Wisdom Teeth

wisdom.teeth

Wisdom teeth, or third molars, develop and erupt into the mouth between the ages of 16 and 25 (the age of wisdom).  When they are unable to fully enter the mouth, they are said to be “impacted.”  This is usually due to a lack of room.  Our jaws are evolving, and due to our refined diet, they are developing shorter.  Therefore, the wisdom teeth become impacted.  9 out of 10 people have at least one wisdom tooth.

Are impacted wisdom teeth a serious condition?

If impacted wisdom teeth are left in the mouth, they can cause damage to neighboring teeth, become infected, or develop other pathologic conditions.  Because the third molar area is difficult to keep clean, infections can develop and spread throughout the body.  Cysts and other tumors can develop and cause destruction of the jaw bones, teeth, nerves and other structures.  Removal of the wisdom teeth can improve and prevent these untoward events.
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Why do my wisdom teeth need to be removed if they are not causing problems?

Just because your wisdom teeth don’t hurt does not mean that they are healthy.  Wisdom teeth are prone to disease and often do not become symptomatic until they are a major problem.  Wisdom teeth should be evaluate and removed in the following instances:

  • infections and/or periodontal disease
  • pericoronitis (inflamed tissue around wisdom teeth)
  • cavities that cannot be restored
  •  pathology such as cysts and tumors
  • Damage to neighboring teeth

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The procedure

Dr. Mueller typically performs the removal of wisdom teeth with local or IV anesthesia.  Patients are asked to refrain from eating or drinking for 6 hours prior to their procedure if they are to have IV anesthesia.  Once asleep, local anesthesia (numbing) is administered, the wisdom teeth are removed, and the areas are closed with dissolving stitches.  The numbness will last 6 – 8 hours and the stitches will dissolve in about a week.

Once the procedure is complete, you will spend a brief time in the recovery room and then are allowed to go home.  Dr. Mueller asks that you keep your head elevated and use ice packs on and off for about 48 hours.  You should start with clear liquids, then non-chew food and then begin taking your prescriptions.  Swelling peaks at 48 – 72 hours.  By the 3rd or 4th day, the swelling should typically be resolved.  Most patients have the procedure done on a Friday and are back to school or work the following Monday.
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Tooth Extractions

extractions

Decayed teeth requiring removal and replacement with dental implants.

Teeth may need to be removed for a number of reasons, usually due to extensive decay, periodontal disease, cracks, or trauma resulting in painful, abscessed and/or loose teeth.   Dr. Mueller will evaluate your specific problem and recommend the proper treatment options, including the options of local or general anesthesia.  He will explain the procedures and make sure that you fully understand your treatment ahead of time.  If your dentist has recently taken x-rays which show all of the teeth in question, please bring them with you to your appointment.  We will provide you with post-operative instructions, extra gauze and a prescription for pain medication or antibiotics (if indicated) after your treatment is complete. You can expect mild to moderate discomfort for a few days following the procedure.  There may be some swelling, stretching of your lip, or bruising.  In general, you should start to feel better after 2-3 days.  If you do not, please let us know.

If you prefer to have sedation or general anesthesia, a preoperative anesthesia evaluation appointment is mandatory.  This allows us the opportunity to review your medical history, determine what procedure(s) are needed and otherwise prepare you for your procedure.

Who should remove my wisdom teeth?

That is a very good question.  There are many doctors who are not oral surgeons that remove wisdom teeth.  They take weekend courses where “practice management consultants” convince them to remove wisdom teeth in order to, “increase their bottom line.”  They are not properly trained to treat the possible complications that can arise from the removal of wisdom teeth.  Dr. Mueller practices by the maxim, “If a doctor cannot treat all of the possible complications of a procedure, they have no business performing the procedure at all.”  Oral and Maxillofacial Surgeons (OMFS)are well versed in the prevention of and treatment of complications of wisdom tooth removal and tooth extractions.  Furthermore, only OMFSs are adequately trained in general anesthesia.