The very last teeth to erupt in your mouth are the 3rd molars, better known as wisdom teeth. The wisdom teeth appear in the mouth between the ages of 16-25, which was once considered the “golden age of wisdom”, hence the name. Today, some studies show that 90% of wisdom teeth will not erupt into a position in the jaw that will allow enough room for adequate oral hygiene. If proper, daily cleaning cannot be completed then decay and infection results. Cavities and gum infections around wisdom teeth can be very difficult to treat, therefore the most practical treatment is removal of the problematic teeth. (Scroll below to see cavity caused by a neglected wisdom tooth)
Often times the wisdom tooth erupts and becomes “stuck”, or impacted, behind the second molars. There are varying degrees of impacted teeth:
- Soft Tissue Impaction: This is where the wisdom tooth almost erupts into proper position, but it gets stuck in the gum tissue. These are the most common impactions and usually cause the most trouble. If the tooth is able to break through the gums, food and plaque can be trapped leading to infection, inflammation, and a foul odor from around the tooth. To aid in the comfort of having them removed nitrous oxide or IV sedation is recommended for this procedure.
- Partial Bony Impaction: This occurs when the tooth gets stuck coming half-way through the bone. This is a little more difficult case to work with. This type of extraction involves pushing the gums back and removing the portion of bone that has trapped the impacted tooth. IV sedation is recommended for this procedure.
- Full Bony Impaction: Full bony impactions occur when the tooth gets stuck entirely within the bone. Most of the time these can be left alone without consequence. However, sometimes pathology may involve these teeth and extraction is necessary to alleviate the problem. IV sedation is recommended. If nerve involvement is suspected, the case may be referred to an oral surgeon.
My wisdom teeth don’t hurt. Do I still need them evaluated?
Impacted wisdom teeth can cause problems. Such as in the image on the right where the wisdom tooth caused a large cavity on the 2nd molar. Both the 2nd molar and wisdom tooth needed to be extracted.