Wisdom teeth removal is a common oral surgery procedure, performed when complications arise from the four third-stage molars known collectively as "wisdom teeth." These teeth, which generally emerge between the ages of 17 and 25, are often too large to fit safely in the gumline, and the resulting shortage of space leads to a condition called impaction. Impacted wisdom teeth can lead to a number of health issues, including mild or serious infection, damage to other teeth and cysts that in rare cases can lead to tumors. Removal is often the preferred way to avoid these hazards.
Symptoms of Impacted Wisdom Teeth
Symptoms of impacted wisdom teeth vary widely, and can include jaw pain and swelling, swollen gums, tooth discoloration, unusual sensations of pressure, headaches, bad breath and unpleasant mouth taste. If any of these symptoms develop, it's important to seek help quickly, so the severity of the situation can be determined. It's also important to note that some people with impacted teeth experience no symptoms at all. Without a dentist's visit and X-rays, it's impossible to tell if problems exist.
Treatment Options
While some oral health professionals recommend surgical extraction at the onset of any symptoms, others follow a more conservative approach, preferring to monitor the level of risk. In some cases, other existing health problems may make surgery impractical, or even dangerous. If surgery is not recommended, or simply not an option, the discomfort from impacted teeth can be lessened with over-the-counter pain relievers, mouthwashes or saline rinses. Such treatment decisions should be made in consultation with your dentist or oral surgeon.
Surgery
If surgery is the chosen option, there are still factors to consider. Simple extractions can be performed by a dentist, using local anesthesia. More complicated removals will need to be made by an oral surgeon, and may require general anesthesia. In either case, surgery involves cutting the gumline to expose the problem tooth. When teeth have already partially emerged, they can often be pulled directly from the mouth. More complicated removals may involve cutting into the surrounding bone to reach impacted roots, or even removal of part of the bone itself.
Aftercare and Potential Complications
Once surgery is performed, proper aftercare is essential. This includes adequate rest, rinsing of the mouth with a sterile solution and the temporary suspension of habits such as smoking. Common after-effects of oral surgery include pain, a small amount of bleeding and swelling of the jaw. Patients should consult with their doctors for proper management of these conditions, including the use of painkillers and methods of replacing gauze packing.
While most wisdom tooth surgeries are successful, complications do occur. These include fever, numbness, continued bleeding, exposed bone (a condition called dry socket), increasing pain, sinus difficulties and infection. Any of these symptoms can lead to serious problems, and anyone experiencing them should contact his dentist or surgeon as soon as possible.
A Note of Caution
There is considerable debate about the need for wisdom teeth extraction when no symptoms have manifested. The American Association of Oral and Maxillofacial Surgeons leans toward preemptive action, and notes that extraction becomes more difficult, and potentially more dangerous, with increased age. They believe that about 85 percent of all wisdom teeth will ultimately need to be removed. The Mayo Clinic, on the other hand, states that there is no clear evidence to support such a position. The American Dental Association comes down squarely in the middle, noting the potential complications of delayed surgery while recommending that those who decline surgery continue to be monitored by an oral health professional.
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