FAQs

It all depends on the position of the wisdom tooth. If it is partially erupted and hinders proper cleaning, it can contribute to the development of cavities in the neighboring tooth, damage to the root of the neighboring tooth, or periodontal pockets. Of course, for the same reasons, cavities can also form on the wisdom tooth itself, and untreated cavities can cause severe pain.

If you have an impacted wisdom tooth, it doesn’t mean that you have to extract it. The decision to extract an impacted wisdom tooth or not depends on various factors.

In children, the assessment usually focuses on whether the wisdom tooth can erupt and fit into the dental arch. In adult patients, the decision considers the presence of any discomfort or complications caused by the wisdom tooth, and the patient’s age also plays a significant role.

It’s a perpetual dilemma for our patients, but unfortunately there is no straightforward answer. The difficulty or ease of surgical extraction of wisdom teeth is influenced by numerous factors:

• the shape of the roots of the wisdom teeth – the more curved or divergent the roots are, the harder it is to extract the tooth
• density of the surrounding bone – the bone in the upper jaw is generally softer, making it easier to surgically extract upper wisdom teeth in most cases
• accessibility of the region – both upper and lower wisdom teeth can sometimes have difficult access, making the procedure more complicated
• during the surgical extraction of upper wisdom teeth, there may be a risk of “sinus perforation” due to the close proximity or contact with the sinus. This complication can be relatively easily resolved during the procedure.
• lower wisdom teeth may be close to the inferior alveolar nerve, which requires special attention and can significantly slow down the surgical extraction of the tooth.

Patients often come to us with pain in their wisdom teeth. Usually, the pain spreads through the lower jaw on the same side, and often to the area around the ear and temple. In younger people, while the wisdom tooth is still growing, the pain is caused by the tooth’s growth itself. If the wisdom tooth is growing in the correct position, the pain may not be significant, but if it is “pushing” against neighboring teeth and is in an incorrect position, the pain can be much more intense. In both older and younger patients, very severe pain can occur due to infection around the wisdom tooth or due to deep decay in the tooth that has already reached the nerve.

Surgical extraction of wisdom teeth looks similar to any other oral surgical procedure. After an adequate diagnosis and treatment plan, the intervention is performed. The first step is to prepare the patient by giving anesthesia, appropriate pain and swelling medications. The next step is to prepare a sterile working field. The wisdom tooth is accessed by lifting the gums, possibly removing a small portion of the jawbone or cutting the whole tooth. After the tooth is extracted, the wound is stitched, and the stitches are usually removed after 7 days. Throughout the procedure, the patient is under anesthesia and does not feel any pain. If the tooth or bone needs to be cut, a dental drill is necessary, which sounds and looks like a regular dental filling.

Inflammation of the wisdom tooth is a term commonly used by patients, but it usually refers to inflammation of the soft tissue (gums) around the wisdom tooth, which is called pericoronitis. It most commonly affects lower wisdom teeth, especially if they have partially erupted or if their crown is covered by gums. In these situations, cleaning around the wisdom tooth is difficult, and bacteria can get trapped between the tooth and gums, creating pockets in the bone (periodontal pockets) that act as a reservoir for more bacteria.

If pericoronitis occurs, it is almost always necessary to prescribe antibiotics and, if possible, extract the wisdom tooth as soon as possible. If the wisdom tooth cannot be extracted by the usual means but instead requires surgery, the infection is first treated, and then surgical extraction is performed.

When there are unerupted or partially erupted wisdom teeth in children, first the position of the tooth is evaluated to determine if there is a possibility for it to properly align in the dental arch. Often, orthodontists are involved in this decision, as it is not uncommon for the tooth to remain impacted due to underdeveloped jaw or lack of space for eruption.

If tooth extraction is part of orthodontic treatment, the decision of when to extract the tooth is made by the orthodontist. Typically, this is between the ages of 13 and 16, when the extraction is simpler and the child is cooperative enough.

The most common reason for this is that there is not enough space in the dental arch for the wisdom tooth to erupt. Another cause can be the improper positioning of the tooth germ, the presence of obstacles on the path of eruption such as extra teeth, changes in the bone, thickening of the mucous membrane. In rare situations, unerupted wisdom teeth can be found as part of some generalized diseases and syndromes.

Wisdom teeth, also known as third molars, are the last teeth to emerge in the upper and lower jaw. They usually erupt between the ages of 20 and 25. They can erupt normally, like any other teeth in the jaw, but they can also cause problems during their eruption.

A wisdom tooth that has fully emerged and is in the correct position behaves like any other tooth, participating in chewing and being cleaned and maintained normally.

The problem can arise with wisdom teeth that are in an incorrect position, partially erupted, or partially covered by bone. Such a wisdom tooth needs to be surgically removed.

Wisdom teeth are the teeth most susceptible to extraction compared to other teeth in the jaw, and there are several reasons for this. It is often the case that there is not enough space for wisdom teeth to fully erupt, so they partially erupt while one part remains in the bone or the whole tooth stays in the bone. These are called impacted or partially impacted wisdom teeth.

However, not all partially erupted wisdom teeth need to be removed. If they are causing an infection due to their incorrect position, they should be extracted. The same applies if their growth causes irregular positioning of other teeth, if they cause cavities or damage to the root of the adjacent tooth, or if they cause pain, and so on.