Wisdom Teeth (Third molars)

Couple who got their wisdom teeth out from a San Francisco oral surgeon.On average, most adults have 32 teeth, each with a specialized purpose. The teeth in the front of the mouth are designed to cut, to grasp and cutting into food, while the back teeth are used for grinding the food before swallowing it.

Wisdom teeth, which are technically the “third molars”, are the last teeth in the mouth behind the second molars. Although most patients should have four wisdom teeth in their mouth, there are some people that have a few more, or a few less depending on their genetics. While the third molars can help with grinding food; they need to be fully erupted above the gums, cleansable and be in function in order for them to be kept. Unfortunately more common these days, the wisdom teeth get stuck or “impacted” under the adjacent teeth or bone and do not fully erupt, often leading to many health complications. This has to do with a lack of enough space to accommodate all the teeth in the mouth. With today’s focus on having the perfect smile, orthodontics and Invisalign treatment straightens the front teeth, leaving less room all the way in the back for the wisdom teeth.

Just like any other tooth, if your wisdom tooth is “impacted” and cannot erupt fully into the mouth; then it should be removed in order to prevent future health complications.

Why Remove Your Wisdom Teeth?

Wisdom teeth are the last teeth to erupt in the mouth, usually when the patient is between 17 and 21 years old. When they are aligned properly and the gum tissue is healthy around the crown, the wisdom teeth do not need to be removed. However because of the refinement of the human diet, most people are maintaining all their teeth, especially their front teeth, leaving less room in the back to accommodate the third molars.

When the wisdom teeth are threatening to erupt incorrectly or become impacted, it is important to remove them before any problems ensues. Some of the problems commonly linked to wisdom teeth include:

Girl with impacted wisdom teeth got her oral surgery in Cupertino CA.Infection | When wisdom teeth are partially erupted, the opening in the gums around these teeth allows bacteria to penetrate in jaw bone and eventually cause an infection that can damage the adjacent teeth and bone. There are numerous studies showing the link between oral infection and how it can impact a person’s overall health.
Loss of second molars | Your third molars may not have enough space to enter the mouth, so they become impacted. Impacted wisdom teeth can cause severe damage and root resorption of the adjacent second molar, leading to a loss of these teeth as well. This is the most common consequence of not removing the third molars in a timely fashion: the loss of the second molar!
Bad Breath or “Halitosis” | Because of the buildup of bacteria in the poorly positioned third molars, constant bad breath is often a problem. This is one of the more common complaints from patients that present to our office who still have their third molars, whether they are symptomatic or not.
Limited opening | Impacted and infected wisdom teeth can cause stiffness of the jaw, jaw pain, and limited opening of the mouth. This is commonly referred to as “Trismus” and it is sign of serious infection. Patients with trismus need to be treated ASAP before they have difficulty with breathing which can become life-treatening!
Development of Pathologic tumors or cysts | Tumors or cysts may appear around the impacted wisdom teeth, resulting in the destruction of the jawbone and other healthy teeth. This is another important reason why the thirds molars should be removed at the earliest sign of a cyst or a tumor on a an X-ray. A panoramic X-ray commonly referred to as a “Panorex” is the first and the best initial X-ray to take to rule-out these tumors and cysts. A subsequent 3D CBCT may be required prior to surgery in order to determine the exact location of critical structures and the extent of the tumor or cyst around the third molars.

Early removal of impacted third molars is the best way to avoid damage to your adjacent teeth, jaw bone and surrounding tissue.

The first step in the wisdom teeth removal process is a consultation. Dr. Massoomi will initially take a panorex X-ray, possibly followed by a 3D CBCT if the third molars are in close contact to the Inferior Alveolar Nerve (IAN) or there is an indication of a pathology. We will then review your past medical history and perform a thorough examination before determining the best course of action in your case. Each patients’ impacted third molars is unique. Based on decades of scientific research articles, patients and their parents are recommended to inquire about their third molars in their mid-teenage years. If there is any indication that they will cause issues in the future, they should be removed in their premature stage. The more premature the third molars, the less the complications. The more developed the roots of third molars, the more complicated the surgery and the more the complications. The roots of third molars are usually fully developed by the age of 19 – 22 years old.

The next step in the wisdom teeth removal process is the surgical extraction. During the consultation, we will discuss the different sedation options for you so that you can remain comfortable during the entire procedure. The vast majority of our patients that present back to our office for their one week follow-up state that they do not remember or feel anything during the surgery. Dr. Massoomi makes it his goal to perform all of his surgeries in a minimally invasive manner, while keeping you comfortable, in order to reduce the postop pain and swelling that are usually seen after most surgeries.

If you are ready to schedule your wisdom teeth exam or consultation, please give us a call today! There is no better place for a successful and comfortable wisdom teeth removal.

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