Most adults develop a set of permanent teeth that includes two sets of incisors, one set of canines, two sets of premolars, and three sets of molars all on the top and bottom arch. Most people only keep two sets of molars. The third set of molars, often referred to as wisdom teeth, are an evolutionary hold over from a time when coarse foods and the lack of dental care caused extensive tooth loss and damage before this final set of teeth developed. Modern diets and hygiene make this third set of teeth almost wholly unnecessary.

Why are Wisdom Teeth Removed?

The refinement of foods and preventive dentistry services, make wisdom teeth unnecessary for the most part. Most patients’ jaws typically do not have adequate space to accommodate the additional teeth. This can lead to impaction, teeth that are unable to erupt. Teeth that are unable to break through gum tissue, are more susceptible to decay, and can adversely affect the health of surrounding teeth. If wisdom teeth are able to erupt, crowding may result. Crowding shifts teeth out of alignment undoing costly, time consuming orthodontic care. The relatively few patients who have adequate space to retain their third molars are likely to have these teeth removed later in life. More than 50% of patients who retain wisdom teeth following initial development have them removed later, and extraction later in life is much more painful since the alveolar bone that surrounds the root structure has fully developed holding teeth firmly in place.

How are wisdom teeth extracted?

Depending on how teeth develop, extraction can be a simple tooth “pulling,” or a surgical removal. For teeth that develop without impaction, dentists may be able to pull the tooth using forceps and local anesthesia. Typically with minimal surgical removal of bone and tissue, the dentist can rock the tooth back and forth until loosened enough to extract. Impacted teeth and those that are otherwise hard to pull will be surgically impacted. For some patients, local anesthesia is enough to numb and relax them during surgical removal, but depending on the number of teeth to be removed and the extent to which the tooth has fused to the gum tissue and jawbone, additional sedation or general anesthesia may be necessary. The dentist cuts away gum and bone tissue in order to extract the tooth. Once the tooth is removed, the incision is closed with stitches. After the procedure dry socket and bone spurs may still cause pain for patients. Dry socket occurs when the protective blood clot that forms following surgery is dislodge. Luckily, this extremely painful side effect of tooth removal is extremely rare (affecting about 5% of people), and easily treated with a quick in-office procedure that promotes healing. Spurs of bone that break off of the jaw or tooth root during extraction can also cause discomfort, but are easily removed. Contact your dentist immediately if you believe you’ve experienced dry socket or bone spur.

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