What are wisdom teeth?
Wisdom teeth are the third and last molars on each side of the upper and lower jaws. They are also the final teeth to erupt; they usually appear when a person is in their late teens or early twenties. Wisdom teeth that only partially emerge or come in crooked can also lead to painful crowding and disease. Because teeth removed before age 20 have less developed roots and fewer complications, the American Dental Association recommends that people between 16 and 19 have their wisdom teeth evaluated to see if they need to be removed.
Impacted wisdom teeth do not always show symptoms, meaning you could have impacted teeth and not even realize it. If symptoms do arise, it is usually the result of the gum on top of the tooth becoming infected or swollen. Symptoms may include pain, swollen and bleeding gums, swelling around the jaw, bad breath, headache or jaw ache, and an unpleasant taste when eating. Some people experience stiffness of the jaw or swollen lymph nodes in the neck.
The procedure of wisdom teeth extraction
Your dentist or oral surgeon may use one of three types of anesthesia, depending on the expected complexity of the wisdom tooth extraction and your comfort level. Options include:
- Local anesthesia.Your dentist or oral surgeon administers local anesthesia with one or more injections near the site of each extraction. Before you receive an injection, your dentist or surgeon will likely apply a substance to your gums to numb them. You’re awake during the tooth extraction. Although you’ll feel some pressure and movement, you shouldn’t experience pain.
- Sedation anesthesia.Your dentist or oral surgeon gives you sedation anesthesia through an intravenous (IV) line in your arm. Sedation anesthesia suppresses your consciousness during the procedure. You don’t feel any pain and will have limited memory of the procedure. You’ll also receive local anesthesia to numb your gums.
- General anesthesia.In special situations, you may be offered general anesthesia. You may inhale medication through your nose or have an IV line in your arm, or both. Then you lose consciousness. Your surgical team closely monitors your medication, breathing, temperature, fluids and blood pressure. You’ll experience no pain and have no memory of the procedure. Local anesthesia is also given to help with postoperative discomfort.
Wisdom teeth: to extract or not?
Wisdom teeth may not need to be removed if they are:
- Grown in completely (fully erupted)
- Positioned correctly and biting properly with their opposite teeth
- Able to be cleaned as part of daily hygiene practices
According to the American Dental Association, wisdom teeth removal may be necessary if you experience changes in the area of those teeth, such as:
- Repeated infection of soft tissue behind the lower last tooth
- Cysts (fluid-filled sacs)
- Damage to nearby teeth
- Gum disease
- Extensive tooth decay
The decision to remove wisdom teeth isn’t always clear. Talk to your dentist or an oral surgeon about the position and health of your wisdom teeth and what’s best for your situation.