For most individuals a complete set of teeth consists of 32 teeth – 16 in the upper jaw and 16 in the lower jaw. However, in most cases, the mouth has insufficient room for all these teeth to have space for functioning and proper cleaning. When a tooth cannot erupt fully to perform its chewing function, it is called an impacted tooth. The most important aspect of this situation is the inability to clean the area around this tooth, which also affects the cleaning of the second molar (the tooth just in front of the wisdom tooth). This can lead to numerous problems, including dental caries and gum and bone diseases. A special X-ray is usually taken of the Oral and Maxillofacial region to determine whether the wisdom teeth are impacted. Teeth can be impacted in a number of ways:
There is not enough room for the gums to retreat as happens when other teeth erupt properly. In this condition the impacted tooth is covered only by soft (gum) tissue, making it impossible to clean the whole area, including the second molar just in front of the wisdom tooth.
This occurs when the lack of room for the wisdom tooth to erupt is more significant. The wisdom tooth is partly covered by surplus gum and partly by the jawbone. The wisdom tooth is not functional in the chewing process and cannot be cleaned, leading in many cases to mouth infections.
This occurs when there is no room for the wisdom tooth to erupt. The wisdom tooth is completely covered by gum and bone, remains completely under the gums and jawbone, and cannot be seen in the oral cavity.
For some patients the best age for extraction is 11-12 years, while in other cases we recommend waiting until the age of 17-18. The younger the patient – in the teens or early twenties – the faster and more predictable the recovery and healing, with very minor risk of complications. Research shows that recovery is better when the teeth are extracted before any problems or infections appear. Dr. Schwartz-Arad and her team will discuss with you whether or not your wisdom teeth should be extracted. You will receive a full explanation of the reasons for extraction and potential treatment plans.
They will also explain the consequences of treating or not treating this condition.
Every impacted tooth is considered abnormal. The treatments envisaged are extraction, exposure, eruption into the oral cavity, or long term observation. If there is insufficient space for the tooth to erupt, the wisdom tooth is impacted. This can lead to a number of problems, including infections, damage to the adjacent tooth, gum disease, damage to the nerve due to the formation of a cyst or growth, and overcrowding of the front teeth. These problems become more frequent after the age of 25.
If you don’t have an impacted wisdom tooth extracted during your teens or early twenties, you could have problems later in life. Extraction at an older age is more difficult for the patient, the healing time is longer, and the rate of complications is higher. Moreover, the longer you wait, the greater the probability of damage to the nerve and adjacent teeth. Treating complications at a later age is more complex and less predictable. It is not always necessary to extract a fully impacted wisdom tooth.
Periodic examination following a consultation with Dr. Schwartz-Arad could be sufficient if there are no other complaints or symptoms, and there is no evidence of disease. In such cases, patients are advised to wait until local symptoms appear, and they may never do so. If they do, the options for treatment will be examined during further consultations.
The type of anesthesia (local, conscious sedation or full anesthetic) depends mainly on the patient wishes, level of anxiety and the extent of the treatment (one wisdom tooth or all four to be extracted). Comprehensive advice and explanations will be given when the treatment plan is determined. Medication will be given on the day (depending on the case) to reduce anxiety and also to reduce swelling and pain after the treatment. The duration of the treatment depends on the number of teeth to be extracted and the type of anesthesia. Usually a responsible adult must accompany the patient, particularly in the case of full anesthetic. Dr. Schwartz-Arad’s extensive experience and the advanced technology used enable you to get through the extractions in a comfortable, non- hreatening way, followed by rapid healing with a minimum of side effects such as pain and discomfort, which sometimes follow this procedure. You will be given careful instructions to ensure that the healing process is as short as possible and to avoid any unnecessary complications. Follow-up visits will be arranged if needed.