While most people have their first two sets of molars by the time they’re about 12 years old, the third set, called the “third molars” but often referred to as wisdom teeth, begin formation in the pre-teen to early teenage years. This time is usually associated with development and maturity, hence the name wisdom teeth.
By the time wisdom teeth form, the other permanent teeth have already established their position in the mouth—usually leaving no room for any additional teeth. As a result, the wisdom teeth can become “impacted” in bone or gum tissue- ie., unable to fully erupt into normal position.
This often results in bacteria traps that can cause infections of the gingiva, bone, or adjacent teeth. We know that there is clear evidence that impacted wisdom teeth cause bone loss around and damage to the adjacent molars (the 12-year or “second” molars), and this is the main reason that wisdom teeth need to be removed in most cases. There used to be the thought that impacted wisdom teeth would “push” the teeth in front of them and result in crowding. Based on many well-designed studies, we now know that there is no evidence to support that claim.
In most cases, the wisdom teeth will not have enough room to erupt and will likely cause significant problems if not removed before formation is complete.
An Oral and Maxillofacial Surgeon is best equipped with the expertise to evaluate the need for and manage the removal of wisdom teeth. Additionally, only an Oral and Maxillofacial Surgeon has the knowledge, experience, and expertise to handle the wide range of difficulty that comes along with wisdom teeth removal.
Additionally, Oral and Maxillofacial Surgeons are uniquely and extensively trained during their residency by Anesthesiologists to safely perform office-based general anesthesia. Unlike having a tooth filled or a crown placed, having wisdom teeth removed is perceived as a much more invasive procedure (because it is!). Other methods of sedation such as Nitrous Oxide (laughing gas), oral conscious sedation, or light IV sedation—while effective for lesser invasive dental procedures—do not generally provide a profound enough level of sedation for a more invasive procedure such as wisdom tooth removal. Thus, Intravenous General Anesthesia (Deep IV Sedation) is almost always a more appropriate and better tolerated option, and that option is the standard of care for an Oral and Maxillofacial Surgeon. It is also important to consider the entire team when performing general anesthesia. Our staff here at Texas Oral Surgery Group are highly trained (and certified!) to assist with office-based anesthesia.
There is a common saying: Everything is fine, until it isn’t fine. And it is those times when it isn’t fine that you want someone with expertise and knowledge to manage any potential situation that arises. While postoperative complications are rare, only an Oral and Maxillofacial Surgeon has undergone the extensive training to properly handle any issues that may arise intraoperatively or postoperatively.
A major thing to consider when planning to remove wisdom teeth is the anatomy of the developing wisdom teeth. There is clear evidence that removing the wisdom teeth earlier in their development (i.e., before the roots are allowed to appreciably form) usually results in a far lower number of complications and much more predictable healing. As oral surgeons, we evaluate the stage of formation of the teeth as well as the anatomical position of the teeth in the upper and lower jaws when deciding the best time for removal. There is no magical “age” that is best for removing wisdom teeth. Each patient needs to be evaluated as an individual. Regular dental check-ups with periodic x-rays can help monitor the development of wisdom teeth.
Please be aware that even if you are not currently experiencing discomfort, your wisdom teeth may still need to be removed. In fact, most of the time impacted wisdom teeth will not show symptoms at all. There is a common saying: “The absence of evidence is not the evidence of absence”. This is particularly true when considering the potential issues associated with impacted wisdom teeth. Just because there are no symptoms does not mean that there isn’t a potential or impending problem ready to occur.
Wisdom teeth extractions are one of the most common dental procedures. For your benefit and health, we encourage you to have your wisdom teeth evaluated by an oral surgeon before you experience any signs or symptoms.
Texas Oral Surgery Group assists patients with wisdom teeth issues on a routine basis. With extensive training in all types of wisdom teeth surgeries, Dr. Larry Stewart and Dr. Wayne Michael are equipped to handle any complications. Give us a call today for an evaluation.Contact Us Today!