Most people start getting their wisdom teeth, also called third molars, when they reach their late teens or early 20’s. In most cases, the jaws are not large enough to accommodate these teeth and they remain under the gum, or impacted. When a tooth develops, it travels to its appropriate position in the dental arch. If the path to eruption through the gum is prevented due to the size of the jaw, the tooth will become partially or totally impacted.
Serious problems can develop from partially blocked teeth, such as infection and possible crowding of and damage to adjacent teeth. More serious complications can develop when the sac that surrounds the impacted tooth fills with fluid and enlarges to form a cyst, causing an enlargement that hollows out the jaw and can result in permanent damage to the adjacent teeth, jawbone, and nerves. If left untreated, a more complicated surgical procedure would be required for removal of the associated tooth, cyst, and tumor that forms.
No one can tell you when your impacted molar will cause trouble, but trouble will likely arise. When it does, the circumstances can be much more painful and the teeth can be more complicated to treat. If you have questions regarding the status of your third molars, see your dentist for an evaluation. The key to timely attention to third molars is regular X-rays of the mouth. With the help of these pictures, your dentist can frequently predict if the wisdom teeth are going to cause trouble, either soon or later in life.
Wisdom tooth removal is easier in younger patients. Roots are not yet fully developed and the bone is less dense. In older patients, removal before complications develop is key to shorter recovery and healing time. The procedure usually takes between 30 minutes and an hour.
Anesthesia can be achieved in three ways. Local anesthesia can be used alone, as when you go to the dentist for a filling. The areas the wisdom teeth are located in are numbered and the teeth are removed painlessly. Nitrous oxide, or laughing gas, also may be used. This dulls your senses and gives a comfortable, relaxed feeling.
In most cases, the procedure is done using intravenous sedation. By giving anesthetic medicines to the patient through the bloodstream, the surgeon can perform the surgery quickly and safely. This technique, most importantly, allows the patient to be comfortable during the procedure and also allows them to have no recall of the surgery. The removal of wisdom teeth is done by an oral and maxillofacial surgeon in his or her office. Make sure your surgeon is certified by the American Board of Oral and Maxillofacial Surgery.
Generally, after surgery the patient experiences some swelling and discomfort. However, with personalized post-operative instructions and medications, the oral and maxillofacial surgeon can reduce the pain.