Wisdom Teeth Removal
Your wisdom teeth are the last ones to emerge, often erupting in your late teens or early 20s. They are also the teeth that are most likely to cause serious dental issues, including severe pain and infections. As a result, many people often have their wisdom teeth removed. Wisdom tooth removal is a surgical procedure that can help to restore the health of your mouth. If your mouth is in pain, Cassity Implants and Periodontics, with the help of dental technology, can conduct a thorough examination to determine the cause. If your wisdom teeth are the culprit, we will remove your wisdom teeth and restore your oral health.
Why do humans even have wisdom teeth?
Wisdom teeth, which were originally referred to as "teeth of wisdom" back in the 1600s, don’t emerge until your late teens or early 20s when you are considered to be older and wiser than you were in your younger years. The term "wisdom teeth" was coined in the mid-1800s. These teeth are the only ones to develop after birth, unlike the rest of your teeth, both primary and permanent, form in utero.
Your wisdom teeth, according to anthropologists, are a remnant from primitive ancestors They were necessary for the diet of the time: coarse, rough foods consisting of leaves, roots, meat, and nuts. With cooking, food became softer, so there is less wear on teeth, rendering wisdom teeth irrelevant. Over time, the human brain increased in size, while the jaw decreased, meaning less space for wisdom teeth, yet, in most adults, they still continue to develop.
Why do wisdom teeth need to be removed?
The most common reason for removing wisdom teeth is because they are impacted. This simply means that they lack sufficient room to develop and erupt, which can lead to a variety of issues.
If your jaw is not large enough to support the third set of molars, your wisdom teeth may stay trapped within your jawbone. They may also grow in at an angle, and press up against adjacent teeth. When this happens, your adjacent, healthy teeth may become damaged, which can open those teeth up to serious complications. They may also shift from their original positions, which can throw off your bite and lead to issues such as uneven wear, or severe jaw pain (known as a temporomandibular disorder). Without enough space, your wisdom teeth may only partially erupt, which can cause the surrounding gum tissue to become irritated and inflamed. Eventually, a condition is known as pericornitis or a localized gum infection will likely occur. Partially erupted wisdom teeth are also more difficult to care for properly, and food may become lodged where you cannot reach with your toothbrush or floss. This can cause tooth decay and even gum disease, which can affect the health of the teeth adjacent to the wisdom teeth as well as the health of your jawbone.
Another reason your teeth are more susceptible to infection and gum disease is due to the way wisdom teeth attempt to come in. Normally, when teeth emerge in a healthy position, the crown is fully exposed, allowing the gums to form an effective seal around the neck of the tooth. If your wisdom teeth do not emerge properly, the gums are too high, often sitting on the crown. As a result of an improper seal, bacteria can make their way under the gumline, causing an infection.
Cysts are another common issue associated with impacted wisdom teeth. While non-infectious, cysts can cause serious damage to teeth and bone. Cysts are fluid-filled sacs that can form as a result of impaction. As time goes on, they continue to expand, slowly destroying surrounding teeth as well as your jawbone. The longer your wisdom teeth remain in your jaw, the more difficult cysts become to treat.
Symptoms of an impacted wisdom tooth often include:
Is removal always necessary?
There is much controversy surrounding whether or not wisdom teeth should be removed if you don’t experience any symptoms. For some, wisdom teeth emerge perfectly normal. For another small percentage, wisdom teeth don’t emerge at all and don’t cause any issues. Removal of these wisdom teeth is often done as a preventative measure, helping to prevent any issues that might develop as a result of hidden wisdom teeth. Even if you have one troublesome impacted wisdom tooth, your others may not present any problems. At Cassity & Legacy Implants and Periodontics, we can monitor asymptomatic wisdom teeth with the use of x-rays, to help determine if extraction is the best course of action.
Risks of Not Removing Wisdom Teeth
Several oral health complications can arise from untreated wisdom teeth. One of the biggest ones is damage to adjacent teeth, as well as your jawbone. As your wisdom teeth attempt to emerge, they push against adjacent healthy teeth, which can then cause them to fracture, and even break, under the gumline, which would require restorations, or even extraction along with your wisdom teeth, and replacement with dental implants. Cysts can also lead to these implications.
Your healthy teeth may also be shifted from their original placement. In being shifted, your natural bite is thrown off. This can lead to uneven and excessive wear of your teeth (leaving them more vulnerable to decay), as well as substantial jaw pain.
If your wisdom teeth are only partially erupted, you may end up dealing with chronic gum disease. When the bacteria get under your jaw line, it attacks gums, teeth, and bone, causing your jaw to become weak. Eventually, your jawbone will no longer be stable enough to support your teeth, which then causes them to become loose, or even fall out altogether.
Your Initial Consultation
Before removing your wisdom teeth, you must first have a consultation with Cassity & Legacy Implants and Periodontics. We will do a comprehensive oral exam to determine whether or not wisdom tooth removal is the right course of action. This will be done not only with a visual inspection, but x-rays as well, so that we can see the position of your wisdom teeth and any damage that may have already been caused. If you have an infection at the time of your consultation, antibiotics may be prescribed, or another treatment is given first, before going ahead with the removal procedure. We will devise a treatment plan that best works for you.
The Surgical Procedure
Depending on the complexity of your wisdom tooth extraction, you will have a few different options for anesthesia as well as sedation. For some patients, a local anesthetic is enough. On the day of your procedure, an injection is given at the surgical site, which will completely numb the area. This will allow you to feel no pain, but you are completely awake and alert.
Getting your wisdom teeth removed can be a stressful experience, so for many patients, sedation is preferred. One sedation method used is referred to as conscious sedation. With conscious sedation, medication is introduced through an IV into the bloodstream. This medication will make you drowsy, but you will not fall asleep. You will feel relaxed, and may even experience temporary amnesia, unable to remember parts, or any, of the procedure. A local anesthetic is still applied.
Another common sedation option is general anesthesia. With this option, you are completely knocked out and sleep through the entire procedure. General sedation is often used for people who have severe anxiety, or if the procedure is going to be particularly complex. Much like conscious sedation, you are still given a local anesthetic, which ensures no pain during the procedure as well as aids in delaying discomfort afterward.
After the anesthesia (and the sedation, if you have chosen to use it) has set in, we will begin the extraction process. For some wisdom teeth, the procedure is not all that different from extracting any other tooth. If the tooth has broken through the gums, we may only need to widen the socket, which is done by gripping the tooth with forceps and wiggling the tooth back and forth. When the socket is wide enough, we simply lift the tooth out.
If your wisdom tooth is still under the gums or is causing other issues, we may need to perform a surgical extraction instead. This procedure is much more involved. We start by making an incision in the gum tissue to expose the impacted wisdom tooth and surrounding bone. We cut away any bone mass that is blocking access to the tooth. If necessary, we will divide the tooth into sections, which will make the removal process easier. Once the tooth is completely removed, the surgical site will be thoroughly cleaned of any remaining debris. We then stitch the wound closed and place gauze over it to help control bleeding, and allow for a clot to form.
Wisdom Tooth Removal Aftercare
If you were administered any form of sedation, you would need to have someone drive you home. Before you leave the office, however, we will supply you with a list of instructions on what to expect after your wisdom tooth removal and how to care for the surgical sites.
Following your wisdom tooth extraction, some pain and swelling are to be expected. Pain can usually be managed with over-the-counter pain medications. Avoid any that may thin the blood, though, as they can promote bleeding. We may provide you with a prescription pain medication, which can help if your pain is severe, or you have had bone removed along with the tooth. Swelling can be minimized with ice during the 24 hours following surgery. You can then get rid of swelling faster with moist heat after 48 hours.
Eat a diet consisting of soft, nutritious foods, which will ease the pain, prevent irritation and nourish you, allowing you to heal faster. Make sure that you keep your mouth clean. We may advise against brushing or rinsing for the first 24 hours. When you resume brushing, be gentle around the surgical site. A saltwater solution rinse several times a day can help kill bacteria and prevent infection.
The most important thing you should do after your wisdom tooth extraction is to rest. Too much activity can aggravate swelling, bleeding, and pain. Stay seated or lie down with your head elevated. You can resume normal activities after the first 24 hours, but avoid any strenuous activities for about a week.
Risks Associated With Wisdom Tooth Removal
As with any surgical procedure, there are some risks associated with wisdom tooth removal. You may experience severe pain that cannot be controlled, even with prescription pain medication. Uncontrollable bleeding may occur. In some instances, the clot may become dislodged, a condition known as dry socket. An open hole leaves your jawbone and gums open to infection.
You may experience numbness in your mouth and lips, even after the anesthesia has worn off. Eventually, it will disappear. This is often due to an injury or inflammation of the nerves within the jaw. You may also have difficulty and pain when opening your mouth.
In rare instances, you may experience more serious issues following a wisdom tooth extraction. These issues include numbness that does not go away, a fractured jaw (which can occur if the tooth was too firmly seated in the jawbone), or an opening in your sinus cavity (which can occur when upper wisdom teeth are extracted).
If you experience any issues during your recovery period that are causing you concern, do not hesitate to call our office immediately. We will be able to examine the surgical site, determine the cause of the problem, and take steps to fix it.
Do you need a follow-up visit?
Unless you have stitches or are faced with complications such as pain, severe swelling, or persistent numbness, you most likely won’t need to return to our office for a follow-up visit. Surgical sites can heal well on their own. Once healed, your wisdom tooth extraction will be able to help prevent such problems as overcrowding and gum disease.
At Cassity & Legacy Implants and Periodontics, your oral health is our number one priority. If your wisdom teeth are causing you pain, don’t ignore it! Call us today to schedule your consultation and find out if a wisdom tooth extraction is the best solution for you.
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