Oral Surgery

Oral Surgery
Why Remove the Wisdom Teeth?

There are many good reasons for removing wisdom teeth, also known as third molars. There are also some risks and complications that are possible when extracting these teeth and sometimes there are some good reasons for leaving them alone. The decision on a specific course of action must be determined by a well informed doctor and patient working together. The aim of removal of wisdom teeth is for the prevention and/or management of diseases of the teeth and jaws.

One of the most common findings is that the mouth is just too small for these teeth to fully erupt into a good functional position. The teeth may remain completely buried in the bone of the upper and lower jaw (full bony impaction), or partially buried in bone (partial bony impaction) sometimes partially covered with a flap of gum called an operculum. Because food and plaque can easily get trapped in this flap of gum over the partially impacted tooth and is difficult to clean, the tooth can get decay and the gum can get a painful infection, called pericoronitis. It can also be caused by repeated trauma from the upper teeth biting on the operculum (flap of gum over lower wisdom tooth). Pericoronitis often recurs, so the definitive treatment is extraction of the offending wisdom teeth.

Because the wisdom teeth are often in a position of the mouth that is more difficult to access for oral hygiene, a very compelling reason for removal of wisdom teeth is an increased risk of tooth decay and periodontal disease not only for the wisdom tooth, but also for the tooth in front of it, the second molar. Depending on the position of the impacted wisdom tooth, it can cause early severe periodontal disease on the second molar, or even root resorption.

Though uncommon, a wisdom tooth that is completely buried in bone may develop into a cyst (detnigerous cyst) or rarely, a tumor (keratocystic odontogenic tumor, ameloblastoma), which can grow to a considerable size and require referral to an oral pathologist and oral surgeon for removal. Some dentists subscribe to the theory that wisdom teeth may push the other teeth in the mouth forward and cause crowding and misalignment. Though research does not show strong support nor negate this idea, its effects are clinically insignificant.

Why early removal of wisdom teeth?

Younger people heal faster and recover better with fewer complications. However, it is important to consider the possible risks and complications involved in the removal of third molars. There are some risks/potential complications which are common to all surgical procedures however major or minor they might be. These may be related to your medical and physical status, as well as the anatomical location of the wisdom tooth, which may cause probable excessive damage to structures nearby.

It is important for you to have a consultation with your dentist to decide whether you may need to see an oral surgeon or if the procedure can be done in our office under local anesthetic, with the option of having nitrous oxide sedation or oral sedation.