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Impacted wisdom teeth are third molars at the back of the mouth that don't have enough room to emerge or grow normally.

Monday, April 26, 2010

Impacted wisdom teeth that are causing pain or other dental problems are usually surgically removed, or extracted.

If you have medical conditions that may increase surgical risks, Dr. James Courey of Manalapan NJ will likely ask you to see an oral surgeon who will communicate with your primary care doctor and dentist about the best course of action.

Managing asymptomatic wisdom teeth If impacted wisdom teeth aren't causing symptoms or apparent dental problems, they're called asymptomatic. Some disagreement exists in the dental community about how to manage asymptomatic impacted wisdom teeth. And research on this topic doesn't strongly favor one strategy over the other.

Some dentists and oral surgeons recommend removing asymptomatic wisdom teeth to prevent future potential problems. The arguments for preventive treatment include the following:

  • An asymptomatic tooth may not be free of disease and may be a particularly vulnerable site for gum disease and tooth cavities.
  • The procedure rarely results in serious complications in younger adults.
  • The procedure is more difficult and more likely to cause complications later in life, particularly among older adults.

Other dentists and oral surgeons recommend a more conservative approach. They note that there isn't enough evidence to suggest that impacted wisdom teeth not causing problems in young adulthood will later cause problems. Therefore, they suggest that the expense and risks of the procedure don't justify the expected benefit.

With a conservative approach, Dr. Courey monitors teeth for decay, gum disease or other complications. He may recommend an extraction if problems arise.

Surgical extraction Surgical extraction of a wisdom tooth is almost always done as an outpatient procedure, which means that you will go home the same day. You may have local anesthesia that numbs the mouth or sedation anesthesia that makes you unaware of the surgical procedure.

During an extraction the oral surgeon makes an incision in the gums and removes any bone that blocks access to the impacted tooth. After the tooth is removed, the surgical wound is usually stitched closed and the empty space (socket) is packed with gauze.

You'll receive instructions for caring for the surgical wound after the procedure and for managing pain and swelling.

Most wisdom tooth extractions don"t result in long-term complications. Problems that can occur include:

  • Dry socket, or exposure of bone when the post-surgical blood clot is dislodged from the socket — a complication that can be painful and delay healing
  • Infection in the socket from bacteria or trapped food particles
  • Damage to sinuses near the upper wisdom teeth
  • Weakening of the lower jawbone
  • Damage to nerves that results in altered sensation in the lower lip, tongue or chin

Why do we have wisdom teeth? Early humans had diets of tough food that probably resulted in enough wear on teeth to make room for the relatively late-emerging wisdom teeth. The softer diets of modern humans — and relatively recent practices of preventive dental care and orthodontic care to straighten teeth — have resulted in mouths that often can't accommodate a third molar.

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