 Wisdom Teeth The last teeth to come in are your wisdom teeth - so called because they usually erupt between the ages of seventeen to twenty-one when you become an adult. When there is adequate room in the jaw and healthy gums, people do not usually experience problems with these teeth.
What problems can occur with wisdom teeth? Several factors can cause problems with wisdom teeth. For some, there is simply not enough room for them to come in. As a consequence, they become trapped in the jawbone and gums, a condition referred to as impacted wisdom teeth. This condition may cause adjacent teeth to become misaligned. When wisdom teeth only partially break through, infection can occur under the flap that is formed. If excessive plaque or food debris gets under this flap, the gum can become infected. Decay can develop in wisdom teeth, because their position in the back of the mouth makes them difficult to clean. Occasionally, a cyst forms around a wisdom tooth causing deterioration of the surrounding bone. How does the dentist determine what course of treatment to use? The dentist begins by taking your medical history including what medical problems you have experienced and what medications you are currently taking. A careful examination of your gums, jaws and teeth is conducted to identify any swelling, tenderness or tooth decay. Dental x-rays are often taken to help confirm the diagnosis and identify any other conditions that might cause potential problems. What kinds of treatments might be used? The dentist may recommend that a surgical procedure be performed by an oral and maxillofacial surgeon and/or medications. Surgically removing the affected tooth is the most frequently used method of treatment. There are different methods of removal depending upon the problem. A tooth that is partially or completely erupted may be taken out by the dentist by simple extraction (Fig. A). In some cases, when the tooth is deep into the jawbone, it may be necessary to divide it into sections before removal (Fig. B). Occasionally it may be necessary to remove some of the bone. When the tooth is impacted, an incision is made in the gum and the tooth is extracted in one piece or in sections (Fig. C). Small stitches are then used to close the incision.
The surgeon may recommend that you not eat for 6 to 12 hours before surgery. When you arrive at the office, you may be given a sedative to help you relax. This can be in pill form or through an IV (intravenous). You may be asleep during the surgery, or you may be given nitrous oxide and oxygen administered through a mask placed over your nose. When you are asleep or completely relaxed, a local anesthetic will be used to numb the area around each tooth being extracted. Your vital signs - blood pressure and pulse - will be monitored continually during the procedure. A trained staff of assistants will be present during and after surgery. What can I expect after surgery? You will be watched very carefully as you recover from the anesthetic and will be allowed to go home when your dentist or surgeon is certain you are ready. It is usually wise to arrange for transportation as you may not be able to drive yourself. Instructions on what to do for the next few days will be given to you. These will probably include that you drink only liquids for a period of time and then progress to soft foods. You may also be given a prescription for pain or other medications and be advised when to return for a checkup. The area that has been worked on will begin to heal immediately after surgery. You may experience some discomfort as well as swelling as the anesthetic wears off. Ice packs applied to the cheek during the first 24 hours following surgery will help keep the swelling down. You should call your dentist or surgeon if you have questions or concerns following surgery. Are there any risks or complications connected with this surgery? Removal of wisdom teeth is a very common procedure; however, as with all surgical procedures, there are some risks which your dentist or surgeon will explain. Complications that can arise include numbness if the impacted tooth was in close contact with nerves. If the nerve is injured when the tooth is removed, numbness can occur; however, this condition usually clears up in a short time. In rare instances, the numbness is permanent. Occasionally, healing is delayed when the blood clot that covers the socket dissolves or is washed away. This condition, called a dry socket, can result in severe, throbbing pain which can usually be alleviated with a dressing and/or medication. A less common complication but one that can also be painful is infection. This can be helped by draining the infection and/or with antibiotics. Some cases involving the removal of the upper wisdom teeth can produce problems in the sinus cavities which are located near these teeth. These problems usually heal in time but may need further treatment. If you are interested in learning more about wisdom teeth, please call our office, and we will be happy to discuss them with you. Copyright © 2000 Contemporary Health Communications, Earth City, Missouri (Commercial use strictly prohibited) | ||||||||||||||||||||||||||||||||||||||||||||||||||||
