Wisdom teeth are another name for any one of four third molars found in the permanent dentition. These teeth are the last or most posterior teeth in the dental arch. Although most people have wisdom teeth, it is possible for some or all of the third molars to never develop. It is also possible for a person to have more than four wisdom teeth. In many individuals, the wisdom teeth aren't visible because they have become impacted (not normally erupted through the gums) under the gingival tissue.
A wisdom tooth is extracted to correct an actual problem or to prevent problems that may come up in the future. Some of the problems that can occur when wisdom teeth come in are:
- Your jaw may not be large enough for them, and they may become impacted and unable to break through your gums.
- Your wisdom teeth may break partway through your gums, causing a flap of gum tissue to grow over them. Food and germs can get trapped under the flap and cause your gums to become red, swollen, and painful. These are signs of infection.
- More serious problems can develop from impacted teeth, such as infection, damage to other teeth and bone.
- One or more of your wisdom teeth may come in at an awkward angle, with the top of the tooth facing forward, backward, or to either side.
Wisdom tooth removal usually is effective in preventing:
- Crowding of the back teeth.
- A wisdom tooth becoming stuck in the jaw (impacted) and never breaking through the gums.
- Red, swollen, and painful gums caused by a flap of skin around a wisdom tooth that has only partially come in.
- Gum disease and tooth decay in the wisdom tooth, which may be harder to clean than other teeth, or in the teeth and jaw in the area of the wisdom tooth.
Risks
After a wisdom tooth is removed, you may experience:
- Pain and swelling in your gums and tooth socket where the tooth was removed.
- Bleeding that won't stop for about 24 hours.
- Difficulty with or pain from opening your jaw (trismus).
- Slow-healing gums.
- Damage to existing dental work, such as crowns or bridges, or to roots of a nearby tooth.
- A painful inflammation called dry socket, which happens if the protective blood clot is lost too soon.
- Numbness in your mouth and lips after the local anesthetic wears off, due to injury or inflammation of nerves in the jaw.
- Rare side effects, including:
- Numbness in the mouth or lips that does not go away.
- A fractured jaw if the tooth was firmly attached to the jaw bone.
- An opening into the sinus cavity when a wisdom tooth is removed from the upper jaw.
How is wisdom tooth extraction performed?
Once it has been determined that a wisdom tooth is problematic, extraction by an oral surgeon or qualified general dentist is usually indicated. Local anesthesia is administered to ensure the tooth can be pulled out without any discomfort. Many people will choose conscious sedation (being put into a sleepy state where pain signals are blocked) so they have little or no memory of having the wisdom teeth extracted. A minor surgery is then performed where the tissue and bone around the wisdom tooth are removed so that the tooth can be cleanly extracted from the socket. Several stitches may be needed to close the surgical site and promote healing of the overlying tissue.