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IMPACTED THIRD MOLARS (WISDOM TEETH)

Wisdom tooth (Third molar)

Wisdom tooth or third molars are the last teeth to develop and appear in the mouth. They usually occur between the ages of 17 and 25, a period that is considered the period of wisdom.

What is a tooth impaction?

When a tooth does not appear fully in the mouth, it is considered “enclosed”. Generally, impacted teeth are not able to penetrate the gums because there is not enough space. Nine out of ten people have at least one incisive tooth.

How serious is the tooth impaction?

If left in the mouth, the impacted wisdom tooth can injure adjacent teeth or cause inflammation. Because the area of ​​the wisdom tooth is difficult to clean, it gathers food residues and bacteria that lead to inflammation of the gums. Oral bacteria can be transmitted from the oral cavity through the bloodstream and cause systemic inflammation and diseases that affect the heart, kidneys and other organs.

Research has shown that when periodontal inflammation is established in the area of ​​the wisdom tooth, the problem persists and worsens, but can be improved by extracting the tooth.

Sometimes a cyst with a fluid or benign tumor may form at the base of a wisdom tooth. As the cyst increases, it can cause more serious problems because it weakens the jaw and destroys adjacent nerves, teeth and other structures.

Should the tooth be extracted if it has not caused any problems so far?

Many people believe that as long as they do not have pain, they should not have to worry about their wisdom tooth. The absence of pain does not mean the absence of a problem. In fact, even the wisdom tooth that are normally suspected are prone to cause trouble. For this reason, the American Association of Oral and  Maxillofacial Surgeons (AAOMS) recommends that third molars should be evaluated at the age of 17-18 to confirm their existence if they have a problem and to suggest ways in which they may be the extraction or retention of the tooth and regular checking of its condition.

In general, physicians and dentists agree that the wisdom tooth should be removed in the following cases:

1) Inflammation and periodontal disease

2) Caries

3) Pathological conditions such as cysts and tumors

4) Damage to adjacent tooth

Fully erupted and functional wisdom tooth with no pain, no caries, healthy gums and good oral hygiene may not require extraction. However, good dental cleaning and X-ray monitoring are needed to detect any changes.

What happens during surgery?

If your dentist or other health care professional recommends that you remove your wisdom tooth, you should visit an Oral and Maxillofacial Surgeon (Maxillofacial Surgeon).

Before your surgery, the Maxillofacial Surgeon will discuss the procedure with you and inform you about the procedure. This is the best time to ask, solve your questions and let your surgeon know about your concerns. Tell your doctor about any illnesses you have had in the past as well as the medications you are taking.

There are many factors that influence the degree of difficulty in extracting a wisdom tooth. Two key factors are the position of the tooth and the morphology of its roots. If the wisdom tooth is deep enough, the operation becomes even more difficult.

Most often, the wisdom tooth are removed with little or no pain. The procedure is usually performed in the office with a local anesthesia. In some very difficult cases, in patients who are not easy to work with as well as in patients who do not want to have a memory recall, general anesthesia is preferred.

What happens after surgery?

After surgery the patient may feel swollen, which is normal and part of the healing process. Cold patches or ice can help reduce edema as well as medicines given by your doctor. You may need to modify your diet after surgery and later move on to a more normal diet.

What if I decide to keep my wisdom tooth?

If after discussing with your Maxillofacial surgeon you decide to keep your wisdom tooth, make sure you brush them regularly with a brush and floss. Your wisdom tooth should be examined frequently and x-rays should be taken every year to make sure your teeth and gums health has not changed.