Wisdom teeth derive their catchy name from the time period that they develop in a person’s mouth. They are the third set of molars, coming in right behind the second, not always breaking through the gums, and they usually appear at the end of a person’s adolescent years to their early twenties. Because this time frame is considered the onset of adulthood, where an individual becomes wiser, the teeth have been coined “wisdom teeth.”
We often hear this term associated with wisdom teeth. What does it mean? Well, most people do not have enough space in their mouth to accommodate 4 extra molars (larger teeth). Remember, the standard human mouth has 32 permanent teeth, so imagine the crowding when you add in 4 more. When the wisdom teeth have developed and the mouth does not hold enough room for them, making it impossible for the teeth to erupt through the gums, this is referred to as impacted teeth.
Types of Impaction
Soft Tissue: No space for gum tissue to retract and allow for proper cleaning.
Partial Bony: The tooth can erupt just barely, but the tooth cannot adequately aid in chewing. Causes problems with cleaning.
Complete Bony: No room for eruption. Stuck in the jawbone. Requires complicated
oral surgery for removal.
Difficult Complete Bony: The tooth is located in an abnormal place or hard-to-reach place for the surgeon. Or the physical anatomy of the person makes it harder to remove the tooth. This is the hardest situation for a dentist/surgeon to remove.
Panoramic x-rays are used in this process to decide if surgical removal will be beneficial and to determine the complexity of the situation. You will need to consult with your dentist for the best route.
Why does it matter?
Many people opt to remove their teeth because of the bad reputation of wisdom teeth. However, there are actually some pretty sound reasons as to why removing these molars is the best decision for your overall health.
When your third molars do not have proper space to fully break through the gums, many problems can occur.
First, let’s look at infection. Remember that your third molars are located at the very back of your mouth. How easy is it to properly brush that area, as well as floss it? Plus, it’s dark back there, and any leftover particles that turn to plaque can quickly harden to become tartar, grow bacteria, as well as create gum problems. Gum infection in that location that dentists most frequently see is pericoronitis. This happens with partially erupted teeth. The gums swell and become irritated, causing lots of pain and problems with eating. Impacted teeth hurt the teeth around them. With improper space to adequately clean the wisdom teeth, gum issues arise, which ultimately affect the other teeth nearby. Eventually, this can cause bone loss after subjecting your teeth to gum disease and decay.
Generally, the non-infectious disease is also associated with impacted teeth. As you neglect to remove such, cysts can develop that expand and slowly eat away at the jawbone. Additionally, rare tumors have also been linked to leaving wisdom teeth in the past teenage years.
Of course, crowding is a general concern, but a concern that has many implications. Crowding your other teeth can cause teeth to shift to try to make room, as well as infection, gum disease, and ultimately, bone loss. If the teeth are so crowded that you cannot properly clean and floss in between, the plaque has a much greater chance of building up. This is precisely what you do not want.
While each of these poses serious problems, you may not initially experience any of them. Removing your wisdom teeth may be based on statistics in the dental world. You have to look at the long-term and how they will eventually affect you.
When is the best time??
The goal is to remove the third molars before they have fully developed their root structure. Sometimes, that means removal happens at the young age of 12 or 13 years old. Other times, people might be 23 or 24. Once past the age of 30, problems begin to arise.
What if I wait?
You can always wait. The choice is yours because it is your body. Be advised, though, that prolonging the surgery by refraining from having it will only increase your risks of one of the above-mentioned conditions. The other thing is = that as you age, your body requires more and more time to recover from surgical procedures. Why not just bite the bullet and get it over with? Your healing process is likely to be much faster if you choose the surgery at a younger age.
Another added risk is that as you wait longer and get older, the impacted teeth are likely to attach to the jawbone. With time, aside from disease and infection, you’re looking at a much more complicated surgery. Each day those teeth sit there, it’s likely that the surgeon will have to do more to get them out. Stick to getting your third molars out during your teenage years or early twenties.
You have a few choices regarding the removal of your wisdom teeth. Some patients worry over the cost of such a procedure and opt to be semi-conscious and awake during the removal. This saves them the cost of needing anesthesia. The doctor simply numbs you and administers great amounts of pain medicine.
On the other side, your doctor will put you to sleep, and you will have outpatient surgery. This is a more popular route because a person will not experience the trauma or anxiety that can otherwise set in when being awake.
The doctor will sedate you with anesthesia and perform the surgery while you are under. This is very safe and just like if you were having surgery at the hospital. The doctor is trained to administer anesthesia and will monitor your vital signs while you sleep.
Before arriving, you will take medication to calm you, as well as help minimize your pain and swelling after the surgery. Bring a friend or family member to drive you home, because you will not be capable of driving after having anesthesia.
You will need to fast before your surgery. No food or drink after midnight the night before, except a sip of water to take your medicine. This is important so that you can have the optimal results with the anesthesia. Patients who ingest food right before surgery typically experience nausea and vomiting. Skip the food!
The procedure should take roughly 30-60 minutes. Although, sometimes, depending on the level of impaction, the procedure can go longer. After your surgery, you will need to stay in recovery for at least 30 minutes to be sure that your body is functioning properly.
Sedation is administered through an IV and will help the medicine take affect faster. Through all of this, your doctor and her staff will make you as comfortable as possible.
Really, that’s about it. You may be told to count to 10, and you will likely make it to 2. Then, you will wake up and it will already be over.
What should I expect after the procedure?
Depending on your situation, your doctor may need to stitch your gums. Most of the time, the doctor will place dissolvable stitches, but sometimes sutures are required. Either way, it is painless to remove or to have them there. Removing your wisdom teeth is a quick procedure, but it acts as a major procedure to your body. You will need to sleep at an elevated posture for a few nights, and you will likely experience pain and swelling. This is completely normal. Stay on top of your pain by taking the pain medicine from your doctor. Additionally, take the
antibiotics your doctor prescribes to avoid infection.
Ice your mouth. This will help alleviate the swelling. Do not plan on going anywhere, as your body will require rest. Around day two or three, you can add heat to the mix to help sooth your swollen cheeks. The second and third day will bring some new reactions. Most patients report stiffened jaws, with difficulty in opening their mouth. Keep applying the heat to help relax your jaws and that should help alleviate a bit of the stress.
Also, your mouth may bleed. This is another common byproduct of wisdom teeth removal. Place a towel over your pillow to avoid staining your pillowcase or bed sheets.
As far as eating goes, you will need to stick to clear liquids for a short while. Broths and jello will be your main sustenance for the time being. Then, you will gradually add in mashed potatoes, pudding, ice cream, and other soft foods. Typically, these foods are added a few days after surgery, when the anesthesia has worn off. Slowly, your mouth will heal and you will eventually be able to eat normal foods again.
Expect a recovery period of one week to two weeks. Everyone is different, so you may fall somewhere in this range or even just outside these parameters. Be patient. Your body will return to its proper function and you will feel fine after a little time passes.
Sometimes, with surgery like wisdom teeth removal, complications arise. The biggest concern is hitting a nerve. The nerve typically rests next to the roots of the third molars. Sometimes, doctors can hit these nerves during surgery. The risk is that you can lose feeling in your lips, chin, or tongue.
Now, with young adolescents, this is not as likely, because the wisdom teeth are smaller and the roots more shallow. However, as a person ages and the teeth are deeply rooted in the jawbone, the risk for something like this is much higher.
Typically, when the nerve is hit during this surgical process, patients will experience temporary numbness and tingling after the anesthesia wears off. Again, as the patient is older and in rare cases, the nerve damage can actually remain permanent. Because of this risk and how it might alter your body, the doctor will have you sign a consent form ahead of time.
A sinus opening can happen as a result of the removal of your upper wisdom teeth. The doctor will monitor your health before the surgery and make sure you do not have a cold or sinus infection symptoms. She may tell you to refrain from blowing your nose for at least two or three days after the surgery. You will be able to wipe your nose, but no blowing and only sneezing through your mouth. If you feel like this is happening to you, then you need to call your doctor immediately. Another procedure may need to take place. (This condition is quite rare.)
Dry sockets are a very common side effect of wisdom teeth removal. Because of the premature loss of a clot in the socket of the empty tooth, dry sockets form. These happen more often in patients who use tobacco or patients that take birth control pills. Another way to develop a dry socket is to sip things through a straw. Avoid it at all costs. If you end up with dry sockets, your doctor can place some special pain medicine in the form of a dressing into the socket for fast relief. The dressing itself does not heal the socket. It only alleviates the pain. The socket heals on its own with time—sometimes a week.
Although not as common, sometimes infections occur after the removal of wisdom teeth. Most doctors put patients on antibiotics ahead of time. In the event that you contract an infection, your doctor will find an antibiotic to counter the problem.
Temporary side effects include bleeding, swollen cheeks, bruising, jaw stiffness, and pain. The key word is temporary. These things will not last forever but be gone in a matter of days. Be patient.
The cost is going to vary for each patient, based on insurance and where the procedure takes place, how it takes place, and whether or not you complied with insurance expectations. Before your surgery, the office should verify your benefits and give you an estimate. Of course, people make mistakes, and sometimes things happen within the surgery that alter the cost of the procedure. Be mindful that you will pay your portion ahead of time, but it is likely you may owe more after the fact.
You can speak to your doctor freely about the various questions ahead of time in your consultation, as well as your pre-op appointment. She will speak to you right before the surgery, right after the surgery, and then, you will consult with her again during your post-op. Then, you can always call your dental office and relay questions through the office manager or an assistant. Speak up. It’s your body and you have the right to know.
Hopefully, you will have a pleasant experience with your wisdom teeth removal. Modern medicine and technology have provided the upper hand, so that your experience can be as wonderful as possible. Also, remember the risks of negligence. The benefits and process far outweigh the risks.