Wisdom teeth are the last teeth to come out and the ones least needed for good oral health. The third molars, or wisdom teeth, are called such because they developed when most individuals became adults which is near 17 years of age.

Because our jaws are smaller than our ancestors, our wisdom teeth may not have enough room to fit in our mouths properly. Therefore, problems may result if these additional teeth attempt to emerge.

Most people have four wisdom teeth, one in each corner of the mouth, and often they are impacted trapped in the jaw-bone and gums. Cramped for room, these impacted teeth grow in many different directions and removal may be recommended by your dentist to prevent potential problems.

Whether wisdom teeth cause your mouth harm depends on several factors, including the size of your jaw and how your wisdom teeth grow in. You may have no symptoms at all, but other teeth in your mouth could be at risk for damage.

If you learn the different ways wisdom teeth can develop and the problems that can arise, you'll be better able to understand why you may need to have them removed.

Infection in the gum

When a wisdom tooth partially breaks through the gum's surface, bacteria can get under the flap, causing an infection in the gum.

Crowding displaces next tooth

An impacted or erupting wisdom tooth can push on adjacent teeth, causing them to become crooked or even damaging them structurally.

Decayed wisdom tooth

Decay forms in a wisdom tooth that is hard to clean due to its position or because it is partialy covered by the gum tissue which may collect cavity causing bacteria.

Poorly positioned wisdom tooth

A wisdom tooth that grows toward the cheek can irritate nearby tissue. If an erupted tooth is crooked it may be hard to clean or make it hard to bite down.

Cyst destroys bone

If the sac that holds the crown remains in the bone, it can fill with fluid, forming cyst that can destroy surrounding bone.

It is best to have wisdom teeth removed around 17 years of age because that is when they usually develop. Removal will be easer as the bone may not be as dense as in an older person. Also, recovery will be faster since the roots usually have not yet fully developed.

The procedure for removal begins with an evaluation of your dental and medical histories. You may also receive two types of x-rays, a panographic x-ray which provides an overall view of your mouth and intraoral x-ray which examines individual teeth. The removal may be done in your dentists or oral surgeon's office or in a hospital. The type and length of the surgery will depend upon how you developed your wisdom teeth are.

You will be given nitrous oxide sedative (laughing gas) to make sure you are completely relaxed. You will also receive a local anesthetic to numb the area around your wisdom teeth. Once you are fully relaxed and your mouth is numb, the surgery will begin. The surgical method used depends on whether your wisdom teeth are erupted or impacted.

Extraction of erupted tooth

Tooth extracted in section

If your tooth is partially or completely erupted it may be extracted or lifted out with forceps. Occasionally, if the roots are deeply embedded in the jawbone; the tooth may have to be split or bone removed.

Incision with the gum flap folded back

Wisdom tooth removed and sutures closing the incision

If your tooth is impacted an incision is made in the gum to reach your wisdom tooth. The incision creates a flap which is peeled back , exposing the jawbone. If the tooth is lodged in the jawbone, bone tissue that is covering the tooth may have to be removed. Tooth may be extracted from its socket in one piece or split for easier removal.

After the surgery is completed, you will rest for a while under close observation as you recover from the anesthetic. When the dentist or oral surgeon is satisfied with your progress, you will be able to go home. You should probably plan to rest and take it easy for the next few days. Since swelling and pain are likely, you will probably be given a prescription for pain medication as well as instruction for your home recovery.

The healing process begins immediately after surgery. The body sends blood to nourish the tooth socket. To control excessive bleeding you may be instructed to bite down on a piece of gauze, applying constant, direct pressure to the area. This helps a blood clot to form in the socket. In a day or two after surgery, soft tissue begins to fill in the opening. Now bone tissue also begins to grow in the socket, becoming dense over the next two to three months.

It is recommended to drink clear liquid at first and a cold compress will also help with the soreness. You should not brush or floss the area near the surgery, but continue to brush the rest of your teeth very carefully.

A follow-up visit may also be scheduled to verify that the socket is healing properly and that your mouth is returning to a normal healthy state. If you have any question or concerns while you are recovering from your surgery, call your dentist or oral surgeon.

A blood clot develops in the tooth socket as the area begins to heal.

The socket begins to fill in with new tissue with the help of the blood nourishing the area.

The bone surrounding the socket begins to grow eventually filling in the socket completely.