Wisdom Tooth Extraction

Wisdom teeth, also called third molars, are the last permanent teeth to develop. They usually begin to come in during the late teens or early twenties, though the timing varies a lot from person to person.

Most adults have four wisdom teeth, one in each corner of the mouth. Many people simply do not have enough room in the jaw for them to come in properly. When space is short, wisdom teeth may become impacted, meaning they cannot fully come through the gum, or they may come in at an angle and create a range of problems.

Impaction

A wisdom tooth that is stuck in the bone or partly covered by gum tissue is impacted. A partly erupted wisdom tooth leaves a pocket of gum around the tooth that is very hard to clean, which makes it prone to infection (a condition called pericoronitis), decay, and gum disease.

Crowding of nearby teeth

As a wisdom tooth pushes against the second molar, it can put pressure on the teeth beside it. Whether this measurably moves other teeth is still debated, but when nearby teeth are visibly affected, extraction may be recommended.

Decay and gum disease

Wisdom teeth that sit at an angle or are partly covered by gum are notoriously hard to clean. Even with careful brushing and flossing, food and bacteria build up where a toothbrush cannot reach, raising the risk of cavities in both the wisdom tooth and the second molar next to it.

Cysts

An unerupted or impacted wisdom tooth develops inside a small sac of tissue. Sometimes that sac fills with fluid and forms a cyst, which can slowly damage the surrounding bone and nearby teeth.

A wisdom tooth that has fully come in, sits correctly in the bite, and can be cleaned well does not necessarily need to come out. These teeth can be monitored at regular dental visits like any other tooth.

The decision to remove a wisdom tooth is made case by case, based on the tooth's position, its effect on surrounding teeth and bone, and any symptoms. X-rays are an important part of that assessment because they show what cannot be seen in the mouth.

Wisdom tooth extraction is done under local anesthetic as a standard approach. You should feel pressure and sensation, but not sharp pain. The dentist discusses comfort measures and pacing with you before treatment so you know what to expect. Nitrous oxide is available when appropriate.

The procedure depends on whether the tooth has fully come in or is impacted:

Erupted wisdom tooth

A fully erupted wisdom tooth is removed much like any other extraction: the socket is widened, and the tooth is loosened and removed. The procedure is usually straightforward.

Impacted wisdom tooth (surgical extraction)

When a tooth is fully or partly trapped in the bone, a small incision in the gum may be needed. The tooth may be sectioned and removed in pieces so that as little bone as possible is disturbed.

Some swelling and tenderness is normal in the days after a wisdom tooth extraction. These general guidelines apply, and the dentist will give you specific aftercare instructions at your appointment:

• Stick to soft foods for the first several days and avoid chewing on the extraction site.
• Keep the area clean. Rinse gently with warm salt water as directed, but avoid vigorous rinsing or using a straw for the first 24 hours.
• Avoid smoking, which greatly increases the risk of dry socket and slows healing.
• Apply a cold compress to the outside of your face to help with swelling in the first 24 hours.
• Take any prescribed or recommended medications as directed.
• Call 780-432-3430 if pain increases several days after the procedure, or if you notice a bad taste or a socket that looks dry. These can be signs of dry socket, which is manageable when treated promptly.

X-rays taken at regular dental visits let the dentist track wisdom tooth development before the teeth cause problems. In younger patients, this monitoring often starts in the mid-teens, while the teeth are still forming and the roots are not fully developed. Extractions at this stage are typically easier, with a faster recovery.

If your wisdom teeth have not been checked recently, mention it at your next appointment and the dentist can review them with current X-rays.