Wisdom Teeth & Surgical Extractions
What are wisdom teeth?
Wisdom teeth, or third molars, are usually the last tooth to erupt in the mouth. Eruption usually occurs in late teenage to early adult years. There are 4 wisdom teeth (2 in the upper jaw, and 2 in the lower jaw) however it is not uncommon to be missing one or more.
Do my wisdom teeth need to be removed?
In some cases, you may lack adequate space for full eruption, or partially erupted teeth may cause pain, swelling and infection, or decay of the second molar (tooth in front). Similarly, wisdom teeth may contribute to crowding, and due to lack of available space wisdom teeth usually require removal when orthodontic treatment is considered. Sometimes, the follicle (protective sac that the tooth develops in) may enlarge with time, and form a cyst, displacing other teeth or vital structures, or presenting a risk for infection.
Do I need to see a surgeon?
General dentists are well equipped to manage most simple tooth extractions. However, in some circumstances, your dentist may refer you to a Specialist Oral & Maxillofacial Surgeon. The reasons for this vary, but may include:
Impaction of teeth (where teeth are partially or fully submerged below the gum - such as wisdom teeth), requiring surgical extraction
Proximity to other important structures, such as the maxillary sinus (the air filled space between the top teeth and the cheek bone), or important nerves such as the inferior alveolar nerve (which supplies sensation to the lower lip and chin)
Needing to consider general anaesthetic (going to sleep) for your procedure
Medical conditions or certain medications warranting extra consideration or care. All specialist-qualified maxillofacial surgeons complete a full medical degree and work full-time as hospital doctors prior to entering specialist surgical training, and thus are well trained to understand and deal with most medical problems, and to liaise with your GP or other specialists if required.
Before considering undergoing complex surgical treatment, you should confirm that your Surgeon is appropriately trained, qualified and registered, to provide the highest level of care available. You can confirm if your surgeon is registered as an Oral and Maxillofacial Surgeon here.
FAQs about Wisdom Teeth & Surgical Extractions
What is “impaction”?
Impaction simply refers to failure of a tooth to erupt out fully into the arch, within the expected time frame. The most commonly impacted teeth are wisdom teeth, followed by canines (eye teeth).
Why are my teeth impacted?
Wisdom teeth are usually impacted due to a lack of space in the arch to allow full eruption. Similarly, this can happen to other teeth such as canines or premolars, where a lack of space can prevent these teeth coming through into the arch. This can also occur due to trauma to developing jaws, failure of a primary (baby) tooth to exfoliate, or sometimes due to congenital conditions.
In other cases, extra teeth (known as “super-numeraries”) may require extraction to allow the correct teeth to erupt into position without obstruction.
How are impacted teeth managed?
Impacted wisdom teeth are commonly extracted, to prevent further problems such as pain, swelling or infection.
Other impacted teeth such as canines or premolars are managed dependent on the individual circumstances, such as the space available for eruption, the position of the teeth, and your orthodontic plan.
Your surgeon will discuss with you further, regarding the management of your impacted teeth dependent on your individual circumstance, and the appropriate risks involved.
What are the risks involved in removal of wisdom teeth?
All surgery entails some level of risk. Oral and Maxillofacial Surgeons are highly trained specialists in mouth, face and jaw surgery, and are experts in the removal of impacted teeth such as wisdom teeth. As risks vary between individuals, your surgeon will undertake a thorough assessment and discuss these risks with you, specific to your individual circumstances. In some cases, a 3-D X-ray such as a cone beam CT scan will be done, to help with planning your surgery to be done as safely as possible.
For further information regarding treatment options etc, see here.