Wisdom Teeth In-Depth


Your wisdom teeth are your third molars. These four teeth are the very last of your adult teeth to erupt. Most of your adult teeth have erupted by around the age of 13. The wisdom teeth come in later, typically in your late teens to early 20s. These molars are located at the very back of your mouth. The last to come in, the wisdom teeth are also the teeth most likely to become impacted. When your wisdom teeth are impacted, they cannot erupt properly, and can, therefore, cause several serious issues. If your wisdom teeth are impacted, Treasure Valley Oral & Facial Surgery can help.

A Short History of the Wisdom Teeth


Thousands of years ago, the wisdom teeth were incredibly important. Back before the invention of cooking, the wisdom teeth were essential for breaking down the variety of course foods that made up a large part of the human diet. The jaw was also much larger and was able to easily accommodate these teeth.

Following the invention of cooking, food was made softer, and therefore much easier to chew. Because of this, humans did not have to work as hard to break down everything they ate. Over time, the jaw began to develop smaller and smaller, to the size it is today. Despite being unnecessary, the wisdom teeth continue to develop. Much like the appendix, the wisdom teeth are classified as vestigial. We still have them, but they serve no functional purpose.

How the Wisdom Teeth Grow


The wisdom teeth erupt gradually. The process begins between the ages of 8 and 10. Around this age, shadows of the wisdom teeth can be detected on X-rays. The crowns of the wisdom teeth begin to develop at around the age of 12. The roots begin to form at around 17. The teeth then begin somewhere between your late teen years and early 20s.

How Do Wisdom Teeth Become Impacted?


Any tooth can become impacted. An impacted tooth is one that cannot erupt properly through the gums. It may not even erupt at all. The wisdom teeth are teeth the ones most frequently faced with this issue. There are a few different reasons why the wisdom teeth may become impacted. One reason is that your jaw is simply too small. If your jaw is too small, it cannot accommodate the third molars. Your wisdom teeth may become impacted because they are growing at an angle.

In some cases, they may even be lying down on their sides and growing completely sideways. Another reason for impacted wisdom teeth is because there is something blocking the path of the molars. This could be soft tissue or bone. Blockages can prevent the teeth from erupting through the gums.

When Should Wisdom Teeth Be Extracted?



An exam is typically done around the age of 15 or 16. This exam helps to determine the positioning of the wisdom teeth. At this age, the roots of the wisdom teeth are not yet fully formed. If the teeth are predicted to be impacted, removing them can be simplified.

The best age to remove wisdom teeth is between the ages of 16 and 20. Between these ages, the roots of the wisdom teeth are short and not fully formed. Additionally, the bone surrounding the wisdom teeth is softer, and there is a larger amount of soft tissue around them. Because of this, healing after removal is simpler. As you get older, the roots of the wisdom teeth become longer. The bone surrounding the teeth also becomes harder. As a result, extracting the wisdom teeth becomes more complex, and healing can take longer.

What are the Effects of Impacted Wisdom Teeth?


When your wisdom teeth are impacted, several issues can arise. One issue that can develop is a localized infection called pericornitis. This type of infection commonly affects wisdom teeth that have only partially erupted through the gums. The wisdom teeth, especially when they have only partially come through the gums, are more difficult to thoroughly clean. If the teeth are not properly cleaned, bacteria and plaque can accumulate, which then leads to an infection.

Partially erupted wisdom teeth can also be faced with issues such as cavities and pulpitis. The plaque and bacteria that linger on the teeth produce acids that begin to erode or eat away at the tooth enamel. This erosion leads to decay, which then leads to cavities. If the cavities go untreated, they grow larger. Eventually, bacteria can travel into the tooth, where it can then attack the pulp. The bacteria can also travel into the root of the tooth, leading to a root infection. Root infections are a common reason why teeth, including the wisdom teeth, need to be extracted.

Impacted wisdom teeth can cause the formation of cysts. Your wisdom teeth develop in sacs inside the jawbone. In some cases, the sacs can fill with fluid, which causes a cyst to form. Cysts can also sometimes occur as a result of an infection. When a cyst forms, it can grow larger over time. As it grows larger, it can harm your jawbone, leading to bone loss.

If the cyst destroys too much bone mass by the time it is treated, you may need to have a bone graft done. This is a surgical procedure that is performed to restore missing bone mass. It involves transplanting bone mass from another area of your body, or a donor, to the affected areas of your jaw. It is also possible that a benign, or non-cancerous, a tumor can form. If a tumor does form, it needs to be removed as well. Removing a tumor also involves removing a portion of soft tissue and bone as well.

If your impacted wisdom teeth are growing sideways toward the adjacent teeth, those teeth are at risk for serious harm. As the wisdom teeth grow, they can butt up against the adjacent teeth. The pressure they exert as they grow can lead to physical damage. Depending upon where the wisdom teeth are hitting the adjacent teeth, this damage may be above the gum line or below it. The damage can lead to the need for a root canal of the affected teeth. In some cases, the second molars may need to be extracted.

Even if your wisdom teeth are growing properly, you may still be faced with issues if your jaw is too small to accommodate all 32 teeth. If your jaw is too small, the wisdom teeth can put pressure on the second molars as they erupt. This pressure can force your second molars out of proper alignment. When they are shoved out of alignment, they can put pressure on the first molars. This can continue until all of your teeth are pushed out of alignment.

When your teeth are pushed out of alignment, your smile is greatly impacted. Crooked teeth also have other serious effects — your risk for cavities and gum disease increases. You are more likely to be faced with tooth damage. Crooked teeth can also cause issues such a bruxism, or the grinding and clenching of your teeth, and TMJ disorder.

Signs of Impacted Wisdom Teeth


There are many signs and symptoms that can point toward having impacted wisdom teeth. One of the most common symptoms is experiencing pain or a throbbing feeling at the back of your mouth. Many patients describe the pain as radiating from the back of the mouth. This pain can occur for many reasons, such as the wisdom teeth pushing against the adjacent teeth. As your other teeth become affected by your impacted wisdom teeth, the greater the pain can become. For some, the pain can become so severe that eating becomes excruciating. You may also find it painful to speak or even move your mouth at all.

Impacted wisdom teeth cause serious problems for your gums. The tissue near the affected wisdom teeth can become swollen. It may also become tender to the touch. In some cases, applying pressure to the swollen tissue can cause bleeding. It is important to note that while swollen gums at the back of the mouth can indicate impacted wisdom teeth, this symptom can also point toward periodontal disease. Either way, it is important that you schedule a dental exam as soon as possible.

In addition to swelling in your gums, impacted wisdom teeth can cause swelling in your jaw. The swelling might not seem all that serious at first. It can worsen over time, however, and make it very difficult, and incredibly painful, to even just open and close your mouth.

Impacted wisdom teeth can also cause other issues that might not seem to be related to the teeth at all. One of these issues is swollen glands in your neck and shoulders. Another issue seemingly unrelated to the wisdom teeth is chronic headaches. The pain in your jaw can radiate up into your head, which can then cause these headaches to occur.

How are Impacted Wisdom Teeth Diagnosed?


While an exam around the age of 15 or 16 to predict the likelihood of impacted wisdom teeth, sometimes the potential is missed. If you are exhibiting symptoms of impacted wisdom teeth or suspect that the wisdom teeth might be impacted, it is important to schedule an appointment right away. A thorough oral examination is performed. The exam begins with a visual examination of your mouth. Partially erupted wisdom teeth can be detected.

Any swelling in the gums or jaw is noted. Diagnosing impacted wisdom teeth also requires dental X-rays. These images can show the exact positioning of the wisdom teeth. They can also show other issues, including cysts, infections, and damage to the jawbone or adjacent teeth. If your wisdom teeth are determined to be impacted, a treatment plan is made, and you are scheduled for wisdom tooth removal.

Extracting Impacted Wisdom Teeth


When your wisdom teeth are impacted, the best solution is to extract or remove them. Extracting the wisdom teeth requires a surgical extraction. There are some patients who can undergo surgery with just a local anesthetic. However, if you are feeling anxious or afraid, sedation may be recommended. Some patients may prefer general anesthesia, as they would prefer to sleep through the entire process.

Before your surgery, we can go over your sedation options to help determine the type to suit your needs. Sedation allows you to remain calm and comfortable during your wisdom tooth extraction. Not only does this help improve your experience, being calm and comfortable also allows us to remove your wisdom teeth in the safest way possible.

After administering the local anesthetic and sedation, the surgical extraction process begins. Surgery begins with small incisions in the gums near the sites of your impacted wisdom teeth. These incisions expose the teeth and the surrounding bone mass. Next, we work to gently remove the wisdom teeth.

Depending upon your situation, this could be as simple as loosening the periodontal ligaments surrounding these teeth and lifting them free. In more complex situations, the wisdom teeth may need to be sectioned, or broken into pieces. After being sectioned, all of the pieces of the teeth are carefully removed. If there are any abnormalities, such as a cyst or tumor, these are also removed in the same procedure. After the wisdom teeth have been completely removed, the surgical sites are thoroughly cleaned. Finally, sutures, or stitches, are placed to close the incisions. After your procedure is completed, you will be held for a short period so that you can be monitored.

If there are no concerns, you will be released to go home. It is important, especially if you have had any form of sedation, that you have someone accompany you to your appointment so that they can drive you home. The effects of certain types of sedation, as well as general anesthesia, can linger for several hours. As you heal from your extractions, it is important to take it easy and take care of yourself. As you begin to feel more normal, you can slowly resume your normal activities and your normal diet. Following your wisdom tooth extractions, you will not need to worry about having those teeth replaced.

Extracting impacted wisdom teeth is essential for restoring the health of your mouth and preventing serious complications from developing. Following the removal of your wisdom teeth, you do not need to have these teeth replaced. If you suspect that your wisdom teeth are impacted, contact Treasure Valley Oral & Facial Surgery at (208) 994-6227 to schedule your appointment today.

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