Wisdom teeth Extraction

Many people require removal of their wisdom teeth also known as third molars. Normally people have three permanent molars that develop in each quadrant of the mouth. The third molars usually will try to grow in at around age 18 to 20 years.

Wisdom teeth are actually no different than any other tooth except that they are the last teeth to erupt. They are just as useful as any other tooth if they grow in properly, have a proper bite relationship, and have healthy gum tissue around them. Unfortunately, this does not always happen.

When wisdom teeth are prevented from erupting into the mouth properly, they are referred to as impacted. A dentist must examine a patient's mouth and corresponding x-rays to determine if the teeth are impacted or will not grow in properly. Impacted teeth may cause problems. Impacted teeth can result in infection, decay of adjacent teeth, gum disease or formation of a cyst or tumor from the follicle, which is the tissue which formed the crown of the tooth. Many dentists recommend removal of impacted wisdom teeth to prevent potential problems.

Is it necessary to remove wisdom teeth?

Erupted wisdom teeth may also need to be removed. The dentist may recommend this if the tooth is non-functional, interfering with the bite, badly decayed, involved with or at risk for periodontal disease, or interfering with restoration of an adjacent tooth. Once again, every case is different and only your dentist can determine if there is a reason for you to have a tooth removed.

Extraction of third molars is generally recommended:

• When wisdom teeth only partially erupt;
• When there is a chance that poorly aligned wisdom teeth will damage adjacent teeth;
• When a cyst (fluid-filled sac) forms, destroying surrounding structures such as bone tooth roots.

The most common reason people choose to remove their wisdom teeth is that their mouth is too small for these teeth to normally erupt behind the second molare into a good position. This can result in one of the following situations:

1. Complete Bony Impaction when the wisdom teeth are completely covered in bone. When the tooth is completly covered with bone it will remain completly covered with its "developmental sack" in which all teeth develop. Later in life, this sack may undergo changes and enlarge and develop ionto a cyst. This cyst will enlarge at the expense of the bone of the jaw. These cysts should be removed and and examined by a pathologist.

2. Partial Bony Impaction whenThe teeth begin to erupt but are not able to erupt completely. In this situation, the upper third molars usually are poisitoned towards the cheek while the lower third molars usually lean forward with only part of the crown sticking through the gum. This situation can to decay and gum disease around the second molar directly in front of it.

The most common complication of the partial bony impaction, is that the flap of gum tissue which partially covers the erupting third molar, creates a pocket where bacteria that are present in the mouth can grow and and cause an infection known as pericoronitis. The swelling and infection can become very serious. The treatment for pericoronitis is extraction of the third molar tooth.