impacted wisdom teeth / wisdom teeth extractions

The removal of impacted wisdom teeth has become so commonplace that the process of having these extractions performed has practically become a right of passage for teenagers. Our pages about wisdom teeth will describe for you which teeth are the wisdom teeth and what conditions must exist for a wisdom tooth to be considered "impacted." We'll also explain for you some of the common reasons why dentists recommend the extraction of wisdom teeth, as well as some reasons why this dental procedure might not be indicated.

Additionally, our pages discuss the best age at which to have wisdom teeth extracted as well as some of the common risks and complications associated with this type of oral surgery. We also make mention of some of the different methods of sedation an oral surgeon might use with their patients who are undergoing impacted wisdom teeth removal, as well as some tips related to post extraction recovery.

What are "wisdom teeth?"

A wisdom tooth is the same thing as a third molar. "Wisdom teeth" are a type of molar. Molars are the chewing teeth found furthest in the back of the mouth. Most humans have first, second, and third molars.

A person's third molars are their wisdom teeth. These teeth come in behind the 2nd molars (if there is room for them and they are aligned properly), usually during a person's late teens or early twenties. Typically a person will have four wisdom teeth: upper left, upper right, lower left, and lower right.

What are "impacted wisdom teeth?"

In dental terminology an "impacted" tooth refers to a tooth that has failed to emerge fully into its expected position. This failure to erupt properly might occur because there is not enough room in the person's jaw to accommodate the tooth, or because the angulation of the tooth is improper.

Classifications of impacted wisdom teeth.

Dentists use specific terms to describe the positioning of impacted wisdom teeth. The most common type of impacted wisdom tooth is one that is impacted mesially. The term "mesial" simply means that the wisdom tooth is angled forward, toward the front of the mouth.

The other types of impactions, in order of frequency of occurrence, are the vertical, horizontal, and distal types.

A horizontally impacted wisdom tooth.

In addition to mesially, vertically, horizontally, and distally impacted, wisdom teeth can also be classified as soft tissue or bony impactions. The term "bony" impaction indicates that the wisdom tooth is still fully encased in the jaw's bone. A "soft tissue" impaction is one where the upper portion of a wisdom tooth (the tooth's crown) has penetrated through the bone, but has not yet erupted fully through the gums.

A bony third molar impaction.

Why might a wisdom tooth be impacted?

The reason why some wisdom teeth are impacted is not an easy question to answer. A primary cause of wisdom tooth impaction is simply that there is inadequate jawbone space behind the person's second molar. Why this lack of space exists is not fully understood, however there does seem to be a correlation between large tooth size, tooth crowding, and the presence of impacted wisdom teeth.

It has been theorized that the coarse nature of stone age man's diet had the effect of producing extensive tooth wear, not only on the chewing surface of the teeth but also on the sides of the teeth where neighboring teeth rest against each other. The net effect of this wear would be a reduction in the collective "length" of the teeth as a set, thus creating enough jawbone space to accommodate the wisdom teeth by the time they erupted. In comparison the diet of modern man does not usually cause a significant amount of this type of tooth wear.

It has also been argued that the coarse nature of stone age man's diet, as compared to modern man's relatively soft diet, probably required more activity of the "chewing" muscles. This activity could have stimulated greater jawbone growth, thus providing more space for wisdom teeth.

The harsh and threatening world of the caveman no doubt often lead to the occurrence of broken teeth and even tooth loss. Once a tooth (or a portion of it) is missing the teeth behind it have a tendency to move forward. This shifting would make more jawbone space available for the wisdom teeth. In comparison, with the advent of modern dentistry there are relatively few reasons why a tooth should be lost or remain in a state of disrepair.