Wisdom Teeth

Wisdom teeth, referred to as third molars, are usually the last teeth to develop.  They are upper and lower teeth whose function is to grind food as part of the digestive process.  They are located in the very back of your mouth, next to your second (or twelve year) molars and near the entrance of your throat.  They usually complete development between the ages of 17 and 25, a time of life that has been called the “Age of Wisdom” or traditionally associated with the onset of maturity.

Although people develop and grow 32 permanent adult teeth (16 in the upper and 16 in the lower jaw), most do not have enough room in their mouth for all of these teeth to completely erupt.  Since the wisdom teeth are the last to develop, they often will not have enough room to adequately erupt into the mouth to become fully functional and cleanable teeth.  This lack of room or space can result in a number of harmful effects on your overall dental health.  When this occurs they are said to be impacted, indicating their inability to erupt into an alignment that will allow them to be able to function in the chewing process.  There are several types of impactions:

  • Soft Tissue Impaction:  There is adequate jawbone to allow the wisdom tooth to erupt but not enough room to allow the gum tissue to recede to allow adequate cleaning of the tooth.
  • Partial Bony Impactions:  There is enough space to allow the wisdom tooth to only partially erupt.  It cannot function in the chewing process and creates cleaning problems.
  • Complete Bony Impactions:  There is no space for the tooth to erupt.  It remains totally below the bone level or,  if even partially visible, requires complex removal techniques.
  • Unusually Difficult Complete Bony Impactions:  The impacted wisdom tooth is in an unusual and difficult to remove position.  The situation can also arise when the shape of the jawbone and other facial structures make removal of this tooth significantly more difficult.

If you do not have enough room in your mouth for your third molars to erupt and they become impacted, several detrimental results can occur:

  • Infection:  Without enough room for total eruption, the gum tissue around the wisdom tooth can become irritated and infected, resulting in recurrent pain, swelling and problems with chewing and swallowing.
  • Damage:  If there is inadequate room to clean around the wisdom tooth, the tooth directly in front, the second molar, can be adversely affected resulting in gum disease (bone loss) or cavities (more appropriately known as dental caries or decay).
  • Disease:  Non-infectious diseases can also arise in association with an impacted wisdom tooth.  Cysts are fluid-filled tissue inside the jawbone which are associated with impacted wisdom teeth and slowly expand destroying adjacent jawbone and occasionally teeth.  They can be very difficult to treat if your wisdom teeth are not removed in your teenage years.  Although rare, tumors can be associated with the delayed removal of wisdom teeth.
  • Crowding:  Although controversial, many feel that impacted wisdom teeth directly contribute to crowding of your teeth, which is most noticeable in the front teeth.  This is most commonly seen after a patient has had braces.  There are most likely a number of factors that cause teeth to crowd after braces or in early adulthood and retained, impacted wisdom teeth are suspected to play a role.

Unless you have an active problem at the time of your consultation, the reason for removal is primarily preventative to avoid long-term problems.  There is less chance of complications and long-term problems if wisdom teeth are removed before they start to hurt.  By the time wisdom teeth become symptomatic, damage may have already occurred.

We will need to see you for a consultation before it is determined that you will benefit from wisdom tooth removal.  We will need to take a special x-ray of your mouth and jaws to determine how much room you have, if any, for your wisdom teeth to erupt.

We recognize that having your wisdom teeth out is not something you really want to do, and we know it is difficult to find a good time in your schedule to have this done.  If this information, combined with information you receive at your consultation appointment doesn’t answer all of your questions, please call our office and speak to one of our Clinical Support staff.