Understanding Wisdom Teeth
Wisdom teeth are the things most patients fear the most, but know little about other than the “horror” stories they have heard from friends and family or have seen on television and movies.
Wisdom teeth are the last teeth to form and enter into the adult mouth. They are the four teeth that enter the mouth behind the molars on the top and bottom jaws on both sides. They may appear anytime from mid to late puberty all the way into early adulthood. These teeth are the most varied both in size and formation. Most people develop these “wisdom” teeth, called third molars, but some lucky few may never have them. Only a full mouth x-ray (panorex) scan can accurately identify their presence or absence.
Many potential problems can develop due to the movement of these teeth into the mouth, a process called eruption. If sufficient room is present and no obstacles block these teeth, they may erupt into a straight, working formation. When the jaw is too small or something blocks the path of the wisdom tooth, it becomes “stuck in place.” This “stuck” condition is called an impaction. Teeth can be blocked by the gums, other teeth, bone of the jaw, or other pathologies within the jaw.
Impactions can lead to many problems including destruction of the jaw bone, destruction of the teeth next to the impaction, development of pathologic lesions, or possibly jaw fracture itself. The location of these impactions can also cause inflammation or infections of the gums around the surface where these teeth erupt, or the development of decay from bacteria that invade the inaccessible spaces between the teeth.
Even wisdom teeth that erupt into a straight, working formation may cause problems. Often, these teeth are located so far in the back of the mouth that they are difficult to keep clean and free of bacteria and plaque. These teeth are more prone to decay and gum diseases. Another common problem that can develop is the cheek being caught between these teeth. The patient will often startle when they bite themselves.