Wisdom Teeth

By the age of 18 the average adult has 32 teeth; 16 teeth on the top and 16 teeth on the bottom. Each tooth in the mouth has a specific name and function. The teeth in the front of the mouth (incisors, canine, and bicuspid teeth) are ideal for grasping and biting food into smaller pieces. The back teeth (molar teeth) are used to grind food up into a consistency suitable for swallowing.

The average size mouth may only have room to accomodate 28 teeth. It can be painful when 32 teeth try to fit in a mouth that holds only 28 teeth. The farthest teeth in the back of each jaw are the third molars, also known as the “wisdom teeth.” If there is limited room for these teeth to come in, then access to clean these teeth adequately is compromised. This leads to increased risks of the development of dental decay (of the third molar or the adjacent tooth), periodontal disease and soft tissue infection around the third molars.

Why Should I Have My Wisdom Teeth Removed?

Wisdom teeth are the last teeth to erupt within the mouth. When they align properly and gum tissue is healthy, wisdom teeth do not have to be removed. Unfortunately, this does not generally happen. The extraction of wisdom teeth is necessary when they are prevented from properly erupting within the mouth. They may grow sideways, partially emerge from the gum, and even remain trapped beneath the gum and bone. Impacted teeth can take many positions in the bone as they attempt to find a pathway that will allow them to successfully erupt.

These poorly positioned impacted teeth can cause many problems. When they are partially erupted, the opening around the teeth allows bacteria to populate the area  and will eventually lead to dental decay (of the third molar and/or the adjacent tooth) or cause an infection. The result: swelling, stiffness, pain, and illness. The pressure from the erupting wisdom teeth may move or damage adjacent teeth and disrupt the orthodontic or natural alignment of teeth. The most serious problem occurs when tumors or cysts (a fluid filled soft tissue sac) forms around the impacted wisdom teeth. This results in the destruction of the jawbone and on some occasions compromises healthy teeth. Removal of the offending impacted teeth usually resolves these problems. Early removal is recommended to avoid such future problems. Removal of the third molar before it is fully formed eases surgical complexity and decreases the risks associated with the surgical procedure.

Oral Examination

With an oral examination and x-rays of the mouth, Dr.Bundy can evaluate the position of the wisdom teeth and predict if there are any current problems or if there may be future problems. Studies have shown that early evaluation and treatment result in a superior outcome for the patient. Patients are generally first evaluated in the mid-teenage years by their dentist, orthodontist or by an oral and maxillofacial surgeon.

All outpatient surgery is performed under appropriate anesthesia to maximize patient comfort. Dr. Bundy has the training, licensure, expertise and experience to provide various types of anesthesia for patients to select the best alternative. These services are provided using appropriate monitoring equipment to provide optimum safety. And our staff are experienced and certified in anesthesia techniques and assisting in surgery performed under anesthesia.

Surgery and Anesthesia Options

In most cases, the removal of wisdom teeth is performed under IV sedation with local anesthesia. IV sedation renders patients semi-conscious. Local anesthesia only or combined with nitrous oxide/oxygen analgesia (“laughing gas”) are also options avalable to patients. These options, as well as the surgical risks (i.e., sensory nerve damage, sinus complications), will be discussed with you before the procedure is performed. Once the teeth are removed, the gum may be sutured. Most sutures that are placed dissolve. To help control bleeding, bite down on the gauze placed in your mouth. You will rest under our supervision in the office until you are ready to be taken home. Upon discharge, your postoperative kit will include postoperative instructions, prescriptions for pain medications as appropriate for your surgery, and possibly a prescription for an antibiotic. A follow-up appointment may be scheduled but often is not necessary. If you have any questions, please do not hesitate to call us at 303.932.7458.

When Should Wisdom Teeth Be Removed

It is ideal to remove your wisdom teeth before they or the adjacent teeth become diseased. The optimal time to remove the tooth is when the root is one-half to three-quarters formed. This allows the tooth to be removed more easily. Typically this stage of development is in the mid to late teenage years. With advancing age the healing of extraction sites is more compromised and prolonged.

Prevention of future disease associated with the wisdom teeth by removal of the teeth if it is felt they will remain impacted or in a compromised position to adequately clean is  the best treatment alternative.