Words of Wisdom: To Have or Not to Have Your Wisdom Teeth

When you go to your dental checkups, there is always the chance of a cavity or other problem that means a filling or even removal of your tooth.  However, dentists seem to really put importance on wisdom teeth, your third set of molars, for repair or removal.  The teeth are a natural part of your mouth, so why do they get such special notice and treatment from the dentists? Here are some words of wisdom behind wisdom teeth.

What are wisdom teeth?
The wisdom teeth are so named because they usually appear in your late teens or early twenties, about the time you are considered a wise and fully capable adult.  These are the last teeth to grow in your mouth and they seem to get lots of problems the early-arrival teeth miss out on.  Since they are the last to arrive, there is sometimes not much room for them and the crowding causes major problems.  The teeth often appear at an odd angle and don’t fit well with the rest. 

What kinds of problems can they cause?
Impacted wisdom teeth are so skewed and misdirected that they either don’t erupt from the skin or just partially break the surface.  These teeth can cause many difficulties for maintaining dental hygiene and are often recommended for extraction or surgical removal.  Partially erupted wisdom teeth are extremely difficult to brush and floss effectively.  This leads to greatly increased risk for tooth decay and gum disease development.  The disease or decay can easily spread below the gum line too, making fillings and other treatments very difficult. 

How are they removed?
Wisdom teeth can be extracted fairly routinely, if they are fully erupted above the gums.  Even with a fully visible and normally aligned wisdom tooth, the far back location in the mouth increases the risk of tooth decay and disease.  If the decay or disease progresses, a dentist may just extract, or pull out the tooth.  The procedure is usually fairly routine, requiring just a local anesthetic and some fancy maneuvers by the dentist.  However, impacted wisdom teeth do not make for good extraction subjects. 

Oral surgery to remove wisdom teeth, especially impacted wisdom teeth is common, but can be much more complicated than extraction.  The placement of the wisdom teeth at the back of the jaw puts them close to a main nerve and often means the jaw bones develop around or over the tooth.  Simple oral surgery can be performed with local anesthetics, but the more complex operations require full sedation.  Oral surgery can require cutting both tissue and bone at times to get at the tooth.  The amount of bone to be cut often determines the sedation required as the bone cutting can be long and painful. 

Recovery
Recovery from wisdom tooth removal can consist of problems and be quite uncomfortable.  For complex oral surgeries, powerful pain killers will probably be supplied and at least 5 to 10 days rest required before normal activity.  A common complication is called “dry socket.”  When the tooth is removed, a blot clot should form and seal the wound completely.  But if the clot forms incompletely, or comes loose, the wound is exposed and becomes very painful and may develop a foul odor.

If you’ve had your wisdom teeth out, you probably don’t miss them. And if you still have your wisdom teeth, it doesn’t necessarily mean that you will have problems now or down the road. I had two of mine out (the bottom two) in high school, but I’ve still got the other pair with no problems reported yet . . . and I’m just as wise (if not more so) than I was then!