FAQ about Minor Oral Surgical Procedures

Frequently Asked Questions about Minor Oral Surgical Procedures

Wisdom teeth, or third molars, do not always erupt properly when they decide to make an appearance. It's wise to get an early opinion from your dentist on getting wisdom teeth pulled before they become impacted, causing pain, swelling, infection, cavities or gum disease.

Why don't wisdom teeth grow in right?

The shape of the modern human mouth is often too small to accommodate wisdom teeth which make their first appearance in young adults between the ages of 15 to 25. Over the course of time in the evolutionary process, humans learned to harness fire for cooking foods and developed blade tools to better process food before consumption, they reduced the need for strong jaws to chew food.

What does impacted mean?

When wisdom teeth don't have room to grow or they haven't reached their final position by age 25, they are considered impacted. Third molar impaction is the most prevalent medical developmental disorder.

What are the problems caused by impacted third molars?

Partially erupted wisdom teeth are breeding grounds for bacteria and germs that may cause infection, and cysts and tumors may grow on a trapped wisdom tooth. Jaw pain and gum disease may occur. Not all wisdom teeth cause problems, however.

Isn’t antibiotic therapy enough to suppress the infection?

Antibiotics only soothe infected wisdom teeth for a short time. Since people frequently use a wide variety of antibiotics, the infection may be resistant to such medication and doesn't solve the real problem: The tooth can't fit in your mouth.

When is removal necessary?

It isn't wise to wait until wisdom teeth bother you. Early removal, as advised by your dentist, is generally recommended to avoid problems, such as an impacted tooth that destroys the second molar. People younger than 16 heal easier too. At an early age, people should be evaluated by their dentist who can track third molar development with the help of X-rays. Second molars should be visible to lessen the chance of damaging them during surgery. This occurs at age 11 or 12, so wisdom teeth should be removed when the decision has been made that they cannot erupt into an acceptable position.

What if there are no symptoms?

People with symptoms of impaction, such as pain, swelling and infection should have their wisdom teeth removed immediately. However, those with no symptoms can avoid the chance of ever suffering from the pain of impacted wisdom teeth or achieve better orthodontic treatment results by having them removed. Asymptomatic impacted wisdom teeth also should be removed to reduce the chance of unexplained pain, accommodate prosthetic appliances, or avoid cavities, periodontal disease, bone shrinkage and tumor development.

How is the tooth removed?

Surgery for impacted wisdom teeth consists of removing of the gum tissue over the tooth, gently stripping connective tissue away from the tooth and bone, removing the tooth and sewing the gum back up.

What is a dry socket?

A "dry socket" occurs when the blood clot is lost from an extraction site prematurely. Basically, the blood clot in the socket serves the same two functions as a "scab" on a skin surface cut. First, it assists in the cessation of bleeding and second, it protects underlying structures during the healing process. Like the child who "picks at a scab" the area heals in time but is painful for far longer than if the "scab" had been left alone.
When the blood clot is lost before the underlying structures have had time to heal, bone is exposed to the oral environment along with fine nerve endings. This is an exquisitely painful but otherwise relatively harmless situation. There are packing materials which the dentist can place to help ease the discomfort both by physically blocking the wound and by the action of the chemicals in the pack on local nerve endings. Tincture of time and good oral hygiene usually resolve the situation.
There are some activities which may increase the propensity for dry socket formation...smoking, drinking carbonated beverages in the first 24 hours after surgery, spitting or drinking through a straw in that same time period...but often "dry sockets" occur for no particular reason at all.