|Most people start getting their third molars (also called wisdom teeth) when they reach their late teens or early twenties. Most adults have four wisdom teeth, but it is possible to have fewer (hypodontia), or more, in which case they are called supernumerary teeth. When a tooth develops, it travels to its appropriate position in the dental arch. In many cases, the jaws are not large enough to accommodate these teeth. If the path to eruption through the gum is prevented due to the size of the jaw, the tooth will become partially or totally blocked (impacted). Unfortunately, you can’t really control the size of your mouth nor how your wisdom teeth grow in. So, there is little one can do to prevent this condition.
Serious problems can develop from partially impacted teeth such as infection, and possible crowding of and damage to adjacent teeth. These may result in swelling, stiffness, pain and illness. The most serious problems occur when tumors or cysts form around the impacted wisdom tooth. This may result in the destruction of the jawbone and may cause permanent damage to the adjacent teeth and nerves. Removal of the offending impacted tooth or teeth usually resolves these problems. No one can tell you when your impacted molar will cause trouble, but when it does, the circumstances can be much more painful and the teeth can be more complicated to treat. Early removal is recommended to avoid such future problems and to decrease the surgical risk involved with the procedure. Removal of impacted teeth is easier in younger patients, has a lower incidence of complications, and recovery is faster.
As with any procedure, the oral and maxillofacial surgeon will perform an oral examination. This will involve x-rays to evaluate the position of the wisdom teeth and predict if there may be present or future problems. Chances are the oral and maxillofacial surgeon will recommend their removal rather than wait for trouble to occur. Wisdom teeth that are not removed should continue to be monitored, because the potential for developing problems later on still exists. As with many other health conditions, as people age, they are at greater risk for health problems and that includes potential problems with their wisdom teeth. The older you get the more difficult wisdom teeth surgery can become. When you are young, the roots are not completely formed and the surrounding bone is softer, which leaves less chance for damaging nearby nerves. Your roots will continue to grow with age, making wisdom teeth surgery more painful and prone to complications as you get older. Studies have shown that early evaluation and treatment result in a superior long term 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. Only after a thorough examination can the surgeon provide you with the best options for your particular case.
Wisdom teeth removal is a common procedure and is performed under either local anesthesia, intravenous sedation, or general anesthesia. Your oral and maxillofacial surgeon will discuss the procedure with you and tell you what to expect. The anesthetic options, as well as the surgical risks (i.e., sensory nerve damage, sinus complications), will be discussed with you before the procedure is performed. This is a good time to ask questions. Talk to your surgeon about any concerns you have. Be sure to let your doctor know about any illness you have and medications you are taking. It is important for patients to know that they should always feel free to discuss treatment recommendations with their surgeon, particularly if they do not understand or are unsure about the recommended treatment.
Oral and maxillofacial surgeons are specialists in this type of dental surgery. In addition we have training, licensing and experience to provide various types of anesthesia. Most outpatient surgery is performed in our office to maximize patient comfort and convenience. These services are provided in an environment of optimum safety, utilizing modern monitoring equipment and our well-trained staff is experienced in the latest anesthesia techniques and procedures. After surgery you will rest under our supervision in the office until you are ready to be taken home. Generally, you may experience some swelling and discomfort, which are part of the normal healing process. Personalized postoperative instructions, medications, and a follow-up appointment will be given to you and/or your driver prior to discharge. You may be instructed to modify your diet following surgery and later progress to more normal foods.