Third molars or "wisdom teeth" usually errupt at age 17-21 years. These four permanent teeth come in behind the upper and lower 12-year molars.
Third molars that are healthy and properly positioned can be a valuable asset to the mouth. Unfortunately, this is often not the case, and problems develop that require their removal. For example, when the jaw is not large enough to accomodate these teeth, they can become impacted - unable to come in or move into their proper place. They may grow sideway, emerge only part way from the gum, or remain trapped beneath the gum and bone.
Vertical Impaction
Horizontal Impaction
Angular Impaction
Why are third molars removed?
Extraction of third molars can affect the overall health of the mouth. Extraction is recommended when the following conditions occur: Wisdom teeth that only partially erupt. (This leaves an opening for bacteria to enter around the tooth and cause an infection. Pain, swelling, jaw stiffness and general illness can result.) Impacted wisdom teeth continue growing without enough room, damaging adjacent teeth, a fluid-filled sac (cyst) or tumor forms, destroying surrounding structures such as bone or tooth roots.
Why remove teeth early?
People between the ages of 16 and 19 should have their wisdom teeth evaluated. If they need to be removed, it should be considered before age 20 when generally fewer complications occur. At a younger age, tooth roots are not fully developed, the surrounding bone is softer, and there is less chance of damaging nearby nerves or other structures. There is also less surgical risk and healing is generally faster.
Extractions of wisdom teeth may be performed by a general dentist. If your dentist anticipates any special care will be needed he, or she, may refer you to an oral and maxillofacial surgeon. An oral and maxillofacial surgeon is a dentist who specializes in surgery and the removal of wisdom teeth.
What to expect of the procedure
Before surgery, your dentist will explain what to expect, have you sign a consent form and give you personalized instructions to follow. Keep in mind these are general items to help your surgery go smoothly.
Wear loose, comfortable clothing and arrange to have someone be with you after surgery. Extractions can be performed under local or general anesthesia. Following surgery, you may experience some swelling and mild discomfort, which is part of the normal healing process. Cold compresses can help decrease the swelling the first two days and medication prescribed by your dentist can help increase the healing process. You may be instructed to drink only clear fluids following surgery and later progress to soft foods.
Some patients experience numbness or tingling following surgery. Normal sensation usually returns in a period of time. Occasionally, a dry socket occurs when the blood clot breaks down earlier than normal. A dressing placed in the socket protects it until the socket heals.
Talk with your dentist about any questions that you have. It is especially important to let your dentist know, before surgery, of any illness that you have and medications that you are taking. If your general dentist has referred you to a specialist, they will both work together to provide you with the best and most efficient care. Keeping your teeth healthy is your dentist's primary concern.