|Complete Bony Impactions: There is NO space for the tooth to erupt. It remains totally below the jawbone or if even partially visible requires complex removal techniques.
|Unusually Difficult Complete Bony Impactions: The impacted Wisdom tooth is in an unusual and difficult to remove position. This situation can also arise when the shape of the jawbone and other facial structures make removal of this tooth significantly more difficult.
|If you do not have enough room in your mouth for your third molars to erupt and they become impacted, several detrimental results can occur:
|Infection: Without enough room for total eruption, the gum tissue around the wisdom tooth can become irritated and infected, resulting in recurrent pain, swelling, and problems with chewing and swallowing.
|Damage: If there is inadequate room to clean around the wisdom tooth, the tooth directly in front, the Second Molar, can be adversely affected resulting in gum disease (bone loss) or cavities (more appropriately known as dental caries or decay).
|Disease: Non-infectious diseases can also arise in association with an impacted wisdom tooth. Cysts are fluid-filled balloons inside the jawbone which are associated with impacted wisdom teeth and slowly expand destroying adjacent jawbone and occasionally teeth. They can be very difficult to treat if your wisdom teeth are not removed in your teenage years. Although rare, tumors can be associated with the delayed removal of wisdom teeth.
|Crowding: Although controversial, many feel that impacted wisdom teeth directly contribute to crowding of your teeth which is most noticeable in the front teeth, usually the lower front teeth. This is most commonly seen after a patient has had braces. There are most likely a number of factors that cause teeth to crowd after braces or in early adulthood and retained, impacted wisdom teeth are likely to play a contributory role. Although wisdom tooth removal cannot be recommended solely to avoid crowding, it can be recommended to absolutely eliminate its possible role in future crowding and other bite changes.
Unless you have an active problem at the time of your consultation, the reason for removal is primarily preventative to avoid long term problems.
We will need to see you for a consultation before it is determined IF you will benefit from Wisdom tooth removal. We will need to take a special x-ray of your mouth and jaws to determine how much room you have, if any, for your Wisdom teeth to erupt.
The upper wisdom teeth are situated close to your sinuses, and their removal can result in a communication between your mouth and the sinus. Once again, if the teeth are removed at an early age, the root formation is minimal, and this complication is very unlikely to occur. Should this occur, it will usually close spontaneously. We may give you special instructions to follow if this is apparent at the time of surgery. I prefer that you dont blow your nose for two or three days following the surgery. You can wipe your nose, but dont blow your nose. If you have to sneeze, you should sneeze with an open mouth into a tissue - - you should not create any pressure in the sinus area, which may dislodge the healing blood clot. If you sense a communication occurring after the surgery, please contact the office. RARELY, an additional procedure may be necessary to close the communication.
Dry sockets continue to be the most common problem people experience following dental surgery. They arise due to premature loss of a blood clot in the empty tooth socket. This seems to occur with greater frequency in people who smoke or are taking birth control pills. While both jaws can be affected, they usually occur in the lower jaw on the third to fifth day. They cause a deep, dull, continuous aching on the affected side(s). Patients may first notice the pain starting in the ear radiating down towards the chin. It frequently begins in the middle of the night, and the Motrin medication usually doesnt help. Treatment involves placing a medicated dressing in the "empty" tooth socket. This will help decrease the pain and protect the socket from food particles. The effectiveness in alleviating the pain lasts for 24-48 hours and usually will require dressing changes every day or two for five to seven days. Dressings usually are removed when you have been pain free for 2-3 days. The dressing doesnt aid in healing. The only reason to place a dressing is for pain control. If Motrin is controlling the pain, the socket will heal without a dressing. An irrigation device will be given to you to help keep food particles from lodging in the extraction site following removal of the dressing.
Dry Socket - No Blood Clot
Occasionally, post-operative infections occur. This usually requires an office visit and clinical examination. Many times, just placing you on an antibiotic for one week will take care of the infection. It will occasionally require drainage of the infected area, which may have accumulated near the surgical site, and even more rarely do the patients need to be admitted to the hospital for intravenous antibiotics and further surgical drainage.
Other temporary problems you may experience in the postoperative period include stiffness of the jaws, chafing around the corners of your lips, facial bruising, and blood oozing from the extraction sites. The postoperative instruction sheet we will provide should answer many of the questions related to these more common concerns. If not, dont hesitate to call the office.