Dental health and wisdom teeth

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 than not, they are misaligned and require removal.

Wisdom teeth present potential problems when they are misaligned as 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 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 do I know if I have wisdom teeth?

Wisdom teeth present potential problems when they are misaligned as they can position themselves horizontally, be angled toward or away from the second molars or be angled inward or outward. Ask your dentist about the positioning of your wisdom teeth. He or she may take an X-ray periodically to evaluate the presence and alignment of your wisdom teeth. Your dentist may also decide to send you to an oral surgeon (also called an oral and maxillofacial surgeon) for further evaluation.

Your dentist or oral surgeon may recommend that your wisdom teeth be extracted even before problems develop. This is done to avoid a more painful or more complicated extraction that might have to be done a few years later. Removal is easier in young people, when the wisdom teeth roots are not yet fully developed and the bone is less dense. In older people, recovery and healing time tend to be longer.

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 dentist 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. Often, for a tooth in this situation, the tooth will be extracted in small sections rather than removed in one piece to minimise the amount of bone that needs to be removed to get the tooth out.