problems with wisdom teeth

Get Wise about Wisdom Teeth

Its summer! Time for the kids to relax, swim, and generally relax. For teenagers and young adults, summer is a great time to take care of their wisdom teeth. My mom was the original person who told me that my wisdom teeth coming in does NOT actually impart any wisdom on me or mean that I was getting any wiser… thanks mom. Regardless, wisdom teeth can cause a whole host of issues and we’ll discuss the ins and outs of wisdom teeth here.

Wisdom teeth are the 3rd set of molars that will begin to erupt anywhere from the mid teens to early 20’s. The majority of people literally do not have room for these teeth. The consequence is that these teeth will not erupt correctly. These teeth can also be impacted which means they are side-ways and will not erupt (or come completely out of the gum) without intervention. The reason we as dentists suggest extracting these teeth is because they are seldom functional teeth. Even if there is enough room, they are the hardest area to keep clean and will often times become decayed or cause decay on the molars in front of them! I personally have seen so many issues and complications and issues with these teeth.

The problems that can happen with impaction or only partial eruption of the wisdom teeth is that they can cause a defect in the gum tissue which can lead to bacteria and food impacting the area and cause 1) Decay or Cavities 2) Pericoronitis 3) Resorption into the 2nd molar.

  • Decay can spread and eventually cause tooth pain or infection. We especially do not want to see a non functional wisdom tooth causing decay on a perfectly functional 2nd molar and cause a need for a restoration or worse, extraction of the 2nd molar too!
  • Pericoronitis is when the gum around a partially erupted tooth gets infected and inflamed. This can be very painful and requires antibiotics and the 3rd molar to be extracted.
  • Resorption can happen when the wisdom tooth is horizontal and starts to externally resorb away the 2nd This can lead to loss of the 2nd molar as well!

In my opinion, the best time to extract the wisdom teeth are when we do it BEFORE symptoms occur. This can lead to a better patient experience, less surgical complication, and hence less post operative discomfort. It has also been shown that recovery in young adults is much faster and less painful than surgery in older adults (over 35). Part of this reason is that in young adults the roots are not completely formed yet in the wisdom teeth and the bone is not as dense making for the extraction process to be much easier.

In our practice, sometimes wisdom teeth need to be referred to a specialist. The reason for this is because some wisdom teeth can be complicated and require further training which the specialist has. Also, in most cases, the most pleasant way (ok pleasant and extractions don’t go together but bear with me here…) to have your wisdom teeth removed is under IV sedation. If done correctly by someone with the correct training, IV sedation should be a safe procedure. Yes there have been some incidences in the news about sedations that have gone wrong, but in my opinion, this was from a lack of training and/or not following protocol.

So, a story about my personal experience….my wisdom teeth were erupted and in normal position (not horizontal) but were causing my gums soreness. I had my wisdom teeth removed the summer after my freshman year of college, which is longer ago than I care to remember.  I had the IV sedation done which went fine, and although there was soreness, discomfort, and some minimal swelling from the removal of the teeth, I only had to take one dose of pain medication and I was out running errands that same evening. By the end of the week I was eating normal foods and feeling 100% again. With varying degrees of angulation and impaction, you can expect varying levels of post operative discomfort and swelling, but all of this can be managed and will prevent much more serious issues in the future.

Don’t be afraid to consult with your dentist about your wisdom teeth. Thanks! Enjoy your summer! And keep smiling !