Oral Surgery (Wisdom Teeth)

wisdom-teeth 92101 dentist downtown san diego

Wisdom teeth (the 3rd molars) on the average erupt around the age of eighteen, even though they actually start to form in the jaw bone a few years earlier. By the late teens as the mandible (lower jaw) has reached its adult size the wisdom teeth start to work their way out of the bone in an upward-vertical position. Some pain may be associated with the eruption as they break through the gum, but this is relatively minor in non-complicated cases.

Whether or not wisdom teeth cause any problems depends on the size of your jaw and how your wisdom teeth grow in. Sometimes wisdom teeth just cause pain or swelling but often serious problems can be avoided if a preventive extraction is performed.  Always have your regular six-month visits to the dentist to keep an eye on any problems that may occur.

The most common wisdom teeth complications are discussed below:

Gum disease: When the wisdom tooth breaks through the gum there may be a flap of gum remaining over the partially erupted tooth. This will result in food, plaque and bacterial build-up underneath the gum causing a localized infection in the soft issue. Pain, swelling, bleeding and inflammation may be some of the consequences.

Crowding: An impacted or erupting wisdom tooth can push on the adjacent tooth. This may in turn transfer the force onto the other teeth causing them to move, perhaps ruining the results of previous expensive orthodontic work as the teeth start to overlap.

Decay: Most wisdom teeth are in the back of the dental arch and are hard to reach and difficult to clean. Subsequent plaque build-up allows them to fall victim to decay or gum disease.

Poor positioning: The wisdom teeth can be positioned in an array of ways. If they are tilted forwards (mesioangular position) they can push on the root of the adjacent tooth and over time absorb the root of that tooth, causing its loss. If they tilt backwards they are in a distoangular position. They can even grow toward the cheek, tongue or downwards. If they irritate the surrounding tissue they generally need to be removed.

Cysts: Wisdom teeth that remain in the jaw bone without eruption can form a cyst. The cyst may grow at the expense of the surrounding bone. As the fluid build-up inside the sac encapsulating the tooth increases, the pressure on the adjacent bone will cause its resorbtion and a blow to the jaw can easily cause it to break.

After reviewing your medical history, dental examination and X-rays, one of our dentists may suggest removal of the wisdom teeth. The extraction can be categorized as follows: simple, tissue impacted, partial bony and full bony extraction. The anesthesia administrated by the dentist may be local in which case just the surrounding tissue around the tooth is numbed, or it may be general where the patient is completely sedated. The dentist may in certain instances refer the patient out to an oral surgeon for the removal of the wisdom teeth.

Depending on the difficulty of the extraction, the average healing time is about one week. Pain and swelling are the most common complications for which the dentist can prescribe pain killers and/or antibiotics as necessary. Bed rest, liquids and following the post-operative instructions given are adjuncts to a speedy recovery.