3 Common Cases That May Warrant a Wisdom Tooth Extraction

Understand wisdom tooth extraction

Why You May Be Better Off Without Your Wisdom Teeth

Third molars, more widely referred to as wisdom teeth, are the most commonly extracted teeth. The reason for this frequently performed surgery is because the human jaw has evolved over many thousands of years. The average human jaw is no longer as large as it once was, thus causing there to be inadequate space for the proper eruption of all 32 teeth.

There are certainly people whose wisdom teeth can properly grow into the mouth; however, more often than not, the teeth are either only partially able to grow into the mouth or are completely impacted below the gumline. The latter scenario can cause major problems if the teeth are not extracted at the appropriate time.  

1. Partial Eruption

In the case where the wisdom tooth is only partially able to erupt (grow into the mouth), an operculum may form. As the tooth erupts, it pushes the surrounding gums out of the way. If it doesn’t grow high enough into the mouth for the gum tissue to surround the bottom of the tooth, part of the gums may continue to cover the chewing surface of the tooth. This piece of gum tissue that stays on the tooth’s biting surface is called an operculum.

If the wisdom tooth fits in the mouth yet an operculum is present, a simple procedure can be done to remove the excess tissue with a laser. If this procedure, known as an operculectomy, is not done, bacteria and food can get stuck in the pouch created between the tooth and the excess gum tissue, causing significant pain and inflammation known as pericoronitis. This inflammation could be so severe as to cause a pericoronal abscess. 

2. Partial Impaction

If the wisdom tooth does not fit in the mouth either due to the direction it is growing or due to a lack of space, the tooth will need to be extracted. This is because it will be impossible to keep the tooth clean as it will be partially covered with gum tissue and will certainly cause either decay on the chewing surface or pericoronitis to the surrounding gum tissue. 

3. Full Impaction

The third scenario to support the need for wisdom tooth extraction is when the tooth is impacted below the gumline. Full impaction is when the tooth fails to erupt into the mouth at all due to inadequate arch length or space. Sometimes, as it attempts to grow into the mouth, it is blocked by an adjacent tooth. When this happens, it pushes the gums in a manner that can cause an operculum. Even more of a concern is the damage it does to the adjacent tooth. The impacted tooth is literally pushing on its neighbor, causing irreversible bone loss and potential tooth decay. 

My motto for wisdom teeth is this: “If you can’t keep them clean, you can’t keep them.”

Written by Dr. Christopher King

Dr. King has been leading King Dental since 2000. In the 20-plus years since opening King Dental, his experiences have only strengthened his excitement for his chosen career. Dentistry is Dr. King’s life’s mission.

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