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Wisdom Teeth
 
Wisdom Teeth
Wisdom teeth may become a problem for you as they grow and develop in each corner of your mouth. Since development normally spans several years, problems often develop gradually. Nevertheless, these gradual changes can cause sudden and severe pain. Understanding why such things can happen may help you to deal with such problems, or better still, to encourage you to take preventive measures before they occur. And the primary preventive measure for wisdom teeth is removal, preferably at an early stage.

The jawbone grows to approximately its adult size by your late teens. Unfortunately, that size is often too small to hold developing wisdom teeth. This happens because our jaws are smaller than those of early humans, who needed large jaws and more teeth for their tougher diet.

When there is not enough room for your wisdom teeth, they may become impacted, or partially trapped in the jawbone and gums. The crown, or top of the tooth, may erupt, or just break through the gum, or it may remain completely within the bone. The roots can grow in unusual directions and may cause a variety of problems in your mouth and with your sinus cavity or the nerve in your lower jaw.

Impacted wisdom teeth can grow in a variety of directions, such as those illustrated below:


A wisdom tooth may grow toward your other teeth, away from them, or even in horizontal or vertical positions. When such conditions occur, it's far simpler and less painful to have them removed early, before they have a chance to firmly anchor in your jaw as the teeth grow and the roots lengthen.

Not everyone has problems with their wisdom teeth. Factors that determine whether you will have problems include the size of your jaw and how your wisdom teeth grow in. There may be pain and swelling, or you may have no symptoms at all, even though the other teeth in your mouth may be at risk of damage. In addition to actual pain, common problems caused by wisdom teeth can include gum disease, crowding, decay, poor position, and cysts.

Since it is not practical for most people to evaluate how their wisdom teeth are developing, the best approach is to visit your dentist or an oral surgeon such as Dr. Ehsan for an evaluation. He will review your dental history, take digital panoramic x-rays, and perform an examination to determine the general health of your mouth and the condition of your wisdom teeth. If a problem with your wisdom teeth is detected, he may recommend surgery to remove them and eliminate or avoid any unpleasant symptoms. Early removal is best for most patients, as it usually helps to avoid much more serious problems later on.

How and where your wisdom teeth are removed depends on several factors, including whether your wisdom teeth are erupted or impacted and how deep the roots are. Surgery may often be done in your dentist's or oral surgeon's office rather than in a surgical center or hospital. Your dentist or oral surgeon will review the recommended procedure with you so that you will fully understand and be comfortable with the procedure before it is done. You will also be given information about eating, medication, rest, driving, and other considerations before surgery as well as after.

After surgery, you will rest while under close observation as you recover from the anesthetic. You normally will be able to go home once your doctor is satisfied with your recovery.

The healing process begins immediately after surgery as your body sends blood to nourish the tooth socket. Simple pressure from a piece of gauze is usually all that is needed to control the bleeding and to help a blood clot to form in the socket, which promotes healing. Within a day or two, soft tissue begins to fill in the socket, aided by the blood clot. Eventually, the bone surrounding the socket begins to grow, eventually filling in the socket completely, as illustrated here:


As your mouth heals, you can promote faster healing and avoid complications by simply following the care instructions that your dentist or oral surgeon will give you. While you may experience some discomfort as your mouth heals, following simple instructions will normally be all that is needed. However, you should call your doctor if you experience excessive bleeding or swelling, persistent and severe pain, fever, or any reaction to medications. A follow-up examination may also be scheduled to make sure that the socket is healing properly and that your mouth is returning to a normal, healthy state.

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