What are Wisdom Teeth?
The wisdom teeth are a third set of molars that develop at the back of the jaw anywhere from the early teenage years through the early 20s. These molars are now less essential as humans have evolved and dental care has improved.
Why Should I Have My Wisdom Teeth Removed?
The lack of room in the jaw to accommodate four additional permanent teeth can lead to a variety of issues when the wisdom teeth begin to erupt or even years later. Removing impacted wisdom teeth before the roots have lengthened and hardened can make surgery and recovery easier and reduce the risk of future complications. Potential problems that may arise from delaying or foregoing wisdom teeth removal include:
- Infection: A tooth that has only partially erupted may cause the surrounding gum to become inflamed and infected. This condition, known as pericoronitis, can lead to pain, swelling, or difficulty chewing. An infection can also put the health of adjacent teeth at risk.
- Cyst Formation: Impacted wisdom teeth may also develop fluid-filled sacs around them called cysts. These cysts may expand within the jaw, causing pain and discomfort. Cysts may slowly cause the bone to deteriorate as well if left untreated. Wisdom teeth extraction is one way of treating cysts and protecting oral health.
- Possible Crowding: Crowding of existing teeth may occur if wisdom teeth erupt or become impacted and there is not enough room to accommodate them. The wisdom teeth may cause other teeth to shift out of position, which can be more noticeable in the front of the mouth. Early removal of wisdom teeth may help alleviate issues of crowding.
- Damage to Adjacent Teeth: It can be difficult to properly clean wisdom teeth due to their location at the rear of the mouth, and this may increase the risk of infection, decay, bone loss, or gum disease around not only the wisdom tooth but the molar next to it as well.
What If I Do Not Have My Wisdom Teeth Removed as a Teenager or Adult?
Wisdom teeth removal is often recommended in the teens or early 20s because as the teeth mature, their roots become longer and may begin to curve, and the bone hardens around them. This can make extraction more difficult, and adults over age 30 may have a greater risk for complications. Treatment is more predictable in younger patients, and it can be easier to remove wisdom teeth while they are still developing.
Some patients have no issues with their wisdom teeth, and they grow in properly without becoming impacted or causing problems. Regular monitoring can help detect potential problems early on and support decisions regarding if or when wisdom teeth should be extracted.
Oral Examination of Wisdom Teeth
Patients should begin having their wisdom teeth development monitored by the time they become teenagers. Many dentists and orthodontists refer patients to an oral surgeon for tooth extraction, but patients may also seek out a consultation on their own.
Dr. Cherry performs a thorough examination of the teeth, gums, and bone, including detailed x-rays or digital images. This allows him to evaluate the development of the wisdom teeth, their current position, and whether there may be potential problems as the teeth erupt. He may recommend wisdom tooth removal if patients are currently experiencing discomfort or if problems are anticipated due to lack of space in the jaw. Extraction is commonly performed under IV sedation or general anesthesia to enhance patient comfort.
Types of Impactions
The wisdom teeth are carefully monitored as they develop to determine if there is enough room in the dental arch, whether the teeth are positioned properly as they begin to emerge, and if there is a potential that they may cause pain or complications, which may warrant having them removed. There are several types of wisdom tooth impaction that can occur:
- Soft Tissue Impaction: The tooth has erupted through the jawbone but not through the gums. The gums are fully or partially covering the tooth, making it difficult to clean.
- Partial Bony Impaction: The tooth has partially erupted through the bone, but it is not fully visible, and it is not properly positioned for chewing or cleaning.
- Complete Bony Impaction: There is not enough space for the tooth to emerge, and it remains trapped within the jawbone. The tooth may be positioned at an angle, further preventing it from developing correctly and leading to surgical removal.
What is an Impacted Tooth?
The average jaw can comfortably accommodate 28 permanent adult teeth. The wisdom teeth, which are the last to develop, bring the total number of teeth to 32. There is often not enough space in the jaw for the wisdom teeth to erupt correctly, and this increases the risk of these molars becoming impacted in the bone or gums.
What Happens on the Day Wisdom Teeth Are Removed?
Many patients are concerned about experiencing pain during wisdom teeth removal surgery, but Dr. Cherry offers several types of anesthesia that can be safely administered and monitored in the office. He will review each patient’s medical history and discuss their preferences in determining the appropriate level of sedation for the procedure. Patients should dress comfortably and wear short sleeves to provide easier access if IV sedation is used. Anesthesia allows patients to feel more relaxed, as they will not see, hear, or remember most of the procedure.
Dr. Cherry will walk patients through the procedure so that they know what to expect before, during, and after surgery. Patients should refrain from eating or drinking for at least eight hours before their appointment to reduce the risk of nausea or vomiting from the anesthesia. A local anesthetic is used to numb the extraction site, and sedation is administered to keep patients comfortable.
Removing wisdom teeth generally takes between 30 to 60 minutes, depending on the complexity of the surgery. An incision is made in the gums to expose the teeth if they have not fully erupted. Teeth may be loosened and removed in a single piece when possible, or they may be sectioned into smaller pieces and removed. Dr. Cherry will extract teeth in a way that promotes healthy recovery and minimizes discomfort based on each patient’s individual situation. Advances in technology and treatment options allow for more precise planning and surgery.
Patients should have a responsible adult accompany them to the appointment in order to drive them home after surgery. It is not safe for patients to drive themselves for at least 24 hours. Post-operative instructions will be provided prior to the procedure so that patients can prepare for recovery.
What If I Have Questions Before Surgery?
Dr. Cherry and his staff are available to answer any questions or concerns patients or their families may have before surgery. Patients will be given post-operative instructions that they can review ahead of time, and instructions can also be found here.
After the Extraction
Sutures that dissolve are periodically used to close any incisions once the wisdom teeth have been extracted, and gauze may be applied to stop any bleeding and protect the newly empty socket. Patients should keep a moistened gauze in place for at least 30-45 minutes following surgery. This will help to form necessary blood clots, which initiate the healing process. A moistened tea bag may also be used as it has a constricting agent, tannin, that helps with clotting. A prescription for pain medication is usually provided- often ibuprofen and, in some cases, a narcotic. Recent studies have shown that alternating between ibuprofen and Tylenol provides better pain relief than narcotic medication.
What Will I Feel Like After the Surgery?
It is normal for patients to feel tired or groggy after receiving anesthesia. Their mouth may also feel slightly numb or tingly as the local anesthetic wears off over the next 6-8 hours. The gums and cheeks may also be swollen after surgery, but this generally resolves within 2-3 days. Applying an ice pack in 20-minute intervals throughout the first 48-72 hours can help minimize swelling and discomfort, along with keeping the head elevated when laying down. Moist heat can be applied starting after 72 hours to reduce stiff muscles in the jaw.
Patients should plan to take 3-4 days off before returning to school or work so that they can rest and recover. Many patients find that by day two or three, they are feeling mostly back to normal, though every patient is different. Strenuous activity, including exercise, should be avoided for at least four days. Patients should notify Dr. Cherry and his staff if they have any concerns about their recovery and how it is progressing.
What are the Risks Associated with Wisdom Teeth Removal?
Wisdom teeth removal is generally a safe and fairly predictable procedure, but as with any type of surgery, there are potential risks. Dr. Cherry works closely with each patient to assess their overall health, dental history, and any risk factors when developing a treatment plan.
Dry socket is a side effect following tooth extraction of the lower teeth. It usually occurs on the 4th day when the blood clot that forms in the empty tooth socket becomes dislodged too soon, exposing the nerves in the bone to air. Avoiding both drinking through a straw and smoking can help minimize the risk of dry socket.
There is also a nerve that runs along the jaw, and some patients experience numbness or tingling in their chin, lower lip, or tongue after the surgery. This sensation will typically resolve, but patients should let Dr. Cherry know about any changes in sensation they experience.
Every patient is different, and it is not possible to list every potential risk or contingency around wisdom teeth extraction. Dr. Cherry is happy to provide more specific information and answer any questions a patient may have about their particular situation or treatment plan.
What Does Wisdom Teeth Removal Cost, and Is It Covered by Insurance?
The cost of wisdom teeth removal varies from patient to patient. Multiple factors are taken into consideration when determining pricing, such as pre-operative exams or imaging, the type of anesthesia used, and the complexity of the extractions. Insurance coverage also differs depending on the policy and the procedures performed. The staff will be able to provide a more specific estimate once the surgical plan has been created and insurance information has been collected.
You’re In Good Hands with Dr. Cherry
Dr. Cherry and his team at Cherry Orchard Oral & Implant Surgery routinely perform wisdom teeth removal for patients whose final set of molars have just developed, or patients who are experiencing pain or complications after teeth have emerged. Patient safety and comfort are a top priority throughout the process. Call (864) 603-2464 to schedule a consultation at our Greenville office and discuss wisdom teeth removal options for improved oral health.