The wisdom teeth are the third molars that force their way into the mouth between the ages of 17 and 21. Two molars appear on the bottom of the mouth and two appear across the top of the jaw. The teeth are the last ones to come into the mouth, and almost everyone has wisdom teeth by the time they turn 25. Some people even have more than four wisdom teeth, but this only occurs in about one to two percent of the population.
Wisdom teeth are sometimes called a vestigial structure, because they are no longer needed due to the way humans have evolved. Humans used to grind strong and hard food, but the teeth were not cleaned properly. The molars were often lost and the third molars replaced the missing ones. Since the missing teeth left gaps in the mouth, the wisdom teeth were able to slip up into the gums without difficulty. However, when the wisdom teeth try to emerge in a normal sized or small mouth with completely intact teeth, then the teeth can get stuck. The wisdom teeth may come in at an angle that press on the second molars or one of the teeth may completely slip underneath an adjacent tooth.
Since wisdom teeth are not necessary and can lead to problems like TMJ, dental decay, gum disease, overcrowding, and tooth damage, they are often removed from the mouth. Your dentist may not consider removal if you can clean the wisdom teeth properly, if your bite is normal and natural, and if you have no problems chewing or biting. Also, the size of the mouth is evaluated when determining whether or not your wisdom teeth can stay in your mouth.
If your wisdom teeth have formed or emerged abnormally, like in the case of an impact, then a separate evaluation of the teeth will take place. X-rays will be taken to locate the teeth and to determine why they are stuck. If the teeth are sideways or forcing pressure against the second molars, then removal may be scheduled to prevent future infections, tooth shifting issues, or dental damage.
Also, your dentist may evaluate your symptoms when deciding whether or not the impacted teeth need to be removed. If symptoms like pain, pressure, swelling, jaw pain, and bad breath are noted, then wisdom tooth removal will typically be scheduled.
When impacted wisdom teeth are removed, the gums are cut and bone is released to expose the teeth. The teeth are then cut into small pieces and removed from the mouth. The gums are then stitched up and gauze is packed around the surgical area. Since impacted wisdom tooth removal is more complicated and extensive than a regular extraction, you may need something beyond local anesthesia. Conscious sedation, nitrous oxide gas, IV sedation, and general anesthesia are all options that can be discussed with a dentist. Keep in mind that IV and general sedation are typically only used in cases where in-depth and serious surgical intervention is needed.
If you do schedule surgery and opt for a more advanced sedative, then you will need a ride home after your operation. Make sure to schedule this beforehand. Also, make sure to stock up on soft foods and clear liquids that you can easily consume after the tooth removal is over.