X-Ray of wisdom teeth requiring extraction

Wisdom teeth are the top and bottom 3rd and 4th (final molars) many people get in their late teens or early twenties. Sometimes these molar teeth can be valuable to the mouth - if they are healthy and break through the gums at an adequately aligned angle. However, most wisdom teeth are misaligned or impacted and require removal. In an article from the American Journal of Public Health, over five (5) million people undergo wisdom teeth extraction. Thus, making it the most common form of oral surgery in the United States. In the article, The Prophylactic Extraction of Third Molars: A Public Health Hazard, research finds the following:

In the United States, prophylactic removal of third molars (wisdom teeth) is advocated by almost all oral and maxillofacial surgeons and many general dentists. Ten (10) million teeth classified as impactions (teeth that fail to erupt into normal position but remain fully or partially embedded and covered by jawbone or gum tissue) are removed every year from mostly healthy young people.

Wisdom teeth sometimes come in horizontal, be angled inward, or be turned outward. Poor alignment may crowd or damage the adjacent teeth, the jawbone, or nerves. Teeth enclosed by soft tissue or within your jawbone cause impaction. Sometimes, the wisdom teeth only partially break through the gums. Partially erupted wisdom teeth create a breeding ground for infection. Dental infections can be severe and damage not just the wisdom teeth but other teeth in the mouth.

Why Do Wisdom Teeth Require Extraction?

Dental x-rays show the cause of wisdom teeth problems. Often, x-rays identify the impacted teeth that require removal. We've listed several reasons patients require wisdom teeth extraction:

  • Damage to other teeth: Your wisdom teeth can push your other teeth out of place and cause mouth pain and bite problems.
  • Jaw problems: Cysts and other issues may develop in the jaw around the wisdom teeth, particularly when partially broken through.
  • Sinus issues: Problems with wisdom teeth often result in ongoing sinus pain, pressure, and congestion.
  • Inflamed gums: The tissue around the wisdom teeth, whether it has broken through or not, can swell. The inflammation makes it harder to keep your back teeth clean, and it could lead to an infection.
  • Alignment issues: Impacted wisdom teeth can cause teeth crowding. You may need additional treatment to straighten your teeth.

What Are Impacted Wisdom Teeth?

A person's mouth has room for twenty-eight (28) teeth. If all four (4) wisdom teeth grow in, your mouth won't accommodate the space for these extra molars. Impacted wisdom teeth involve a dental issue where the third molar, known as the wisdom teeth, are prevented from breaking through the gums for some reason. For example, the position of surrounding teeth or the angled vertical position of your wisdom teeth cause the eruption. Although unerupted wisdom teeth (wisdom teeth that haven't broken through your gumline) usually do not result in symptoms, they may cause the development of cysts or neoplasms. In addition, partially erupted wisdom teeth can develop cavities or pericoronitis. If either of these occurs, you will need a dentist to remove your wisdom teeth. Preemptive treatment of partially erupted or impacted wisdom teeth can prevent future oral health care issues.

When Do I Get My Wisdom Teeth Taken Out?

Some dentists will recommend removing wisdom teeth if they do not fully emerge. Oral surgeons believe it is better to remove wisdom teeth at a younger age before complete formation. When recovery is generally faster after surgery. Other dentists may wait and make sure the wisdom teeth will cause problems such as crowd the other teeth or growing in at an angle. Symptoms that may indicate it's time for wisdom teeth removal:

  1. The gums enclose the whole tooth.
  2. The tooth is only partially through the gums.
  3. The crowding of nearby teeth.
  4. You experience pain because of the wisdom teeth.
  5. You keep getting infections.
  6. You develop cysts.
  7. You develop gum disease around the wisdom teeth.
  8. You experience tooth decay.
  9. You have damage to nearby teeth.

What's the Process of Wisdom Teeth Extraction?

Your general dentist might be able to extract your wisdom teeth. Still, you might need a referral to an oral surgeon for removal. An oral surgeon is a qualified dentist that has completed four years of specialized training. Their advanced education includes anesthesiology, diagnosis, and surgical treatment of defects, injuries, and diseases in the mouth.

Impacted wisdom tooth extraction: This depends on how many roots it has and its location under your gum. Being sedated for this procedure is expected, and the application of an anesthesia to the impacted area. Next, your surgeon makes a small cut in the bone covering the impacted tooth. Finally, your tooth is cut into small pieces and removed through the opening.

Wisdom tooth extraction: Typically, if the wisdom tooth has erupted through the gum, standard tooth extraction is performed. First, your oral surgeon uses anesthesia to make you more comfortable. Factors like placement and exposure of the wisdom tooth mean your dentist may need to cut into your gum line to remove the tooth. Sometimes, you may have the option to have a wisdom tooth removed under full sedation even if surgery isn't necessary.

Wisdom Teeth Stitches 

When you have your wisdom teeth removed, sometimes, there is a need to have stitches, also known as sutures, to hold the gum tissue together while they heal, preventing infection. When you are stitched up, you will not feel anything because your mouth will still be numb from the local anesthetic used when removing your wisdom teeth. If your tooth extraction requires it, your oral surgeon will let you know which type of wisdom teeth stitches he or she will put in and what kind of care instructions are needed to promote the healing process. Some wisdom teeth stitches will dissolve on their own with time and do not require you to come back into the dental office to have the stitches removed. Other sutures, however, must be removed by your dentist, usually seven to ten days after your wisdom teeth are removed.

Frequently Asked Questions About Wisdom Teeth

These are the common questions surrounding wisdom tooth inflammation and surgery. Of course, some people don't have problems with their wisdom teeth. If that's the case, you might not face a dental emergency. But, very few people avoid the inevitable extraction of their wisdom teeth.

Question: Do you go to the hospital for wisdom tooth surgery?
Answer: Unfortunately, many teenagers, adults in their 20's and 30's will have to go through a surgical procedure to address their final set of molars. While surgery isn't always the correct answer for problematic wisdom teeth, for many patients, the process of new tooth growth can be painful and even lead to infection. Oral surgeons often remove wisdom teeth in-office, but all four (4) extraction cases may require surgical removal in a hospital setting.

Question: What else can happen as a result of impacted wisdom teeth?
Answer: The lack of room for growth may lead to impacted wisdom teeth. Did you know infection can set in when food and bacteria get trapped in the teeth? In addition, they can hurt your existing teeth, causing shifting to make room for the new molars. Most oral surgeons recommend extraction at the first signs of any problems.

Question: Should I deal with my new wisdom teeth now or later?
Answer: Wisdom tooth removal is an effective treatment and eliminates the problems that come with their growth. For example, oral surgeons stop the crowding that occurs at the back of your mouth. In addition, surgeons prevent your wisdom teeth from impacting further and help avoid gum disease and tooth decay accompanying improper growth. The sooner you deal with impacted wisdom teeth, the better chance you have of preventing complications. Further, regular dental checkups are vital to good oral health. Finally, your dentist keeps a close eye on your incoming wisdom teeth and recommends extraction before the painful eruption of these molars.

Question: Are there risks or side effects of wisdom tooth surgery?
Answer: As the case with any surgery, wisdom teeth extraction has some complications or risks. You should be aware of these beforehand, so you're making an informed choice about removing your wisdom teeth. Experienced oral surgeons do everything possible to avoid adverse side effects. Risks include excessive bleeding, jaw pain, extended recovery, soreness, and an inability of the gums to heal. The most common complication is the development of dry sockets post-extraction.

Question: What if I wore braces and I think my wisdom teeth are inflamed?
Answer: Do you feel constant pressure but not acute or sharp pain? Often, a sign your wisdom teeth are growing in, but they don't have room, and overcrowding occurs. You don't want to harm or ruin your existing smile. Perhaps you've had orthodontic treatment like braces or clear aligners. You invested a lot of time and money to have straight, aligned teeth. Unfortunately, overcrowding caused by wisdom tooth growth may shift the surrounding teeth, and the result leaves many patients unhappy. Nobody wants crooked, misaligned teeth and to go through surgery and orthodontic treatment again. Do you wear a retainer? If you answered yes, you might need to wear it to stop your existing teeth from shifting until you can see your dentist.

Question: Is extraction always necessary?
Answer: Do you cringe when thinking about having your wisdom teeth removed? Some people don't have issues with them, but the majority have them removed. Why is this necessary? The set of four (4) molars in the back of your mouth are difficult to clean with brushing correctly. But, if you have no issues with them and can keep them clean, you may not need unnecessary surgery. However, most people will deal with one (1) or more wisdom teeth, so it's something to discuss with your dentist regularly.

Question: How do I know if I require wisdom teeth removal?
Answer: The most common symptom is pain, which tends to come and go. Wisdom tooth pain may last on and off for several years. Pain is a sign your wisdom teeth are growing or impacted. What happens if the pain persists? When your wisdom tooth pain worsens or persists, you should go to the dentist. The pain may be a result of complications.

Question: Should I tough it out and wait to have my wisdom teeth removed?
Answer: Some wisdom teeth grow crooked or at an angle, the most common causation for immediate removal. You will notice this when you feel pain as they grow, and it seems like it never stops hurting. Others come in fine but decay over time. Since wisdom teeth are hard to reach or see, cavities, dental caries, and decay are commonplace. Discomfort and pain come in waves or acutely start and stop. The pain often persists for several weeks or months and, in some instances, years. What happens if you try to tough it out and ignore the pain? Your wisdom tooth may break due to decay and spread a more painful infection in your mouth. Dentists do not recommend a tough-it-out approach.

Need Help Finding a Local Dentist or Oral Surgeon?

Wisdom teeth surgery can be performed at both general dentist offices and by oral surgeons. The Smile Generation connects you with trusted, experienced, and qualified dentists and oral surgeons. Smile Generation strives to be your trusted resource for all your dental health needs. If you are looking for how to find a dentist near me, the Smile Generation provides a search tool, "Find a Dentist". You may also call us at +1 (800) 764-5343 or use our Website's Live Chat feature located in the lower right-hand corner of your screen.