TreatmentWisdom Tooth

Wisdom teeth are the last of your teeth to come in, or erupt, through the gums. Sometimes a wisdom tooth becomes impacted, or stuck below the surface of your gums, and grows at an odd angle, possibly causing complications.

Wisdom teeth, or third molars, are the last permanent teeth to appear (erupt) in the mouth. These teeth usually appear between the ages of 17 and 25. Some people never develop wisdom teeth. For others, wisdom teeth erupt normally — just as their other molars did — and cause no problems.

An impacted wisdom tooth may :

  • Grow at an angle toward the next tooth (second molar).
  • Grow at an angle toward the back of the mouth.
  • Grow at a right angle to the other teeth, as if the wisdom tooth is "lying down" within the jawbone.
  • Grow straight up or down like other teeth but stay trapped within the jawbone.

Definition

Wisdom teeth are the third and last molars on each side of the upper and lower jaws. They are also the final teeth to erupt; they usually come in when a person is in their late teens or early twenties.

Signs & Symptoms

Wisdom teeth that only partially emerge or come in crooked can also lead to painful crowding and disease. As teeth removed before age 20 have less developed roots and fewer complications, the American Dental Association recommends that people between 16 and 19 have their wisdom teeth evaluated to see if they need to be removed.

Cause

As wisdom teeth are the last permanent teeth to come in, or erupt, there is often not enough room left in your mouth to accommodate them. This can lead to wisdom teeth that are impacted (below the gum line and not erupted). If teeth are impacted, swelling and tenderness may occur in the area of the third molar.

Diagnosis

A tooth extraction is a relatively routine procedure. Your dentist or a dental specialist, called an oral maxillofacial surgeon, will recommend either local anesthesia, if the teeth are erupted, or IV sedation or general anesthesia, if the teeth are impacted. The oral surgeon will recommend the best anesthetic option to the person who is having their wisdom teeth extracted.

Treatment

If the wisdom teeth are erupted, the tooth (or teeth) will be removed. After surgery, you may be asked to bite down softly on a piece of gauze for 30 to 45 minutes after you leave the office, to limit any bleeding that may occur.

If the wisdom teeth are impacted and embedded in the bone, the oral surgeon will put an incision into the gums and remove the tooth or teeth in sections in order to minimize the amount of bone being removed. Some pain and swelling may occur, but it will normally go away after a few days; however, you should call your dentist or oral surgeon if you have prolonged or severe pain, swelling, bleeding or fever.

Removal of wisdom teeth due to crowding or impaction should not affect your bite or oral health in the future.

If surgery is completed, swelling and tenderness in the face and neck are common, as is bruising. Ice packs and pain medications prescribed by the dentist or oral surgeon will help, but if you have any questions or are concerned about what you are experiencing, contact your oral surgeon.