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Midland OMFS
6112 Merlin Court
Midland, MI. 48640
989.839.9979
800.894.2727

Mount Pleasant OMFS
4851 E. Pickard
Mount Pleasant, MI. 48858
989.773.8065
866.773.8065

Wisdom Teeth

By your middle teens, your jawbones have nearly reached their adult size. The last four teeth to enter your mouth, known as the wisdom teeth, rarely have enough room to properly erupt. The size of your jaw and how your wisdom teeth grow in can determine whether wisdom teeth will cause your mouth any harm. You may experience symptoms such as pain and swelling or no symptoms at all, but the other teeth in your mouth and the jaws themselves could be at risk for damage o disease.

How many wisdom teeth do I have?
Most people have four wisdom teeth, some have fewer, and rarely some individuals have more.

Why do wisdom teeth need to be removed?
If under-erupted, out of position, or impacted (blocked from coming into the mouth by bone, other teeth, gums, poor position or growths/tumors) wisdom teeth are not removed they are likely to cause problems at some point in a persons life. Examples include:
1) Infections that can stop your ability to chew, swallow, talk and/or breath if left untreated.
2) Gum disease/periodontitis/pyorrhea that can spread to your good teeth, causing them to be lost.
3) Damage and erosion from the pressure or rubbing of wisdom teeth against the adjacent roots, leading to loss of the adjacent teeth in your mouth used for chewing (your first and second molars).
4) Bone loss of the adjacent molars that you are using to chew with (first and second molars).
5)Because the wisdom teeth are so far back in the mouth and usually out of position, they are extremely difficult to keep clean, so they have a high rate of developing cavities, leading to costly repair, pain and/or infections.
6) There can be formation of pathological cysts that require surgery to remove.
7) There can be formation of benign tumors that often require removal of adjacent teeth and part of the jawbone to cure.
8) Even cancer/malignancies have rarely developed from impacted wisdom teeth leading to disfiguring bone removal surgeries.
9) Chronic infections around wisdom teeth have been linked to the progression of diabetes, cardiovascular disease, stroke, and other chronic inflammatory illnesses.
10) In some individuals, pressure from impacted wisdom teeth plays a significant role in crowding of the rest of their teeth. If you have had orthodontics/braces to straighten your teeth, then removing your wisdom teeth is the most you can do to try to prevent re-crowding of your teeth (after your braces are removed) and having to do orthodontics again.
11) Studies have shown that chronic problems around wisdom teeth may contribute to preterm and low birth weight infants.

How many wisdom teeth will be removed at a time?
In the past, wisdom teeth were some times removed two at a time. This is no longer done. Given modern instruments, advanced techniques, sedation improvements and up to date surgical training, four or more wisdom teeth can be removed in one procedure with less bruising, swelling, muscle stiffness and discomfort than occurred after removing just two wisdom teeth/third molars only a few years ago. Removing all the wisdom teeth at once saves you from having two or more surgeries. This saves time, money, recovery time and gives you only one sore recovery period instead of two or more.

When should I remove my wisdom teeth?
Studies have shown that early evaluation and removal of wisdom teeth produces superior results when compared with removal later in life. In the past, patients were advised to wait until their early twenties to remove their wisdom teeth. By then, the wisdom teeth were partially in, so it was believed they would be easier to remove. Many studies proved that theory was incorrect. The only reason a wisdom tooth pushes its way partially into the mouth, is that root growth down into the jaw is driving it up. Therefore, it is far better to remove the wisdom teeth before the roots have a chance to grow deep into the bone. Only when the roots are allowed to grow deep into the bone, is extensive surgery required near important or vital structures that can lead to a long recovery and development of complications. Current recommendations state that wisdom teeth should be removed before one third of the root has developed.

A study in 2007 surveyed 100,000 patients who had their wisdom teeth/third molars removed before one-third root developmen was complete. The study found that the complication rate was so low that it approached 0.0%. This clearly proves that early removal of wisdom teeth with short roots is far safer than at any other point in a patient’s lifetime.

What age should I have my wisdom teeth/third molars removed?
The current recommendation is to have the wisdom teeth removed between the ages of fifteen to seventeen. Fifteen to seventeen year old patients usually have little to no root growth of their wisdom teeth and so that is the best time to do the surgery. We routinely remove wisdom teeth in patients as young as twelve years old. The tooth removal can be combined with other surgery that the patient requires. Usually this applies to patients who are having surgery at a younger age to facilitate orthodontics/braces treatment.

Females often mature and have more root growth of their third molars/wisdom teeth at an earlier age when compared to males. Therefore, females should be referred for a wisdom tooth evaluation as close to age fifteen as possible.

How does a maxillofacial surgeon know if I don't have enough space for my wisdom teeth to come in?
Using modern clinical and radiographic evaluations, a maxillofacial surgeon can accurately tell if you will have enough room for the wisdom teeth to come into your mouth after after jaw growth is complete. After your consultation, you will receive good advice regarding whether your wisdom teeth should be removed because you will never have enough space for them.

Statistically, less than 5% of the entire population actually has enough room for their wisdom teeth/third molars to fully erupt and be useful for biting. Some people have their wisdom teeth in their mouth, but the teeth are tipped or tilted so they do not contribute at all to the patient’s ability to chew. If the teeth are improperly tipped or tilted they do not self clean and are difficult to keep clean and consequently those teeth have a higher chance of having a cavity at some point in the patient’s lifetime.

Are there other reasons why it is better to do surgery at a younger age?
There are several reasons why it is preferable to remove wisdom teeth on younger patients. Young teens have less bruising, swelling, muscle stiffness and post-operative discomfort than older patients do. Young teens have the ability to heal, re-grow or repair nerve and sinus injuries, and therefore have almost no permanent complications from maxillofacial surgery. Teens have strong immune systems and have the lowest post-operative infection rates. In teens, the wisdom teeth and their roots are not deep in the jaw, therefore less bone needs to be removed and the surgical sites are less sore afterwards, their surgical defect/socket defect is small and closes quickly, so the recovery is easier and faster. In young teens (with small teeth and small roots) the bone defect is small and has a lower chance of collecting food and bacteria, dramatically reducing the chance of infection.

How do I get referred to a maxillofacial surgeon?
If you are fifteen years old already and no one has mentioned, looked for, or discussed your developing wisdom teeth, then simply mention it to your dentist or physician and they will refer you to a maxillofacial surgeon for an evaluation and comfortable treatment.

Should I be sedated for my maxillofacial wisdom tooth surgery?
Sedation for this type of surgery is routine, highly recommended, usually requested, often expected, and is the “standard of care.” You will not feel the necessary oral numbing injections. You won't feel the vibrations, or hear, smell, or remember anything about the procedure. Studies confirm that patients who are sedated have lower complication rates, lower infection rates, less post-operative discomfort, bruising, swelling, and jaw/muscle stiffness. For more information, see the I.V. sedation section in our website.

Will medical or dental insurance cover the cost of removing wisdom teeth with I.V. sedation?
Most dental and/or medical plans cover all or much of the cost of wisdom tooth removal. It is usual and customary for your dental and/or medical insurance to cover the cost of I.V. sedation if more than one wisdom tooth is removed at the same time.

How do I get a consultation for wisdom tooth removal?
If you are having symptoms or problems with your wisdom teeth and feel you need to have them removed, please call during normal business hours to schedule a consultation with one of our maxillofacial surgeons. Most of the time you should see your general dentist first to get a referral to our office. If you do not have a dentist, or had to have treatment for your wisdom teeth in a hospital emergency room, you can contact our office and we will attempt to get a referral from your general dentist, your emergency room physician, or your family physician as quickly as possible.