Wisdom Teeth Surgery
Oral Surgery Norwood, MA | Mansfield, MA
By the age of eighteen, the average adult has 32 teeth; 16 teeth on the top and 16 teeth on the bottom. Each tooth in the mouth has a specific name and function. The teeth in the front of the mouth (incisors and canines) are ideal for grasping and biting food into smaller pieces. The back teeth or molar teeth are used to grind food into a consistency suitable for swallowing. The average mouth is made to hold only 28 teeth. It can be painful when 32 teeth try to fit in a mouth that holds only 28 teeth. The last four teeth to erupt in the mouth are the Third Molars, also known as “Wisdom Teeth.”
Wisdom Teeth Presentation
To provide you with a better understanding of wisdom teeth, we have provided the following multimedia presentation. Many common questions pertaining to wisdom teeth are discussed.
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Why Should Wisdom Teeth be Removed?
Most wisdom teeth that have erupted into the mouth are nonfunctional because of poor position due to lack of space. Since they are located in the back of the mouth they are difficult to clean and difficult to restore when they become decayed. Poorly positioned erupted wisdom teeth trap food and plaque and irritate the cheek. They are prone to developing dental caries (decay) and periodontal disease which can spread to involve adjacent teeth. There is no benefit to keeping non-functional or poorly functional wisdom teeth. In most cases, these useless teeth are at risk for infection and should be removed.
In most cases, removal of wisdom teeth is performed under intravenous general anesthesia or intravenous conscious sedation. However, there are several anesthetic options available for wisdom tooth removal including intravenous general anesthesia, intravenous conscious sedation, nitrous oxide gas anesthesia with local anesthesia, oral sedation with local anesthesia (often referred to as Novocain). During your consultation appointment, Dr. Turesky will assist you to select the anesthetic technique that best suits your needs.
If you are scheduled to have intravenous general anesthesia or intravenous conscious sedation, please carefully review our information regarding; Before Intravenous General Anesthesia and Sedation, prior to your surgical appointment.
Due to insufficient space, most wisdom teeth are unable to properly erupt into the mouth. The unerupted wisdom teeth remain trapped or impacted within the jaw bone. Impacted teeth may grow vertically, sideways, or backward as they attempt to find a pathway that will allow them to erupt successfully. Often they will partially emerge from the gum as they seek out space in the mouth.
Impacted wisdom teeth can cause many problems. When they have partially erupted they are impossible to clean. The opening around the partially erupted wisdom tooth provides an environment that promotes bacterial growth which can cause tooth decay, gum inflammation, periodontal disease, pain, infection, unpleasant tastes, and odors. Pressure from an erupting wisdom tooth may contribute to gum inflammation, pain, jaw stiffness, and crowding of teeth.
Crowding and shifting of teeth due to pressure from erupting wisdom teeth is a particular concern following orthodontic therapy. Orthodontists will usually recommend an evaluation for the removal of wisdom teeth to minimize the risk of orthodontic relapse or shifting of teeth after braces have been removed.
The most serious problems related to impacted wisdom teeth can occur when cysts, or in rare cases tumors, form around the impacted teeth, resulting in the destruction of jawbone and injury to healthy teeth. Cysts and tumors associated with impacted wisdom teeth are due to degenerative changes in the follicle (sac) that surrounds impacted teeth. Cysts and tumors can develop at any age. They can become very large before they are discovered causing extensive damage. Early removal of impacted wisdom teeth is recommended to prevent these problems and to decrease the risks associated with surgery in older patients.
Studies have shown that patients treated at a young age generally experience a superior outcome compared to older patients. As wisdom teeth develop in older patients, the roots become longer and the jawbone becomes denser. Therefore it becomes more difficult to remove wisdom teeth with advancing age. Complications are more inclined to occur and healing proceeds more slowly in older patients. Patients are usually first evaluated for wisdom tooth removal in their mid-teenage years.
Prior to surgery, a thorough review of your medical history, examination of your mouth, and dental x-rays (panoramic radiograph) will be necessary so that Dr. Turesky can evaluate the wisdom teeth for present or future problems. Dr. Turesky will present all treatment options and discuss the benefits and risks of each option. Surgical risks associated with the procedure such as sensory nerve injury and sinus complications will be discussed with you at this time. Dr. Turesky will review instructions to help prepare you for the procedure and answer all questions you may have regarding treatment.
The Surgical Procedure
Removal of four impacted wisdom teeth under intravenous general anesthesia typically requires 45 minutes to 1 hour of treatment. The entire visit on the day of surgery usually requires approximately two hours of your time at the office. This includes check-in, surgery under anesthesia, recovery from anesthesia, administration of post-operative instructions, final postoperative evaluation, and scheduling a post-operative examination.
Please keep in mind, due to individual differences from patient to patient and potential scheduling delays, time spent in the office on the day of surgery can vary substantially.
Following removal of the wisdom teeth, you will rest under our supervision in the office until you have recovered from the effects of anesthesia and we have reviewed post-operative instructions with you. Upon discharge, your post-operative kit will include; written post-operative instructions, prescriptions for pain medication, Peridex (chlorhexidine) oral rinse, and antibiotics if necessary. Chemical ice bags with a soft retention device to help keep the ice properly positioned will be provided in the recovery room. A follow-up appointment will be required approximately one week after surgery for a post-operative examination.
The average time required for convalescence at home after impacted wisdom tooth removal typically ranges from one to four days depending on the extent of the surgery. Most patients require three days off (plus or minus a day) from school or work after the removal of four fully impacted wisdom teeth under general anesthesia. During your initial consultation, Dr. Turesky will be able to provide you with more specific information concerning how much time off you should require after surgery. If you have any questions, please do not hesitate to call us at the Norwood office: Norwood Office Phone Number 781-762-7077, or the Mansfield office: Mansfield Office Phone Number 508-543-3754 / (508) 339-6200.