Wisdom teeth (or third molars) usually emerge in young adults in their late teens or early twenties. Although it is possible that you will never have any problems with your wisdom teeth “coming in,” most people’s mouths are too small to accommodate the new teeth properly, and can result in problems.
If the wisdom teeth are misaligned – positioned horizontally, pointed towards or away from the second molars, or pointed inward or outward – they can cause crowding of other teeth, and damage to the jaw and nerves. Wisdom teeth can also become entrapped (covered by the soft tissue and bone of the jaw); such teeth are referred to as impacted. Impacted wisdom teeth often become infected, resulting in pain, swelling, or actual disease.
If you are of an age when your wisdom teeth are beginning to come in, most dentists recommend X-rays to determine how they are emerging, and whether there is room in your mouth for them to do so without causing problems, or if they are becoming impacted. If the analysis shows that there may be problems, in most cases the recommendation is extraction of the third molars.
What can you expect if you have your wisdom teeth removed?
If the wisdom teeth have emerged properly and are fully visible above the gum line, they can be extracted as easily as any other tooth. If the tooth has become impacted, and part or all of it is hidden beneath the soft tissue and bone of the jaw, then oral surgery is necessary. During oral surgery, a local anesthetic is applied to the area to numb the tooth. If the tooth is seriously impacted, or if all four wisdom teeth are being removed at once, some dentists and oral surgeons may recommend general anesthesia, so that you sleep through the process.
To remove an impacted wisdom tooth, first an incision is made in the soft tissue to reveal it, and then it is gently separated from the bone and soft tissue that is covering it. If the tooth is impacted such that it is partially hidden by the bone of the jaw, either some of the bone may be removed, or the tooth may be broken up and removed in pieces. After the extraction your dentist may have to stitch up the incision to close it properly and allow it to heal.
Because third molar extraction is oral surgery, there may be some residual pain and swelling in the days following the procedure. The incisions may bleed lightly, but this usually stops within 24 hours. Your dentist will recommend medications to handle any pain and to prevent infection, and may make other recommendations to speed your recovery.