Wisdom teeth coming in
For most people, wisdom teeth begin to come in when you are a teenager. However, wisdom teeth can remain below the gums for years and then begin to emerge a little bit as late as your twenties or thirties.
Just because wisdom teeth come in doesn’t mean they need to be taken out. Whether wisdom teeth should be removed is a complex decision between you, your general dentist, and potentially an oral surgeon.
What problems can wisdom teeth develop?
There is nothing especially magical about wisdom teeth, but because they are located very far back in the mouth, they do tend to develop problems that are difficult to treat. Because of their position, many patients have a hard time cleaning them. This means they can easily develop cavities, and those cavities are hard to reach with the instruments we usually use for fillings. Fillings that are placed in wisdom teeth are more likely to fail or to develop decay underneath them, leading to an infection.
Wisdom teeth are also more likely to grow at off-angles, and this means that sometimes they are still partially covered by gum instead of fully erupted into the mouth. The gum flaps that cover them tend to trap food, leading to an extremely painful infection called pericoronitis.
Do I need to have my wisdom teeth out?
We can’t predict whether the problems outlined above will happen to your wisdom teeth. Some patients have wisdom teeth their entire lives and never develop any of the above problems. Some patients develop one or many of these problems immediately. The worst of all, however, is developing one of these problems in older age.
This is because wisdom teeth are usually some of the most difficult teeth to remove, and the older you get, the more that difficulty grows due to changes in your bone. It will also usually take an older patient much longer to recover from having a wisdom tooth removed. For this reason, if your dentist suspects that your wisdom teeth are likely to cause issues, she will probably recommend you have them removed.
Should I go to sleep to have my wisdom tooth removed?
Every wisdom tooth is different just like every patient is different. For some patients who have four (or more!) wisdom teeth which will be difficult to remove, it is probably a good idea to go to sleep for the procedure. For other patients who only have one or two wisdom teeth or whose wisdom teeth are pretty easy to remove, going to sleep may not be necessary.
Unlike local numbing injections, going to sleep means much greater medical risk and cost. For patients who choose for one reason or another not to fully go to sleep during their wisdom tooth removal, we offer prescriptions for sedative medication and of course add lots of numbing medication to make the area comfortable for the procedure. For patients who prefer to go to be unconscious, we partner with excellent oral surgeons who perform advanced wisdom tooth removal as well as IV sedation.