Extractions & Wisdom Tooth Extractions

Our main goal is to preserve your natural teeth and keep them healthy for as long as possible. There are times, however, when it is in your best interest (or your child’s) to have a tooth extracted (removed). This could be the case for a variety of reasons. Perhaps you have a tooth that has been severely damaged by trauma or decay; or an impacted wisdom tooth that may cause trouble for you later on. Maybe your teenager will soon undergo Orthodontic Treatment and have insignificant space for his adult teeth, referred to as crowding. Or your younger child has a baby tooth that’s stubbornly adhering, even though it’s past time for it to go.

Whatever the reason, tooth extraction is more often than not a very routine procedure. How straightforward this minor surgery is will depend on where the tooth to be extracted is located in the mouth, and what its roots are like. For example, a front tooth with a single straight root is easier to remove than a molar with multiple roots. This is especially true when that molar is a wisdom tooth that is impacted, meaning it is below the surface surrounded by gum tissue and bone. Often, a wisdom tooth is blocked from fully erupting (growing in) by other teeth in its path.

Still, tooth extraction is nothing to be feared when done by an experienced hand. Keep in mind that a tooth is not rigidly fixed in its surrounding bone, though that’s how some may picture it. In fact, it is attached to the bone via a network of fibers that form what’s known as the periodontal ligament. By carefully manipulating the tooth, we can dislodge these fibers and free the tooth without much trouble.

Wisdom Teeth are the third and final set of molars that most people get in their late teens or early twenties. Sometimes these teeth can be a valuable asset to the mouth when healthy and properly aligned, but more often, they are misaligned and require removal.

Wisdom teeth present potential problems when they are misaligned – they can position themselves horizontally, be angled toward or away from the second molars or be angled inward or outward. Poor alignment of wisdom teeth can crowd or damage adjacent teeth, the jawbone, or nerves. Wisdom teeth that lean toward the second molars make those teeth more vulnerable to decay by entrapping plaque and debris. In addition, wisdom teeth can be entrapped completely within the soft tissue and/or the jawbone or only partially break through or erupt through the gum. Teeth that remain partially or completely entrapped within the soft tissue and /or the jawbone are termed “impacted.” Wisdom teeth that only partially erupt allow for an opening for bacteria to enter around the tooth and cause an infection, which results in pain, swelling, jaw stiffness, and general illness. Partially erupted teeth are also more prone to tooth decay and gum disease because their hard-to-reach location and awkward positioning make brushing and flossing difficult.

How Do I Know if I Have Wisdom Teeth?

Ask your dentist about the positioning of your wisdom teeth. He or she may take an X-ray periodically to evaluate for the presence and alignment of your wisdom teeth. Your dentist may also decide to send you to an oral surgeon for further evaluation.

Your dentist or oral surgeon may recommend that your wisdom teeth be extracted even before problems develop. This is done to avoid a more painful or more complicated extraction that might have to be done a few years later. Removal is easier in young people when the wisdom teeth roots are not yet fully developed and the bone is less dense. In older people, recovery and healing time tend to be longer.

How Are Wisdom Teeth Removed?

The relative ease at which your dentist or oral surgeon can extract your wisdom teeth depends on their position. Your oral health care provider will be able to give you an idea of what to expect during your pre-extraction exam. A wisdom tooth that is fully erupted through the gum can be extracted as easily as any other tooth. However, a wisdom tooth that is underneath the gums and embedded in the jawbone will require an incision into the gums and then removal of the portion of bone that lies over the tooth. Oftentimes, for a tooth in this situation, the tooth will be extracted in small sections rather than removed in one piece to minimize the amount of bone that needs to be removed to get the tooth out.