Wisdom Teeth - Namibian Dental Association

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Wisdom Teeth

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Q: What are impacted wisdom teeth and why must they be removed?

A: The last four molar teeth, right at the back in each corner of the mouth are called the wisdom teeth. They normally erupt into the mouth at about 17 to 21 years of age. Because they are the last teeth to appear in the mouth there is sometimes not enough space and they get stuck behind the teeth in front of them. Sometimes wisdom teeth do not grow into the mouth at all. These un-erupted or partially erupted wisdom teeth are then called ‘impacted wisdom teeth’.

In some cases wisdom teeth have enough space to erupt normally and will not cause problems. Patients where this happens are lucky and can treat their wisdom teeth just like ordinary teeth with no treatment necessary.

Problems with impacted wisdom teeth normally fall into three categories:

  • Peri-coronitis. Often only the corner of an impacted wisdom tooth erupts through the gum into the mouth. The gum tissue around this partially erupted tooth is always infected because food and bacteria get stuck below the gum. This chronic infection around the tooth is called peri-coronitis and can cause chronic discomfort that can turn into acute episodes of infection which causes severe pain and swelling.

  • Crowding. If wisdom teeth have no place to erupt into the mouth they start to ‘push’ forward against the other teeth. This can cause crowding of the teeth in front of the mouth, shifting of teeth and malocclusions. Patients who had orthodontic treatment are at risk of having the results of their orthodontic treatment ruined by this crowding caused by impacted wisdom teeth.

  • Root caries. A wisdom tooth that is angled forward and pushes against the root of the tooth in front of the wisdom tooth can be the cause of root caries. The long term effect of a wisdom tooth pressing against the root of another tooth is often the development of root decay of the tooth in front and can even lead to the loss of the affected tooth.

It is good practice to regularly evaluate erupting wisdom teeth and to take appropriate action before any of the mentioned problems with impacted wisdom teeth occur. Normally young patients will be evaluated round about the age of 18 years for possible problems with their wisdom teeth. An x-ray will be taken to determine the presence and position of the wisdom teeth as well as the potential for future problems with these teeth.

If wisdom teeth are causing specific problems, or if it appears that they will cause problems in the future, it will be recommended to have them removed.

Removal of wisdom teeth can often be done by a dentist in the dental surgery under local anesthetics. Because of the amount of anesthetic needed, wisdom teeth are often removed in sessions, two at a time.

In difficult cases or if patients are reluctant to have wisdom tooth surgery performed under local anesthetics while they are awake, the surgery can be done under general anesthetics in a hospital. Complicated cases, where the wisdom teeth are very deep in the jaw bone or where the nerves of especially the lower jaw are near the wisdom teeth, will be referred to a specialist Maxillo, Facial and Oral Surgeon to have the surgery done.

Also see the question about wisdom tooth surgery and referral to a specialist surgeon.

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