When is a Wisdom Tooth Extracted?
Wisdom teeth are the teeth that come into the mouth last, at age 16-21 (average 18). Most people get four wisdom teeth, one in the back of each of the four quadrants of the mouth. But it is not uncommon for a wisdom tooth to be missing and for some people get none.
An "impacted" tooth is one that is stuck in the bone and cannot fit or come into the mouth properly. Impacted third molars are a frequent occurrence in teens and young adults. Sometimes they start to come into the mouth but the mouth is not big enough to hold another tooth. They do not completely erupt, remain partially under the gum, and are easy targets for infection. It is not unusual for teens and young adults to appear in the dental office swollen, unable to open, febrile and in pain when this happens.
Wisdom Teeth Impacted Totally Under the Bone
If wisdom teeth are positioned in such a way that they are positioned impacted under the bone, covered by bone, and not partially in the mouth at all, often they are better left alone. Why? Because studies have shown more risk in the removal operation of severe bony impactions that in leaving them in the jaws. These full bony impactions rarely cause infections and, contrary to common and intuitive belief, they do not push other teeth out of alignment. They can often just sit there peacefully for a lifetime.
When a Wisdom Tooth Erupts Partially but the
Whole Tooth Does Not Fit in the Jaw
When wisdom teeth are partially in the mouth and partially submerged, the gum around them can become infected and inflamed causing swelling in the area around the cheek or down the neck. This seems to happen more often at exam time or when young patients are under stress. Under stress, the immune system does not function as well as usual, and in a standoff with bacteria, the bacteria may start to get the upper hand. That is usually when the patient with an impacted third molar shows up at the dental office with swelling and pain. This swelling is called pericoronitis, or infection tissue around the crown of the tooth Frequently there is flabby gum around the back of the tooth and/or a flap of gum (called an operculum) extending over the biting surface of the tooth. Debris and bacteria collect and are trapped under this gum tissue and an infection is the result.
If the tooth is properly erupted and oriented, it may be possible to trim away the excess gum flap around the back of the tooth (an Operculectomy).
If the tooth is hopelessly submerged and there is no room for it to erupt normally, the tooth should be extracted. Extraction of impacted wisdom teeth is typically preformed by oral and maxillofacial surgeons (or just "oral surgeons").
SEE DRAWINGS OF IMPACTED WISDOM TEETH
|
|
