Wisdom teeth, or third molars, are the last molar teeth to grow in our mouths. They generally come up late teens or early twenties 8 or so years after the previous molar. Normally there are four, but size and number can vary. Some people have none, others miss upper or lowers.
Generally, because they are the last tooth, if there is not enough space in a person’s mouth, problems arise as the wisdom teeth are impacted. Why do we not have enough room? This becomes a serious debate of whether you believe in evolution and that we came from the ape… Our jaws are getting smaller and our brains are getting larger.
Most commonly these teeth cause gum infections, cysts, decay/cavities to neighbouring teeth, food trapping and ulcers. Another common problem is crowding of the other teeth, causing the front teeth to buckle. As there is no room for any of them at the back, they push forward causing crowding.
Most people come to the dentist when they have an issue. When this occurs with wisdom teeth, your dentist will discuss your options. Removal of just the offending tooth may be proposed, or removal of all of them.
Sometimes It can be easier to remove just the offending tooth, however, in the long run; wisdom teeth will decay more readily than others due to difficulty in keeping them clean. Eventually they all become infected and removal is the only choice. Every patient who has been through this scenario wishes that they just had all four out at the start.
Early detection and elective removal before problems is preferred. Removal as a result of problems later on can require more invasive surgery including cutting of gum tissue and jaw bone posing greater risk to nerves and other structures.
There are four options for removal:
- Removal with local anaesthetic. “in the chair with just injections” when indicated
- As above but with some form of conscious sedation. At Lucas Dental we can offer Penthrox (green whistle) or Valium tablets.
- Intra venous sedation. Every few weeks we have a visiting fully qualified anaesthetist that can offer “twilight sedation” Although not completely unconscious, IV sedation is safer and the vast majority of patients do not remember anything. Also, you can go home after a short recovery time.
- General anaesthetic in a hospital setting. This requires going to hospital after referral to a specialist Oral Surgeon. This may be proposed if the wisdom teeth are severely impacted or if the patient requests.
Our friendly Treatment Consultant will organise every step should x-rays, referral be required or arrange your IV sedation appointment.
Several x-rays may be requested by our skilled dental surgeons in order to achieve the correct diagnosis. It is vital to ensure we know exactly the shape and form of the roots and the tooth’s proximity to important nerve and blood vessels.
Each and every person is different and the key is to assess, discuss and choose the scenario that best fits each patient.