August 25, 2014

Wisdom Teeth – Nature’s cruel joke? Yes.

Congratulations! You’ve made it through most of high school, you are thinking about SATs, applying to colleges, the Justin Beiber concert this weekend (or whatever it is you kids listen to,) and of course your wisdom teeth.

Our wisdom teeth begin developing very early, but mature in the late teens. They get their name because they emerge as we (at least in the Old Days) become adults and in theory ‘wise.’ Of course I’m 35 and in no way feel I’ve reached an age of wisdom, so don’t look at me here. Most of us have two upper and two lower ones, also called ‘3rds’ or 1,16,17,32. Some lucky individuals have fewer. These people are more evolved than the rest of us. Beware of them, they may have mutant powers. Other lucky folks have extra ones, known as supernumeraries. Why do we have teeth that exist only to be pulled? Good question, Timmy! Back in the day our ancestors had much wider jaws that allowed for wisdom teeth to erupt unimpeded. Additionally, they frequently lost teeth to trauma and decay, so there was more room for eruption. Now our jaws are more slender, and we are keeping our teeth. Great, except the poor wisdom tooth still wants to come in.

An example of a mouth crowded by pesky wisdom teeth.

An example of a mouth crowded by pesky wisdom teeth.

After having the wisdom teeth extracted by Boulder Dental Arts.

After having the wisdom teeth extracted by Boulder Dental Arts.

About 5% of the population is ‘lucky’ and has sufficient room for their wizzies to fully erupt. As long as they keep these teeth clean they don’t need to worry, all is well. The rest of us…. Well somewhere along the line something will become a problem and the tooth will need to be removed. The reasons are varied – some people cannot keep them clean, some are impacted and impinging on the nerves, others press against the tooth in front, creating decay. There is debate over whether they cause crowding issues and ruin years of braces. The reality is the odds are you will need your wisdom tooth out at some point in your life, and younger is better.

When you are young your bone is ‘soft’ and the immature tooth is fairly loose in the jaw. The procedure to remove one is fairly simple on a teen. But, like tonsils, if you need them out as an adult it will suck and you will not enjoy it. The tooth roots are longer, the complications are more, and it tends to be locked tightly into the bone. The healing process is also prolonged. So do yourself (and me) a favor and get them out early, if need be.

The Big Day: There’s two ways to approach this procedure. An oral surgeon can give you medicine to reach a level we call conscious sedation. You will either not remember the procedure or feel like it was a dream. Alternately a general dentist can give you an oral anxiolytic, some noise canceling headphones, and a ton of anesthetic. You will be awake, but comfortable. Either way results in similar recovery, and the decision should be based on your preference, trust in the practitioner, and finance.

After the fact: This surgery will slow you down, but it won’t take you out of the game. Plan on feeling a bit roughed up for about 6-8 days, with days 4 and 5 being the least comfortable. You will need to limit your physical activity slightly. Depending on age the sockets (or ‘holes’) will fill in within 3-6 weeks. You must keep these clean, which is actually fun. Eventually bone fills into the space, and it is like the teeth vanished into the air.

The best way to find out if you ‘need’ your wisdom teeth out is to speak with your dentist. Make sure to have a panorex x-ray, or in complicated cases a 3-D scan, taken to show the location of the wisdom teeth and to reveal any complications that might be present. The more you know.

By Dr. Jeffery Patrician, Boulder Dental Arts.