What About My Wisdom Teeth?

           Well, what about them? Your wisdom teeth, or third molars as they are technically known, are the last teeth to erupt in your mouth. They generally do so between the ages of 18 and 21 and they are located farther back in your mouth than any of your other teeth. This is if they are present at all. Your wisdom teeth are the most liable to go undeveloped and thus to be missing naturally. Wisdom teeth are really no different from your other molar teeth as long as they erupt fully (come in all the way). It is when they cannot fully erupt (when they are impacted) that they present a problem.

           There are three types of impactions divided into two categories. There are soft- tissue impactions, bony impactions and different combinations of each. Soft-tissue impactions occur when only gum tissue covers your wisdom teeth and bony impactions are just what the name implies. Impactions can be either full or partial. Any sort of impaction can pose a problem for you. Studies have also shown that, all other things being equal, if your oral hygiene is lacking you are better off having your impacted third molars removed. It is your degree of risk, either potential or actual, that determines whether extraction of these teeth is warranted.


This swelling at the last tooth by the tongue is pericoronitis.

           The main problems associated with impacted wisdom teeth include misalignment of the forward teeth as the impacted third molars try to force their way in and an infection of the gum tissue surrounding partially soft-tissue impacted wisdom teeth called pericoronitis. Maceration (chewing on your own gum tissue) is a consequence of full soft-tissue impaction. Erosion of the immediately frontward tooth roots and cyst or tumor formation around your impacted third molars are much lesser risks.


An impacted upper wisdom tooth leaning on the molar in front of it.

           Anyone who has experienced pericoronitis or maceration will tell you how extremely unpleasant these conditions can be. They could also tell you that, as these difficulties recur, they tend get worse and worse. Extraction is the only option for treatment in these situations. Misalignment of the teeth forward of your impacted wisdom teeth occurs as they try to erupt. This force is transmitted frontally and your teeth with the smallest roots are the ones most likely to move. Your anterior teeth, especially on the lower have the smallest roots and are most easily displaced. Recent evidence from studies published in Japan suggests that impacted wisdom teeth can also cause a more severe type of misalignment called anterior open bite where your front teeth remain separated on closing. If this happens during or after orthodontic treatment (braces), your case may either be impeded or fail. If you are undergoing orthodontic treatment and you have unerupted third molars, you should strongly consider their extraction as a preventive measure.

           There are reasons for keeping asymptomatic impacted wisdom teeth besides the side effects that, though they may be more common among third molar extractions, are possible with the removal of any tooth (post-operative pain, infections, bleeding, jaw fracture, lockjaw or dry socket). Any medical conditions that preclude extensive non-emergency surgery prohibit the extraction of asymptomatic impacted third molars as well. On the lower, your impacted third molars may be lying sideways on top of the nerve canals that run the length of your jaw bone on each side. If this is the case, removing them can cause nerve damage that may result in permanent numbness of your jaw or lower lip. This risk can be assessed through X-Rays. The older you are, the more difficulties are associated with the removal of impacted wisdom teeth so it is best to extract them as early as possible. However, the older you get without a first episode of trouble from impacted third molars, the less likely they will become problematic thereafter.




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Dr. Barry F. McArdle, D.M.D. ~ 118 Maplewood Avenue, The Captain Moses House, Suite B-7, Portsmouth, NH 03801

Questions or Request an Appointment: Contact Us     Phone: 603-430-1010     Email: drmcardle@mcardledmd.com     Website: http://mcardledmd.com