Wisdom teeth, technically known as third molars, are the last four of 32 teeth to erupt in the mouth. When there is inadequate space in the mouth to accommodate this growth, wisdom teeth can essentially become stuck. Not only can the teeth grow crookedly and become misaligned, but they can also become painful and cause damage to other teeth. If left untreated, impacted wisdom teeth can lead to infection and more severe health concerns such as cysts or tumors. Many oral health professionals recommend their removal during the teenage years as a preventative measure.
Dr. John Freeman is a board-certified oral and maxillofacial surgeon with extensive experience performing wisdom teeth extraction. He has performed this procedure for thousands of patients of various ages, including adolescents and young adults, in the Katy, TX, area. Wisdom teeth removal is a standard procedure that serves to relieve the pain associated with third molars that do not emerge fully or correctly. The surgery can help to prevent any further issues from developing and is often recommended to protect your future oral health.
If a dentist has referred you or your child for a wisdom tooth evaluation, we invite you to contact the office of Dr. Freeman to schedule an appointment.
Every tooth a person will ever have is present at birth, waiting in the skull structure for its time to emerge. First, the initial set of 20 baby teeth erupts and falls out. Then, 32 permanent adult teeth grow into the mouth. The first set of molars usually arrives around age six, followed by the second set around age 12. Wisdom teeth are the final set of molars that most people get in their late teens or early twenties, generally between the ages of 17 and 25. They are the last four permanent teeth positioned at the very back of the mouth, at both the top and bottom, near the entrance to the throat. Historically, they have been called “wisdom” teeth because they arrive at a more mature and experienced age.
Wisdom teeth are thought to be evolutionary relics, just like the appendix or tailbone. Though they may have served a purpose to our ancestors, they do not appear to be a necessary tool in modern human life. About 22% of adults never develop wisdom teeth or develop only some of their teeth. For others, wisdom teeth erupt normally and cause no problems. However, in many cases, the wisdom teeth do not have adequate jaw space to grow, causing issues that only surgery can effectively address.
Wisdom teeth removal or wisdom tooth extraction is the removal of one or more wisdom teeth with forceps or surgery. The procedure can be done by a dentist or an oral and maxillofacial surgeon.
Children, teens and young adults are the usual candidates for wisdom teeth removal, mostly because it’s much easier to extract wisdom teeth at a younger age. Wisdom teeth roots become more solidly anchored in the jawbone with time, making tooth extraction during later adulthood more difficult. Furthermore, recovery following tooth extraction is faster in younger patients. Extracting wisdom teeth before they begin to cause dental and other problems is also common practice in many parts of the world.
However, anyone experiencing problems with their wisdom teeth can be a candidate for removal, no matter their age and status.
In general, wisdom teeth should be removed when they cause problems or if there is potential for them to cause problems. The American Dental Association recommends wisdom teeth removal when there is any of the following in the mouth:
If you have an impacted wisdom tooth, i.e. trapped inside your jaw or gum, you will likely need to have it surgically removed, especially if it starts to cause problems.
Your dentist will monitor your wisdom teeth and look for signs of infection, gum disease and other dental issues. If they find that wisdom teeth removal is necessary or a sound preventive measure in your case, they may perform the extraction themself or refer you to an oral and maxillofacial surgeon such as Dr. Freeman.
Wisdom teeth removal is a convenient procedure with quick recovery times. The procedure is typically performed in a dental or oral surgery office under IV sedation. Here is what you can expect before, during and after your wisdom tooth extraction.
You will first need to meet with your dentist or oral surgeon, who will speak to you about your concerns and walk you through the process. It is important that you disclose your medical history and be open about any medications and supplements you are currently taking. Before tooth extraction, most patients are advised to:
It is also important to have an X-ray before wisdom tooth extraction. This helps Dr. Freeman decide on the best course of action.
Wisdom tooth extractions usually begin with IV sedation. Your dentist or surgeon will numb the treated area with local anesthetic injections. This part of the procedure may be slightly painful, but anesthesia helps you feel as comfortable as possible during tooth extraction.
If your wisdom tooth is impacted, Dr. Freeman will make an incision in the treatment area and may need to remove bone if it is blocking access to the tooth. He will then pull out the tooth with forceps or may need to cut the tooth into half for easier removal. If your tooth is already easy to access, Dr. Freeman will skip the first two steps and extract the tooth using an elevator to loosen it from its socket and forceps to pull out the tooth.
The whole procedure takes about 30 to 45 minutes but may take a little bit longer if you are having multiple teeth extracted. For simple tooth extractions, multiple teeth can be quickly removed in one sitting. There is usually no limit on how many teeth we can remove at once.
Wisdom teeth extraction does not require an overnight stay, so most patients can return home on the day of their treatment. Dr. Freeman will ensure you are provided with detailed post-operative instructions. He will also provide any medication necessary to help manage swelling and discomfort and to minimize the risk of infections.
You may feel slightly numb and drowsy right after your surgery. As your anesthesia begins to wear off, you will start to feel sore in the treatment area. Holding a cold compress against your jaw can also alleviate any pain and swelling. If necessary, take pain medication to manage discomfort. In the first 24 hours, a blood clot will form inside the socket where the tooth was. This is normal and should not be removed!
Plan to rest for the remainder of the day after your surgery and use saltwater to keep your mouth clean. You may resume some normal activities three days after surgery, but continue to avoid strenuous activities for at least a week. Avoid excessive spitting, drinking through a straw, eating hard or chewy foods, aggressively brushing your teeth and other activities that could dislodge the blood clot from the socket. Eat only soft food for the first 48 hours, then gradually introduce semi soft foods as tolerated. Do not use tobacco products, as they can delay healing and increase the risk of complications.
Rarely, wisdom teeth removal complications can include:
Wisdom tooth extraction is straightforward for most patients, and complications aren’t common when an experienced oral surgeon performs the procedure.
In some cases, wisdom teeth may not require removal. If the molars erupt fully, grow normally and are positioned to bite correctly with their opposing teeth, extraction may not be necessary. Also, if you can reach them with a toothbrush, your wisdom teeth may pose no dental health problems and should be left alone.
Some experts believe that wisdom teeth that haven’t come through but don’t cause symptoms don’t require removal. Up to 80% of young adults in Europe have at least one wisdom tooth that hasn’t broken through, but not all have their wisdom teeth surgically removed. There may be no medical reason to have asymptomatic unerupted teeth extracted.
Wisdom teeth that do not have adequate room to grow into the mouth fully or develop normally become impacted or partially impacted. This means they are unable to emerge from the gums and can become harmful to adjacent teeth or bone. An impacted wisdom tooth may:
Extractions are most often performed on impacted wisdom teeth to manage an active concern such as pain, swelling, decay or infection, or to prevent serious issues from developing in the future.
If more than one wisdom tooth becomes impacted, a variety of harmful outcomes can occur, including:
Damage to nearby teeth – Impacted wisdom teeth can damage the second molars, which are directly in front of the wisdom teeth. This can cause tooth decay (cavities), periodontal disease (gum disease) and possible bone loss.
Infection – When left untreated, bacteria and food can become trapped under the gum tissue. The resulting infection can cause considerable pain and swelling that make the area difficult to clean, posing even more harm to your oral health.
Disease – Though disease is a rare consequence of impacted wisdom teeth, cysts and tumors can occur in the areas surrounding the affected tooth. Untreated cysts can cause infection and injury to the nearby bone or nerve tissue.
Tooth crowding – Another theory suggests that impacted wisdom teeth can put pressure on other teeth, causing them to become misaligned (twisted or crowded). This can be especially problematic for someone who has undergone prior orthodontic treatments to straighten their teeth.
Sinus issues — Impacted wisdom teeth on the upper jaw can lead to sinus pressure, pain, headaches and congestion.
What Signs Indicate My Wisdom Teeth Should Be Removed?
Extraction may be necessary if you experience wisdom teeth symptoms such as:
Schedule regular exams with your dentist to monitor your wisdom teeth as they develop. When the time is right for removal, consult an oral surgeon. An oral surgeon has the advanced education and training required to successfully perform the full scope of oral and maxillofacial procedures, including wisdom teeth extraction. Request a consultation with board-certified surgeon Dr. Freeman if you have questions about wisdom teeth coming in and associated complications.
As a highly qualified board-certified oral and maxillofacial surgeon, Dr. John Freeman has helped countless patients achieve better oral health and function. His intricate understanding of facial anatomy and oral health makes him a top choice for patients in and beyond Houston, TX. Dr. Freeman can work with you to effectively resolve or prevent any pain, discomfort or further issues associated with impacted wisdom teeth. Early treatment often provides the best chance of avoiding damage and infection and can help safeguard your future dental health.
If you or your child has been referred for wisdom teeth extraction, we encourage you to call us at (281) 599-9445 for a consultation with Dr. Freeman. He will perform an evaluation, answer any oral surgery-related questions you may have and design a treatment plan that is right for you.