Mother nature is generous when it comes to our teeth. First we get baby teeth, then permanent teeth, and finally around age 18 we start getting a set of molars called wisdom teeth.

 What are Wisdom Teeth?

Wisdom teeth are third molars. Normally people have three permanent molars that develop in each quadrant of the mouth. The first molars usually grow into the mouth at around six years of age. The second molars grow in at around age 12. The third molars usually will try to grow in at around age 18 to 20 years. Since that is considered to be the age when people become wiser, third molars gained the nickname, "wisdom teeth." Actually, they are no different than any other tooth except that they are the last teeth to erupt, or grow into the mouth. They are just as useful as any other tooth if they grow in properly, have a proper bite relationship, and have healthy gum tissue around them.

 What is an impaction?

When wisdom teeth are prevented from erupting into the mouth properly, they are referred to as impacted.  A dentist must examine a patient's mouth and his or her x-rays to determine if the teeth are impacted or will not grow in properly.  Impacted teeth may cause problems and can result in infection, decay of adjacent teeth, gum disease or formation of a cyst or tumor.  Many dentists recommend removal of impacted wisdom teeth to prevent potential problems.

Erupted Wisdom Teeth

Erupted wisdom teeth may also need to be removed. Your dentist may recommend this if the tooth is non-functional, interfering with the bite, badly decayed, involved with or at risk for periodontal disease, or interfering with restoration of an adjacent tooth.

 When should Wisdom Teeth Be Removed?

Many people have little or no concern when their wisdom teeth erupt.  On the other hand, there are also quite a few who have a lot of discomfort.  If you experience any of the following symptoms it may be time to have your wisdom teeth removed. 

• pain
• infection in the mouth
• facial swelling
• swelling of the gumline in the back of the mouth
  

Many dentists will recommend removal of the wisdom teeth when the roots are approximately three-fourths developed (usually in the adolescent years).  Early removal will help eliminate the problems listed above and alleviate the potential concern of an impacted tooth that destroys the second molar.

What is involved in the extraction procedure?

Wisdom tooth extraction involves accessing the tooth through the soft and hard tissue, gently detaching the connective tissue between the tooth and the bone and removing the tooth.  Each year millions of Americans have their wisdom teeth removed. The vast majority of patients heal flawlessly with little or no discomfort.

What is a dry socket?

However, a small percentage of patients experience dry socket (alveolar osteitis) the  most common post-operative complication from tooth extractions.   Dry socket is a painful condition that occurs when the blood clot in the extraction site does not form correctly or is prematurely lost.  The blood clot lays the foundation for new tissue and bone to develop.  Dry socket delays the healing process-much like picking at a scab on the knee delays the growth of new skin.  Research confirms that patient risk factors including smoking, taking oral contraceptives (the high estrogen levels can double the chance of a dry socket), and insufficient oral healthcare habits significantly increase one's likelihood of dry socket.  Stop smoking for at least 24 hours after wisdom teeth extractions as it decreases blood supply to the area and brings toxic products that decreases healing.  Because of the estrogen levels, female patients should consider scheduling tooth extractions during days 23-28 of their menstrual cycle to reduce the risk.  Your oral surgeon or dentist will also offer other home care instructions that can help minimize the concern.