By the age of 18, the average adult has 32 teeth; 16 teeth on the top and 16 teeth on the bottom. Each tooth in the mouth has a specific name and function. The teeth in the front of the mouth (incisors, canine, and bicuspid teeth) are ideal for grasping and biting food into smaller pieces. The back teeth (molar teeth) are used to grind food up into a consistency suitable for swallowing.
The average mouth is made to hold only 28 teeth. It can be painful when 32 teeth try to fit in a mouth that holds only 28 teeth. These four other teeth are your third molars, also known as "wisdom teeth."
Wisdom teeth, or third molars, are the last teeth to develop and appear in the mouth.They are called “wisdom teeth” because they usually appear during a person's late teens or early twenties, which has been called the “age of wisdom”.
The normal position of wisdom teeth is behind the upper and lower second, or 12-year molars.Many times the jaw of modern humans are not large enough to accommodate the four wisdom teeth.This is why wisdom teeth cause more problems than any other teeth in the mouth.
When a wisdom tooth is blocked from erupting into the mouth normally it is termed “impacted”.A tooth may be only partially impacted; meaning it erupts through the gum only partially, or it may fail to break through at all and thus remains totally impacted.
Serious problems can develop from partially impacted teeth, such as pain, infection, and crowding of, or damage to, adjacent teeth.For totally impacted teeth, more serious problems can occur. If the sac that surrounds the impacted tooth fills with fluid and enlarges it will form a cyst.This enlargement can hollow out the jaw and result in permanent damage to the adjacent teeth, jawbone and nerves.If the cyst is not treated, a tumor may develop from the walls of the cyst and a more involved surgical procedure may be required for removal.
Many problems with wisdom teeth can occur with few or no symptoms, so there can be damage without your knowing it.It is important to know that as wisdom teeth develop, their roots become longer and the jawbone denser.Thus, as a person grows older, it becomes more difficult to remove wisdom teeth and complications can become more severe.In addition, as people age there is an increased chance of the symptoms mentioned above.For these reasons, the surgeon may recommend the removal of wisdom teeth even if they are not yet causing obvious problems, particularly for young adults.
How Serious is an Impacted Tooth?
Wisdom teeth are the last teeth to erupt in the mouth. When they align properly and the gum tissue is healthy, wisdom teeth usually do not need to be removed. Unfortunately, this does not generally happen.
The extraction of wisdom teeth is necessary when they are prevented from properly erupting in the mouth. They may grow sideways, partially emerge from the gum, and even remain trapped beneath the gum and bone. Impacted teeth can take many positions in the bone as they attempt to find a pathway that will allow them to successfully erupt.
These poorly positioned impacted teeth can cause many problems. When they are partially erupted, the opening around the teeth allows bacteria to enter and will eventually cause an infection. The result: swelling, stiffness, and pain.
The pressure from the erupting wisdom teeth may move other teeth and disrupt the orthodontic or natural alignment of teeth.
The most serious problem occurs when tumors or cysts form around the impacted wisdom teeth, resulting in the destruction of the jawbone and healthy teeth.
Must the Tooth Come Out if it Hasn't Caused Any Problems Yet?
Not all problems related to third molars are painful or visible. Damage can occur without your being aware of it.
As wisdom teeth grow, their roots become longer, the teeth become more difficult to remove and complications become more likely. In addition, impacted wisdom teeth are more likely to cause problems as patients age.
No one can predict when third molar complications will occur, but when they do, the circumstances can be much more painful and the teeth more difficult to treat. It is estimated that about 85% of third molars will eventually need to be removed.
With an oral examination and x-rays of the mouth, Dr. Lewis can evaluate the position of the wisdom teeth and predict if there are present or may be future problems. Studies have shown that early evaluation and treatment result in a positive outcome for the patient.
Treatment of impacted wisdom teeth involves their removal using special surgical techniques appropriate for each individual case.Dr. Lewishas specialized training in removal of wisdom teeth is called an Oral and Maxillofacial Surgeon.
The removal of wisdom teeth can be performed on an outpatient basis, either in the Dr. Lewis' office, or in certain cases, as an outpatient in a hospital setting.If the tooth is impacted, an incision is made in the gum tissue and the tissue is turned back so the tooth can be seen.If bone is covering the tooth, it may need to be removed in order to expose and extract the tooth.The tooth may be removed whole, or in some cases it may be cut into sections, and each section is then individually removed.Usually, the surgical procedure will take between 30 and 45 minutes, although this varies according to each case.
All outpatient surgery is performed under appropriate anesthesia to maximize patient comfort. Dr. Lewis has the training, license and experience to provide various types of anesthesia for patients to select the best alternative.
In most cases, the removal of wisdom teeth is performed under local anesthesia, laughing gas (nitrous oxide/oxygen analgesia) or general anesthesia. These options, as well as the surgical risks (i.e., sensory nerve damage, sinus complications), will be discussed with you before the procedure is performed.
Once the teeth are removed, the gum is sutured. To help control bleeding, bite down on the gauze placed in your mouth. You will rest under our supervision in the office until you are ready to be taken home. Upon discharge, your postoperative kit will include postoperative instructions, a prescription for pain medication, antibiotics, and a follow-up appointment in one week for suture removal. If you have any questions, please do not hesitate to call us at (216) 261-1010.
To provide you with a better understanding of wisdom teeth, we have provided the following multimedia presentation. Many common questions pertaining to wisdom teeth are discussed.
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For a brief narrated overview of the wisdom tooth removal process, please click the image below. It will launch our flash educational MiniModule in a separate window that may answer some of your questions about wisdom teeth.
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Our services are provided in an environment of optimum safety that utilizes modern monitoring equipment and staff who are experienced in anesthesia techniques.