Wisdom teeth are the third permanent molars. They are the last teeth in the human dentition to develop and erupt, usually around the age of 16-24. As this is the age of the beginning of wisdom, they are termed wisdom teeth.
Before the days of modern antibiotics in 1945, a wisdom tooth infection commonly leads to death.
In the modern era, there is often not sufficient space in the jaws to accommodate the presence of another set of teeth. The wisdom teeth become misaligned in their attempt to erupt into the mouth. The situation whereby the teeth are jammed or entrapped in the jaws is termed impacted.
Why do wisdom teeth need to be removed?
When a wisdom tooth is impacted, it is usually partially covered by gum tissue. This gum that covers the teeth does not provide a tight seal like your skin and food and bacteria can collect under and around it. The bacteria will multiply and cause an infection leading to pain, fever, swelling and jaw stiffness. This episode will repeat itself regularly if wisdom teeth extraction is not done.
Non functional teeth
Due to the space constraints of the jaw, the wisdom teeth cannot erupt into a proper alignment that is useful for chewing and eating. In cases of the upper teeth, if wisdom teeth removal is not done, the teeth can super-erupt and impinge onto the lower gums.
Due to the jammed position of the wisdom teeth, it is difficult to clean the area around the teeth, leading to decay of the wisdom teeth (not so bad after all, it needs to be taken out) or worse, decay of the perfectly aligned 2nd molar in front.
The most common cause of root canal treatment in the lower 2nd molars or loss of 2nd molars are procrastination in wisdom teeth removal, causing decay of the 2nd molars.
Poor alignment of lower front teeth
As the wisdom teeth tries to erupt from their impacted position, they exert a horizontal force, causing the lower front teeth to be misaligned with time. Hence esthetics is compromised.
Cyst (fluid filled sacs) can formed in the jaw.
How is the tooth removed?
Most of the time, wisdom teeth extraction can be done for the upper teeth. Wisdom teeth surgery is reserved for the lower teeth as they are impacted by a bony overgrowth. This involves a simple surgical procedure whereby the gum is retracted (Fig 1), a bit of the surrounding bone is removed to loosen the teeth before it is sectioned into smaller pieces (Fig 2) and removed (Fig 3 and 4).
You can have your wisdom teeth surgery under local anaesthesia, which is the most common requested form of anaesthesia. However if you are tense or nervous, you can have wisdom teeth removal done with Laughing gas, IV-Sedation (Twilight Sedation) or GA (General Anaesthesia).
Some dis-comfort, swelling and mild bleeding is inevitable. In most cases, normal activities can be resumed within a few days after surgery. You will be usually given mouth rinses, analgesics and antibiotics.
Why is it better to remove the wisdom teeth when you are young?
It is recommended that wisdom teeth removal be done prophylactic in young adults whether they are causing problems or not. Surgery is technically easier due to the fact that the bone is less dense, roots are not fully formed and the healing rate is faster and better in younger patients. In older adults, a more prolong healing period is inevitable.