Wisdom teeth normally erupt between the ages of 18 to 24 years of age. They are called as such, because a moderate amount of wisdom is supposedly achieved at about the same time these teeth typically make their appearance. It is common for wisdom teeth to be impacted, meaning there is no space for them to erupt in an ideal position. This can create dental problems in the future if teeth are too crowded, leading to difficulties in maintaining oral hygiene and an increased risk of cavities and other complications. If wisdom teeth are causing or will cause problems, as a person ages, the effects of retained, impacted and mal-positioned wisdom teeth can be more consequential.


Do I Need My Wisdom Teeth Removed?

If wisdom teeth erupt and are in a good position, then there is no need to remove them. If wisdom teeth are impacted and are not causing any problems whether clinical and/or radiographic, then in general there is no real justification for their removal. However, wisdom teeth need to come out if any of the following problems are occurring:


Infection

When a wisdom tooth starts to push through the gums, an infection can start around the top of the tooth. Infection and inflammation (swollen red gums) can cause severe pain, swelling, swollen lymph glands under the jaw, difficulty swallowing, radiating ear pain, jaw stiffness and sometimes fever. This is called peri-coronitis, and usually happens once food gets stuck between the erupting tooth surface and the overlying gum tissue. Repetition of this condition is annoying and painful and necessitates wisdom tooth removal.


Crowding

A wisdom tooth may push nearby teeth out of their correct position, however they are not believed to be associate with crowding of the lower front teeth. If you are doing orthodontics or have done orthodontics, and your orthodontist is in favor of taking them out, then it is highly recommended to follow the orthodontist’s advice and pull the wisdom teeth out.


Cysts

Sacks of fluid called cysts can form around the tooth and may displace the tooth. The cysts can destroy bone and damage surrounding teeth and gums and accordingly teeth removal will stop this condition and revert tissues to its normal health condition.




Damage to Nearby Molars

A partially impacted wisdom tooth that is inclined forward and part of it is visible and part is hidden under the gums, may cause serious damage to the adjacent tooth. This usually happens as a result of food stagnation between the two teeth, which is very difficult to clean in this space. This usually causes caries/decay to the adjacent tooth or the wisdom tooth ot both of them. Even if you are not complaining of anything, the mere presence of such condition, warrants immediate wisdom tooth removal to preserve adjacent tooth structure.


Why Do I Need All Four Wisdom Teeth Removed?
The impacted tooth causing problems needs to be extracted, but so does its opposing tooth. This is because teeth keep moving until they hit something. So, if only one tooth is extracted then the opposing tooth will keep moving (supraerupts) until it hits the gingiva of the extracted tooth, causing problems.

As it supraerupts, it also increases its surface area, causing more food and bacteria to accumulate around and beside the tooth. Therefore, having the two opposing teeth out at the same time saves the extraction procedure and consequent healing time from having to occur twice.

The difficulty of the extraction procedure determines whether they can be extracted at the dental office or in a hospital. We can discuss your options with you. It is also important to know the outcomes associated with the procedure, which will be explained further when you visit Dr. Raed M. Abutteen Dental Center. In the vast majority of cases, the procedure is often performed in a dental office setting, under local anesthesia, with minimal recovery time.

At Dr. Raed M. Abutteen Dental Center, we use our en-suite Three-dimensional (3D) imaging with conventional computed tomography and cone-beam computed tomography (CBCT) to study your case accurately. This 3 dimensional imaging allows us to better evaluate the number of roots your wisdom tooth has, the roots configuration, the available surrounding bone thickness and topography and the relationship and proximity of the roots to important anatomical structures such as the lower main lower jaw nerve “Inferior Alveolar Nerve” and the maxillary sinuses. This three dimensional imaging and analysis in comparison to the classical 2 dimensional panoramic imaging, contributes to optimal risk assessment and, as a consequence, to more adequate surgical planning and minimizing side effects such as injury to the inferior alveolar nerve among other complications.

Regular two dimensional panoramic x-ray lacking the third dimension, bone thickness, number and roots configuration and root to nerve position

Read More