Dentistry News

Wisdom teeth are the third and final set of molars that most people get in their late teens or early twenties. Sometimes these teeth can be a valuable asset to the mouth when healthy and properly aligned, but more often, they are misaligned and require removal.

Wisdom teeth present potential problems when they are misaligned – they can position themselves horizontally, be angled toward or away from the second molars or be angled inward or outward. Poor alignment of wisdom teeth can crowd or damage adjacent teeth, the jawbone, or nerves. Wisdom teeth that lean toward the second molars make those teeth more vulnerable to decay by entrapping plaque and debris. In addition, wisdom teeth can be entrapped completely within the soft tissue and/or the jawbone or only partially break through or erupt through the gum. Teeth that remain partially or completely entrapped within the soft tissue and /or the jawbone are termed “impacted.” Wisdom teeth that only partially erupt allows for an opening for bacteria to enter around the tooth and cause an infection, which results in pain, swelling, jaw stiffness, and general illness. Partially erupted teeth are also more prone to tooth decay and gum disease because their hard-to-reach location and awkward positioning makes brushing and flossing difficult.

How Are Wisdom Teeth Removed?

The relative ease at which your dentist or oral surgeon can extract your wisdom teeth depends on their position. Your oral health care provider will be able to give you an idea of what to expect during your pre-extraction exam. A wisdom tooth that is fully erupted through the gum can be extracted as easily as any other tooth. However, a wisdom tooth that is underneath the gums and embedded in the jawbone will require an incision into the gums and then removal of the portion of bone that lies over the tooth. Oftentimes, for a tooth in this situation, the tooth will be extracted in small sections rather than removed in one piece to minimize the amount of bone that needs to be removed to get the tooth out.

Impacted Wisdom Teeth

The reason dentists so often recommend removal of wisdom teeth is that, more often than not, they do not come in straight. About 44 per cent of the time the wisdom teeth come in angled forward. Called mesioangular impaction, this malformation points the tooth toward the front of the mouth.

About 38 per cent of the time, the wisdom tooth never comes completely through the gum line. This malformation is known as vertical impaction. In relatively rare cases, about 6 per cent of the time, the wisdom tooth is angled backward, toward the rear of the mouth. This phenomenon is known as distoangular impaction. It is also possible for a wisdom tooth to come in sideways. This phenomenon, known as horizontal impaction, occurs in about 3 per cent of wisdom teeth that come in growing at a 90 degree angle to neighboring teeth, growing their roots into the neighboring molar.

Why Are Wisdom Teeth Removed?

Wisdom teeth are extracted because:

• They are erupting in to an abnormal position, such as tilted, sideways or twisted.

• They are trapped below the gum line due to lack of space.

• An infection has developed from trapped food, plaque and bacteria, known as pericoronitis.

• The way the patients teeth bite together has changed, causing misalignment of the jaws.

 Oral and maxillofacial surgeons specialize in dental surgery. Your dentist may choose to refer you to see a surgeon for your extractions. The most common reason for this is because of where the wisdom teeth are positioned and the difficulty level of the extraction.