Wisdom Teeth Removal

Wisdom teeth {also called third molars} are the last permanent teeth to erupt into the mouth at around age 18, the so called “age of wisdom”. Most adult-sized mouths can accommodate only 28 teeth fully erupted. However, most adults have 32 teeth trying to fit into a size 28 mouth and it simply will never fit. Teeth don’t know the difference and keep trying to force their way into the mouth. This is the cause for the problems with wisdom teeth.

Left in place, wisdom teeth can cause a variety of problems that sooner or later cause patients to seek treatment.The first of these is crowding of the 28 teeth in front of the wisdom teeth.In the lower arch, the wisdom teeth are angled forward against the back of the adjacent molar teeth with their roots firmly planted in the solid vertical bone called the ramus of the mandible.The heavy ramus bone gives the wisdom teeth great leverage to apply extreme force against the neighboring teeth which can cause shifting of the teeth resulting in bite problems and crowding of the small lower front teeth.This is particularly troublesome if patients have gone to the expense and effort to straighten their teeth with orthodontics to see everything “go up in smoke” when the wisdom teeth collapse the occlusion.

The second problem with leaving in impacted wisdom teeth is damage to adjacent teeth from root decay, bone loss and gum disease which can lead to multiple teeth being lost.This is caused by developmental sacks surrounding the top of the developing wisdom teeth opening into the mouth.Due to the lack of space for eruption, these sacks now become a reservoir for food debris and bacteria which can’t effectively be removed.This often results in decay of adjacent teeth roots which can’t be filled and when abscessed cause the loss of the adjacent second molar tooth and the unsupported opposing upper molar as well.The wisdom teeth are not only the cause but also usually are also decayedrequiring removal.The result is one cavity of the adjacent tooth root and 4 teeth are lost.

The pain can be continuous day and night causing loss of sleep and concentration.  Infection can be very severe requiring hospitalization due to inability to open the mouth or swallow, difficulty breathing due to swelling requiring placement of breathing tubes and admission to the ICU for I.V. antibiotics fighting for your life.

The fourth problem is cyst or tumor formation from the sacks around the wisdom teeth.The severity of this problem was highlighted by a recently published study from the nationalized health system of Sweden.In this study, the largest of its kind ever done, it was noted that if left untreated after 25 years 7% of the participants{at the beginning age of15 to 20 years} developed a cyst or jaw tumor of which 6 were cancers.The bad results were extremely high, totally unacceptable. When added to other data from previous studies it reveal the problem to be even worse.The previous data reveals that 85% of jaw tumors occur between the age of 45 and 65 years.In the Sweden study, the study was completed when the participants were 43 to 45 years old, missing 85% of the jaw tumors.This data suggests that it is not safe to observe impacted wisdom teeth for any reason other than the most dire of health risks.

The fifth and last problem with impacted teeth is the risk of broken jaws.The wisdom teeth are located in the “L” shaped angle of the lower jaw.Any structure which is “L” shaped is weak by virtue of its structure.The impacted wisdom tooth displaces as much as 60% of the bone support in the critical “L” shaped corner of the jaw greatly weakening it if it receives a blow.The statistical data from other studies show that a person is 2.8 times more likely to have a fracture of the jaw through the angle of the jaw if hit than someone who doesn’t have wisdom teeth.In over 30 years of experience removing teeth, our doctor has never had a jaw to fracture.However, on the average we see two patients per month with jaw fractures through impacted wisdom teeth.

These 5 problems with impacted wisdom teeth are the real reasons that they have to be removed.Pain may be the motivating cause that brings patients in to see us but these 5 are the reasons we must remove the wisdom teeth.

THE CONSULTATION VISIT

The ability to discuss the proposed surgery, be informed of the potential risks, and be given instructions for the best care before, during and after surgery are the reasons for having a consultation appointment.In addition, no general anesthetic can be administered on an outpatient basis without a consultation visit.Although we do not recommend it, patients with a hardship trying to schedule a procedure may be granted a consultation appointment and procedure appointment on the same day as long as they do not wish to have general anesthesia.This is not desirable because it doesn’t allow patients the proper preparation before surgery to reduce adverse problems.

ANESTHESIA CHOICE

On the average, it requires approximately 20 to 30 minutes to remove 4 impacted wisdom teeth.There are three choices of anesthesia to keep the patient comfortable for the 20+ minutes it is going to take to remove them.The choices are listed under GENERAL ANESTHESIA SERVICES.Our surgeon will examine your mouth and look at your x-rays to determine the best method of treatment and discuss with you the anesthesia choice.There is definitely a choice of anesthesia to be made. Not everyone requires nor should they necessarily have general anesthesia for wisdom tooth removal.However, some patients experiencing high levels of anxiety may need the extra comfort of not being aware of the procedure.This decision is to be determined on an individual basis with agreement of the patient, the surgeon and the parents where applicable.

The best results for the removal of impacted wisdom teeth comes from the cooperative efforts of a properly informed, prepared patient, a well trained and equipped operating team, and great anesthesia.We do our best to minimize problems for patients by preparing them with an abundance of information, to give them peace of mind of what is expected of them and what will be done.We are available and prepared to provide for our patient’s needs in every aspect of care.

If you have any questions or wish to schedule an appointment for removal of impacted wisdom teeth, call for a consultation appointment and bring current x-rays if you have them.