All About Wisdom Teeth

Most everyone seems to have a story about their wisdom teeth. Many people have them pulled or extracted before they even erupt (recovery from wisdom tooth extraction is much easier for young people than older people; therefore dentists will often recommend that wisdom teeth be removed before they’ve even erupted to avoid later problems). Some have had impacted wisdom teeth that required immediate extraction due to pain or other issues. But what are wisdom teeth, and why do we have them in the first place?

Wisdom teeth are the third set of molars, which erupt between age 17 and 21 (and sometimes as late as 25). Scientists believe wisdom teeth were the evolutionary answer to our ancestors’ early diet of coarse food — like leaves, roots, nuts, and meats — which required more chewing power and resulted in excessive wear of the teeth. The modern diet with its softer foods, along with the advent of tools such as forks, spoons, and knives, has made the need for wisdom teeth nonexistent. As a result, evolutionary biologists now classify wisdom teeth as “vestigial organs” — body parts that have become functionless due to evolution.

Wisdom teeth don’t naturally present a problem in a healthy mouth with plenty of space for the teeth to erupt. However, the majority of people’s mouths become overcrowded when the wisdom teeth appear, which can cause crowding for the rest of the teeth. Wisdom teeth are also often misaligned, presenting horizontally, or angled in the wrong direction completely. Crowded or misaligned wisdom teeth can cause problems such as structural damage in surrounding teeth, the jaw bone, or even nerves. When this happens with fully erupted wisdom teeth, the teeth can generally be removed by a simple extraction.

Unfortunately, not all wisdom teeth can be removed quite so easily. Some sets of wisdom teeth don’t fully erupt, or never erupt at all, yet still manage to cause problems. In fact, when this happens, it’s called an impaction. When wisdom teeth are impacted, there is a risk of infection, especially with those teeth that are partially impacted. The opening in the gums can allow bacteria to enter and cause an infection. The infection can create problems ranging from pain and jaw stiffness, to general illness and gum disease. Teeth which are impacted need to be removed by an oral surgeon. How are wisdom teeth removed?

The procedure for removing wisdom teeth varies depending on the positioning of the teeth, and whether or not they are impacted. In general, however, it is as follows:

- A local anesthetic will be injected to numb the affected area.

- If needed, sedation will be administered. This can include valium, nitrous oxide, or an IV sedative. The level of sedation required depends on a combination of the patient’s pain tolerance and level of anxiety about the extraction, and the type of procedure being performed (impaction generally requires a greater level of sedation than a simple extraction).

- Once sedation has taken effect, an incision is made in the gum and any bone that is blocking the tooth removed. The tooth is then extracted and the site of extraction cleaned of any debris. Stitches, if needed, are made to promote healing, and the extraction site packed with gauze to control bleeding and help a clot form.

How long does recovery from wisdom tooth extraction take?

The first 24 hours are the most uncomfortable; your dentist or oral surgeon will address what types of medications can be used to ease discomfort during your appointment. Plan to keep activity levels low for at least a week to avoid dislodging the clots from the sockets. Only soft foods should be eaten at first, with semi-soft foods being added as they are tolerable. Alcohol and tobacco should be avoided completely. Some bleeding is normal, but excessive bleeding should be reported to your dental health professional. Swelling and bruising of the cheek and mouth area is also normal and generally lasts several days.

Depending on the complexity of the extraction, recovery can take from a few weeks to several months. Most people find that after a week or two, their mouths are healed enough to be relatively comfortable.

If you have questions about wisdom teeth and their extraction, give Dr. Kotre’s Ann Arbor dental office a call at 734-677-2156. Alternately, if you have pain or discomfort in the wisdom tooth area, and have never had them extracted, Dr. Kotre is always willing to schedule a consultation to see if they may be causing a problem, and suggest ways the discomfort may be alleviated, including a referral to an oral surgeon, if required.