Frequently Asked Questions
Below are some of the most frequently asked questions patients have about wisdom teeth. If you have any other questions, or would like to schedule an appointment, we would love to hear from you.
Q: What are wisdom teeth?
A: Wisdom teeth are the third molar teeth. These are located in the very back of the jaws. They often do not have enough space to erupt and are usually not significantly involved in chewing.
Q: How many are there?
A: Most people have four third molars.
Q: Does everybody have them?
A: No. A lot of people do not form all four of their wisdom teeth.
Q: When do they appear?
A: Wisdom teeth commonly "come through" or erupt in the late teens, or early twenties.
Q: Why do most people have problems with them?
A: Most people do not have enough space for the third molars to erupt properly. Due to a lack of space, lower wisdom teeth will only partially rise and become stuck. This is known as being impacted. The back half of the wisdom tooth cannot be cleaned, and gum infections (pericoronitis) become common. Upper wisdom teeth tend to poke toward the outside, irritating the cheek, and can also bite on the lower gum. Because wisdom teeth are so far back in the mouth, they are difficult to clean properly, they tend to decay very quickly, and get infected.
Q: What are the common symptoms?
A: Pericoronitis is a gum infection due to a buildup of bacteria that is not removed by a toothbrush. Commonly, the lower gum overlying the wisdom tooth will be red, inflamed, tender to palpation, and may have pus exuding. If left untreated, the mandibular lymph nodes ("the glands") will become swollen and tender. Trismus (difficulty in opening the mouth) will occur, and the patient may have a raised temperature. This can lead to serious medical infections.
Q: If wisdom teeth require removal, when is this done?
A: Generally, the preferred time for wisdom teeth to be removed is in the late teens. At this age, removal is much easier. The roots which hold the teeth in are much shorter, and the bone is much more elastic in the teenage years. Younger patients also heal up faster, and suffer less post-operative problems than older patients. After the mid twenties, the roots are fully formed, and the bone starts to become hard and brittle. This can make their removal significantly more difficult and time consuming.
Q: Do I need all of them removed, if only one is causing pain?
A: When assessing wisdom teeth, it is a very good idea to take a long-term approach to all four wisdom teeth. If there is enough room for the teeth to come all the way through, and able to be brushed and flossed, then they may be left in place. Unfortunately, this is usually not the case. On most occasions, there is not enough space for all the wisdom teeth. If wisdom teeth are impacted and partly through, they will likely cause problems if left long enough. If they are very deeply embedded, then consideration may be given to leaving them. If someone is going to have trouble with all of their wisdom teeth at some age, it is easy to prevent the pain from happening by early removal of the wisdom teeth.
Q: If wisdom teeth do need removing, is sedation or a local anesthetic better?
A: This is an individual choice for the surgeon and the patient to decide together. Under sedation, all four wisdom teeth can be removed, even if very difficult, at the same time. This is usually done as an in office procedure. Under a local anesthetic, relatively easy wisdom teeth can be removed from very cooperative patients. The removal of wisdom teeth is a procedure that the majority of patients would prefer not to be conscious for.