Nature has provided most of us with wisdom teeth regardless if we have enough room or not for them to evolve normally in the mouth.
When discussing tooth extraction with our patients, and especially parents, we are asked the same worrisome questions: do we not need all our teeth? In which case should we have wisdom teeth extracted? Should we have two or four wisdom teeth extracted at the same time?
How DO wisdom teeth grow
Each of our teeth has a special role to play in the mouth, but not all mouths can accommodate 28 or 32 teeth, if you include the wisdom teeth. The eruption of our 4 wisdom teeth (also called third molars) is quite slow and may not even happen.
From 8–10 years, shadows of the teeth are visible on X-ray. At the age of 12, the crown is formed. Roots are developed around 17–18 years, corresponding to the average age of eruption. At 25, when they find enough space on the dental arch, 90% of wisdom teeth have erupted.
At what age should we have wisdom teeth extracted?
As a preventive measure, it is strongly recommended to conduct an examination at age 15 or 16 to assess the growth and the likely direction of the wisdom teeth. Since the roots are not yet formed at this period of growth, in the event of extraction, the surgery can be greatly simplified.
The best age to minimize surgery risk is between 16 and 20 years. During this period, the roots of the wisdom teeth are short and only half-formed. Certain factors contribute to facilitating surgery and healing: the bone surrounding a wisdom tooth is softer and the tooth is surrounded by a large capsule of soft tissue.
It is recommended proceeding with the prophylactic removal of wisdom teeth before the age of 25 and in some cases up to 30 without major problems. At our Clinic, Dr. Martin Dubois and Dr. David Côté perform this procedure as well as numerous complex extraction cases regularly.
Why should we have them removed?
Several reasons can justify the extraction of wisdom teeth.
- For some people, wisdom teeth may cause pain.
- It is recommended extracting them to allow the alignment of other teeth where there is a lack of space in the dental arch.
- Impacted teeth increase the chances of developing a cyst or a benign tumor.
- The semi-impacted teeth are difficult to access and impossible to clean properly. Bacteria and remaining food particles can cause problems, including cavities.
- Impacted and semi-impacted teeth can cause localized disease in gum and bone surrounding the teeth.
- Horizontal wisdom teeth can cause resorption of the adjacent tooth, that is to say, the second molar. If the latter is affected significantly, it will also have to be extracted.
- Inflammation of the tissues surrounding the crown of the tooth (pericoronitis) and soft facial tissue infection (cellulitis) are possible complications of included or semi-included wisdom teeth.
How surgery is done
The dentist takes a panoramic X-ray of the patient’s mouth to assess the degree of difficulty in the procedure.
- The doctor tells the patient the risks associated with the surgery, then he answers the patient’s questions.
- Depending on the patient’s level of apprehension, the dentist may prescribe relaxants for the surgery.
- The procedure is usually done under local anesthesia and it is preferable to extract the four teeth at the same time, depending on their position in the mouth.
- When necessary, the dentist makes an incision on the gums to clear an operative area, he then gains access to the teeth, and proceeds to remove them.
- He closes the wound with resorbable sutures, prescribes the patient with painkillers and gives postoperative advice.
- An appointment for the extraction of 4 wisdom teeth lasts about 2 hours.
- The dentist will ask to see the patient as needed.
What to do after surgery
After the procedure with local anesthesia, you can easily recover in the dentist’s chair. Do you want to heal quickly from your surgery? Follow your dentist’s instructions.
What activity can I do?
After your surgery, plan to rest for the remainder of the day. You can resume normal activities the next day. For at least a week, avoid any strenuous activity that could dislodge the blood clot from the socket.
Drink plenty of water after the surgery.Don’t drink alcoholic, caffeinated, carbonated or hot beverages in the first 24 hours. Do not drink with a straw for at least a week, because the sucking action can dislodge the blood clot.
What to eat
Eat only soft foods like yogurt or applesauce for the first 24 hours. Start eating semisoft foods when you can tolerate them. Avoid hard, chewy, hot or spicy foods that might get stuck in the socket or irritate the wound.
How to manage pain
You may be able to manage pain with a prescription pain medication – given by your dentist – or an over-the-counter pain reliever, such as acetaminophen. Holding a cold pack against your jaw also may relieve pain.
Some oozing of blood may occur the first day after wisdom tooth removal. Avoid excessive spitting so that you don’t dislodge the blood clot from the socket. Replace gauze over the extraction site as directed by your dentist.
Swelling and bruising
Swelling and bruising of your cheeks usually improves in two or three days. Use an ice pack as directed by your dentist.
Cleaning your mouth
Do not brush your teeth, rinse your mouth or use a mouthwash for the first 24 hours after surgery. For a week, gently rinse your mouth with warm salt water every 2 hours and after meals. Mix 1/2 teaspoon of salt in 8 ounces of water. After the first 24 hours, resume brushing teeth being particularly gentle near the surgical wound to avoid disrupting any stitches.
Do not smoke for at least 24 hours after surgery – and wait longer than that if possible. Using tobacco products after oral surgery may delay healing and increase the risk of complications.
If you have absorbable sutures, they will disappear in a few weeks. If your stitches need to be removed, schedule an appointment to have them taken out.
Our dentist Dr. Dubois achieved oral surgery distinction
Dr. Martin Dubois is a general dentist who achieved academic distinction for his performance in the field of oral surgery during his studies at the University of Montreal. Furthermore, he completed specific training on the extraction of wisdom teeth at the International Dental Institute in Brossard, Quebec, under the tutelage of Dr. François Thériault, a maxillofacial surgery specialist.
Do you have concerns about wisdom teeth?
Today, the absence of wisdom teeth is becoming more common. That’s not because our children are increasingly turbulent, but because over time, man’s diet has changed and today, two molars are more than enough to do the chewing.
If you have questions on your wisdom teeth or those of your children, feel free to ask Dr. Martin Dubois who will be happy to answer you.