Wisdom teeth are the third set of molars in normal adult dentition. They usually erupt between the ages of 17 and 21. If they are aligned properly with the other teeth there is no inherent reason to remove them. This said, if the wisdom teeth compromise the adjacent teeth in any way they should be removed. These issues include alignment, eruption, decay and impaction. Basically, if the tooth is aligned properly and it fully erupts into place it can be left in the mouth. This should be decided on a case by case manner by your dentist. Sometimes misaligned wisdom teeth cause hygiene problems with the gums, decay problems with adjacent teeth, or even cyst growth in the bone. Any wisdom tooth that could damage another tooth should definitely be removed.
The best way to diagnose treatment for wisdom teeth is a panalypse x-ray. Our office has a digital panalypse x-ray machine which rotates around the head in about 10 seconds and takes a complete x-ray picture of the mouth. The image created shows the jaw, sinuses and wisdom teeth. New digital technology has extremely low radiation compared to conventional films and offers an exciting ability to visualize unerupted wisdom teeth and their roots. The same picture can be used to diagnosis possible orthodontic issues even before a child's permanent teeth erupt. A panalypse picture can also help us diagnose other rare issues like cysts, tumors, or congenital deformities.
There are three classifications of wisdom teeth. The first is erupted wisdom teeth. This just means that it has broken through the gingiva. It may just be partially exposed or even completely out of place. The second classification of wisdom tooth eruption is soft tissue impaction. This just means that the tooth is still covered by the gums so it is not visible inside the mouth. The third classification is boney impaction. This refers to a tooth that is still covered by bone. Wisdom teeth can be extracted no matter what their classification. One of the benefits of panalypse x-ray is that your dentist can evaluate the wisdom teeth and their roots to see if the extraction will be an easy one. If it is tricky, or if multiple wisdom teeth are being extracted we usually send patients to an oral surgeon. Oral surgeons utilize mild general anesthesia to make the experience easier on the patient. Every case is unique unto itself. Most patients have heard horror stories of chipmunk cheeks, but in most cases there is little swelling or discomfort. Naturally the boney impacted teeth take more healing time than the simple removal of an erupted tooth. Issues which complicate removal of erupted wisdom teeth include multiple roots which diverge in different directions, proximity to nerves in the jaw, or impaction's which place the tooth very close to the sinuses. Generally speaking, wisdom tooth extraction is much easier on the patient than is commonly thought by the general public.