Wisdom teeth are actually our third molars… which erupt into our mouths behind our 2nd molars during the late teen years or early twenties – if there is room and they are aligned properly.
Dr. Willoughby and his staff have over 25 years of experience with a wide variety of oral surgery and tooth extraction procedures. No two procedures are exactly the same – some healthy teeth require simple elevation of the tooth other badly broken down decayed teeth require flaps in the gum, sectioning of the tooth and bone removal –this is referred to as a surgical extraction.
Dr. Willoughby routinely removes wisdom teeth and performs all types of tooth extractions – often times in combination with the very latest in bone grafting and guided tissue regeneration techniques in order to preserve the surrounding level of bone and soft tissue.
Wisdom teeth are the last (third) molars to emerge from the gums, and typically appear when a person is between the ages of 16 and 22. There are usually four wisdom teeth: upper left and right and lower left and right although some people have more and some have fewer. If a tooth fails to emerge fully into its position, its is called “impacted.” Either there is not enough room for the tooth, or the angulation of the tooth is improper. When that happens, oral surgery may be necessary.
Types of Impaction
Most often the impacted tooth is angled diagonally forward, known as mesial impaction however there are several other types of impactions including a horizontally impacted wisdom tooth or a full boney impaction. Sometimes, the wisdom tooth or teeth erupt through the bone correctly, but unable to fully emerge through the gum tissue – this is referred to as a soft tissue impaction.
When the wisdom tooth is still inside the bone or gums, there is usually less concern about the timing of the extraction. However, when it has partially emerged through the gum tissue, the problem becomes a lack of dental hygiene.
Plaque Around a Partially Erupted Wisdom Tooth
Once the tooth, starts to emerge through the gum, the problem becomes how to keep it clean. The gum normally stretches around the base of the tooth but never attaches itself directly to the tooth’s crown –there is always a small naturally occurring space referred to as a “sulcus” that encircles the crown where the gum forms a collar or a gingival ‘cuff’ around the tooth. When a tooth is fully erupted, and plaque / bacteria are not removed, decay and infection can set in. If the gingival sulcus is not cleaned, it will become over-run with bacteria and infection will set in. This will eventually lead to attachment loss and the formation of a gingival pocket. In the case of an impacted tooth, when this same thing happens Dentists refer to it as “pericoronitis”.
When the crown of the tooth is only partially exposed, a flap of gum forms over the rest of the crown making it near impossible to keep the gingival cuff free of plaque and bacteria…so millions of bacteria work their way down underneath this flap where they multiply and spread around the rest of the impacted tooth causing inflamed gums and bone loss as well as bad breath, pain, swelling, and inability to open the mouth fully. In severe cases, the infection can even spread to involve the cheek and neck. Once the initial episode occurs, subsequent attacks can often become more frequent and more severe. If the impacted tooth is tipped up against an adjacent tooth, decay can also spread to that tooth.
Wisdom Tooth Removal is now required…
The opening in the gum now provides an open door for the periodontal disease and infection to spread into the surrounding gums and bone. Wherever bacteria can make a home, multiply, and deposit their acid excretions, decay happens and infection can spread. At this point, the only practical option to remove the impacted tooth. Dr. Willoughby has experience with wisdom tooth removal. By extracting the impacted wisdom tooth, Dr. Willoughby can give the rest of your teeth more room, prevent any cysts from developing around the impacted tooth, and improve your overall dental health.
Wisdom teeth are also commonly removed for Orthodontic Reasons. As a Premier Preferred Provider of Invisalign many of Dr. Willoughby’s younger patients have been through Invisalign Clear Aligner therapy to straighten their teeth and so he knows that Wisdom teeth may cause movement of teeth (particularly the front teeth) when the wisdom teeth try to erupt. If the impacted wisdom teeth are not removed either before or soon after Invisalign therapy is completed, this can potentially compromise the long term success and retention of the orthodontics.
Please contact our office if you would like to know more about wisdom teeth and whether they should be extracted. Our modern facility and expert training makes all dentistry easier, faster, and more pain-free than in past years.
Using 3D digital scanning technology, Dr. Willoughby and his staff can take very accurate 3-D digital pictures of your jaw to determine the exact position of your wisdom teeth. This 3D scan helps Dr. Willoughby to accurately assess the level of complexity of your specific case and give you a better idea of what potential post op. complications may occur.
If you are an anxious patient, don’t forget to ask about our sedation services, which you can request for any tooth extraction procedure.
Contact Us Today! (604) 541.1800
If you or a family member think you may be having problems with your wisdom teeth, contact our office today and we would be happy to make you an appointment to learn more about how you can achieve the beautiful, functional smile you’ve always wanted!