Most of us will develop 32 permanent teeth. Unfortunately, many of us will not have enough room in our mouth to accommodate and look after them. Many factors have contributed to this phenomenon, but it is clear that the oral health of the average Canadian has greatly improved over the past few decades. As a result, less permanent teeth are lost at an early age. This, in combination with greater access to orthodontic treatment and correction of dental crowding, means that there is even less room for our third molars (wisdom teeth) to erupt into functional positions where we can look after them and keep them healthy.
Since wisdom teeth are located in the back of the mouth they tend to be more difficult to look after which over time will often result in gingival (gum) inflammation, recession, food entrapment, pocketing, bone loss, and infection. It is generally best to have these teeth extracted before more significant and often irreversible damage takes place.
Wisdom teeth are the most common teeth to remain impacted, and it is not unusual for young adults to start developing symptoms from them in their mid-teenage years. An impacted tooth is a tooth which has not erupted into the mouth due to overlying gum tissues, bone, or due to the tooth’s position relative to adjacent teeth. Impacted teeth can contribute to problems which are usually better to avoid with their preventative removal. These problems include infection, periodontal disease, decay and damage to adjacent teeth, crowding pressures, as well as bone loss from chronic inflammation, or due to the development of jaw cysts derived from dental follicular tissues.
Orthodontists will often recommend early removal of the wisdom teeth to help prevent crowding after their orthodontic treatment has been completed. Most patients will benefit surgically from quicker healing and fewer complications when their wisdom teeth are extracted while they are still developing and they are less attached to the bone. The removal of impacted wisdom teeth is the single most common procedure which Dr. Johnson performs.
Surgical Exposure of Teeth
Not all impacted teeth will require extraction and for some patients Dr. Johnson may recommend that they continue to be observed or be surgically exposed. Exposure of teeth may help them to erupt into their proper position or to make them easier to look after. Maxillary cuspid teeth are the most common teeth to require this intervention. In these cases, Dr. Johnson will surgically expose the crown of the impacted tooth. In many instances, it may also be necessary to guide the angled tooth to its proper position, and for these teeth, Dr. Johnson will bond an orthodontic attachment to it. The orthodontist will then be able to advance the tooth into its proper position over the next few months.