removing teeth

cutting

Wisdom teeth extractions
Wisdom teeth, or third molars, are the last permanent teeth to erupt, usually between the age of 17 and 25 years. However, they do not always erupt properly when they decide to make an appearance. It's wise to get an early opinion from your dentist on getting wisdom teeth pulled before they become impacted, causing pain, swelling, infection, cavities or gum disease.

Why don't wisdom teeth grow in right?
Although we have seen a reduction in the size of the human jaw during the course of human evolution, we still retain the same number of teeth. Thus, as the jaw became smaller, the teeth became crowded, and the space required for the proper growth of wisdom teeth became no longer available.

What does "impacted" mean?
When wisdom teeth don't have room to grow or they haven't reached their final position by age 25, they are considered impacted - no place to go and no plans to grow. Third molar impaction is the most prevalent medical developmental disorder. A full set of healthy teeth sometimes doesn't leave much room for wisdom teeth to erupt.

What kind of problems can impacted third molars cause?
Partially erupted wisdom teeth are breeding grounds for bacteria and germs and may lead to infection. They may also cause problems to the adjacent second molars. In addition to jaw pain and gum disease, which may also develop, impacted third molars are ripe sites for the growth of tumors and cysts. Not all wisdom teeth cause problems, however.

Can't I just use an antibiotic?
Antibiotics only correct the infection caused by impacted wisdom teeth for a short time. Since the actual problem is not solved, it is prone to relapse over and over again.

When is removal necessary?
The positions of the third molars are determined using X-rays. If your dentist decides that the wisdom teeth are impacted and likely to cause problems in the future, he may recommend their removal. In such a case, the earlier the removal is done, the better for you, instead of waiting till they cause a problem or infection. And the younger you are, the easier you heal and recover from the surgery.

What if I don't have any symptoms?
People with symptoms of impaction, such as pain, swelling and infection should have their wisdom teeth removed immediately. However, those with no symptoms can avoid the chance of ever suffering from the pain of impacted wisdom teeth or achieve better orthodontic treatment results by having them removed. Asymptomatic impacted wisdom teeth also should be removed to reduce the chance of unexplained pain, accommodate prosthetic appliances, or avoid cavities, periodontal disease, bone shrinkage and tumor development.

How is the tooth removed?
Surgery for impacted wisdom teeth consists of removing of the gum tissue over the tooth, gently stripping connective tissue away from the tooth and bone, removing the tooth and sewing the gum back up. This is most often done under local anesthesia.

Will it make any difference to my face or mouth?
Taking wisdom teeth out may cause some swelling for a few days. But as soon as the area is healed, there will be no difference to your face or appearance. Your mouth will feel more comfortable and less crowded, especially if the teeth were impacted.

What should I expect after a wisdom tooth is taken out?
The amount of discomfort will depend on how easy the removal of the tooth was. There is usually some swelling and discomfort for a few days afterwards, and it is important to follow your doctor’s advice about mouthwashes, painkillers, antibiotics, etc, to help with the healing. It is best to stay fairly quiet and relaxed and avoid smoking and drinking for 24 hours afterwards to make sure there are no bleeding problems. There may be some stitches to help the gum heal over – your dentist will probably want to see you again about a week later to check on the healing, and to remove any stitches.

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© All images here are taken by Dr Joseph Varghese. All these photos are of our own patients.