Removal of wisdom teeth is often recommended by dentists due to varying reasons. In this series of videos, Dr. Lyuda explains what prompts a dentist to recommend extracting one or all of the wisdom teeth otherwise known as third molars.
Wisdom Teeth Extractions
Dr. Lyuda explains the different reasons why she may recommend to extract a wisdom tooth.
Dr. Lyuda: Hi, my name is Dr. Lyuda, and today I have a few words of wisdom for your wisdom teeth. I’ve been asked that question a lot, if everyone needs their wisdom teeth extracted, and the answer is no, but for a majority of the population the answer is yes.
I would say the most common reason we see wisdom tooth being extracted is if there is a cavity, big cavity, and the person is in pain. It’s very likely that wisdom teeth do get a cavity, because they’re so far back and it’s really difficult for a person to reach back with a toothbrush and get all that plaque off. So majority of the time wisdom teeth do get decayed and we do need to take them out.
One of the second reasons is called pericoronitis, and that’s when the wisdom tooth just starts to erupt and that gum tissue just overlaps the tooth and it creates that pocket where bacteria enters and it creates an infection. If it happens once we can put a patient on antibiotics or an antibacterial rinse and see if it happens again, but if it happens twice that means that they’re pretty much prone to it and we really should get the wisdom tooth out.
The third reason is orthodontics. A lot of us as children go through braces to get our teeth straight and get them into correct bite, and sometimes there just isn’t enough room in your arch for movement. So often orthodontists will ask us to remove those wisdom teeth before the treatment starts, or after the treatment completed before the retainer is placed so that those wisdom teeth don’t put pressure on your teeth and make them crowd again.
Another reason, which is actually pretty common, is when those wisdom teeth are malpositioned, when they’re not growing perfectly straight, vertically up, but they’re leaning towards a tooth in front of it. They cause two problems. One, it’s called periodontal defect and that they destroy some of that bone behind the tooth and it creates a really, really deep pocket where a lot of bacteria gets collected and it causes a cascade reaction where you end up losing more bone. If you lose enough bone you can end up losing both the wisdom tooth and the tooth in front of it.
Another reason is that due to that pressure of that wisdom tooth leaning in front of that tooth in front of it can cause root reabsorption. Your root will literally just start dissolving or it will look like a cavity on an x-ray, and we would have to remove that tooth as well. So we do this for preventative reasons because we see this way too often that that reabsorption does happen.
But once in a while we do see people have great hygiene. They brush really, really well. They have enough room in their mouth. Their wisdom teeth have grown into their perfect position. There is absolutely no need to take those teeth out, and we just keep an eye on them.
Wisdom Teeth Extraction Simulation
This is a simulation of the process of extracting a wisdom tooth that is partially bony impacted.
Dr. Lyuda: Let me walk you through a simulation of partial bony impacted tooth being extracted at our office. Here is an example of a patient with a partial bony impacted wisdom tooth. As you can see, you cannot see the wisdom tooth, as it is hiding underneath the gum and is just partially poking through the bone if we were to retract the gums away. In order for us to remove this tooth, we first have to flap the gums, which means to retract them away from the bone, so we’ll do that. It’s going to expose the crown portion of the tooth, and then we have to do a procedure called troughing, which means we have to remove some bone around the crown of the tooth to create some space, so that way we can create some mobility in the tooth for an easy removal. Then we are going to close the gums together with sutures, and you’ll be done for healing.
Can All 4 Wisdom Teeth Be Removed At One Time
A very common question we get asked is if it’s ok to extract all 4 wisdom teeth on the same day. Ultimately that comes down to personal preference of minimizing visits as about half of the patients prefer to get all extracted during the same visit while the other half prefers to get 2 extracted at a time for a total of 2 visits.
Speaker 1: [inaudible 00:00:06] where you go cause I’ve known right from the start.
Dr. L: I do get asked how many wisdom teeth can we extract at a time and it’s really a personal preference. We can certainly take all four teeth out especially if you are on a time crunch and you’re just one appointment and about one week of healing after that and you don’t have to worry about it again. Some people prefer to just have one side done so we’ll take the upper and the lower on one side and then about maybe two weeks later the upper and the lower on the other side and that way you can still use the other side to eat and to manage any discomfort that you might have.