide surgery is necessary. A full or partial removal of the tooth or teeth may be needed. The surgeon will talk to you about the surgery and what to expect. This is a good time for you to ask questions, share your concerns, tell the surgeon about any illnesses you have, and what medications you take. Wisdom teeth extractions are usually done In the surgeon’s office. To prepare do the following: • Wear comfortable clothing with a shirt with short sleeves or sleeves that can be easily rolled up. • If you are to get intravenous (through the veins) anesthesia, don’t eat or drink anything after midnight the night before the procedure. • Make sure a family member or friend is available to help you home after the procedure. What should I expect during surgery? You will be given either local anesthesia, intravenous sedation or general anesthesia. The surgeon will recommend the right method for you. The time your surgery will take depends on how complicated your case is. 4 | WISDOM TEETH MANAGEMENT • If your teeth are fully erupted, each tooth can then be simply extracted from its socket using specially designed instruments. • If gum is covering the tooth, a surgical incision (cut) will be made to turn back the gum tissue to expose the tooth, which then will be removed. • If bone covers the tooth, the surgeon will remove enough bone to allow access and removal of the tooth. If any surgical incision is made, the surgeon may place stitches in the area to help the wound to heal. Types of Impaction The relative ease with which a wisdom tooth may be removed depends on several conditions, including the position of the tooth and root development. Below: A comparison of normal and types of impacted wisdom teeth. Normal Vertical Horizontal Mesioangular Distoangular | 5 What happens after surgery? Immediately after your surgery, you will be given time to recover in the oral and facial surgery office. Your adult family member or friend can then drive or accompany you home. Before you leave your surgeon will give you detailed instructions and prescriptions for medications to make your recovery more comfortable. Other suggestions that may help: • Try applying an ice pack to the face for the first 48 to 72 hours to reduce swelling and discoloration of the skin. If the jaw is sore and you can’t open your mouth as wide as usual, moist heat applied to the face may help. • If you experience excessive bleeding and/or pain 72 hours after the surgery, call the surgeon’s office immediately. • For the first 2 days after surgery, eat soft foods and drink fluids (NOT with a straw, as the sucking action may interfere with clotting). • Don’t eat hard or sticky foods which may damage your jawbone, especially if bone was removed during your surgery. 6 | WISDOM TEETH MANAGEMENT • Don’t smoke. Smoking can interfere with clotting and healing. • You may start brushing your teeth the 2nd day after surgery, but avoid disturbing the blood clots in the surgical area. • Don’t rinse your mouth vigorously until clotting is complete. Your surgeon may ask you to gently rinse your mouth with salt water to help healing. • Gently open and close your mouth to exercise your jaws and help restore movement. What are the possible risks and complications of wisdom teeth surgery? Wisdom teeth surgery is common and serious complications don’t usually occur. However all surgical procedures come with certain risks of complications. Feel free to talk about these with your oral and facial surgeon before surgery. • Infection: After your surgery, let your surgeon know right away if you experience signs of infection, including: - Fever - Abnormal pain and swelling - Salty or bad taste that doesn’t go away - Pus forming in area | 7 • Dry socket: When the blood clot in the empty tooth socket dissolves too soon or is dislodged, a painful condition called dry socket can occur. Bone and nerves are exposed to air, food and fluids, which can cause intense pain. If pain increases a few days after surgery, it may be dry socket. Call your surgeon right away so steps can be taken to decrease your discomfort. Dry socket Impacted Clot fomation wisdom tooth following surgery Premature Empty extraction dissolution of clot socket with inflammation • Damage to neighboring teeth and dental work during extraction. 8 | WISDOM TEETH MANAGEMENT • Numbness, changed sensation: In some cases, sensory nerves may be located near wisdom teeth. During surgery these nerves may be irritated, causing numbness or lack of feeling in the lip, tongue, chin, cheek, gums or teeth. It’s uncommon for this numbness to last beyond a short period, but in rare cases it may be permanent. • Sinus complications: Sometimes upper wisdom teeth roots may penetrate into the sinus cavity. Removal of the teeth may leave an opening in the sinus that usually heals without a problem. However, rarely sinus pain or draining may occur. Contact your surgeon if you think this is happening. • Root fragments broken off during surgery: Roots can be long and delicate and a piece may break off during surgery. If the piece is too near a nerve or the sinus cavity, or if its removal may damage neighboring teeth, the surgeon may choose to leave it. These root fragments rarely cause problems and can be monitored with X-rays. • Fractured (broken) jaw: If the jaw is thin and the teeth deeply impacted, removal of wisdom teeth can weaken the jawbone. This is very rare. If a fracture (break in the bone) occurs the surgeon will see the fracture on an X-ray and treat it. You will be given instructions on eating until the break is healed. (Jaw joint pain or abnormal joint function is another rare complication which would need further treatment.
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