What are wisdom teeth and why are they called wisdom teeth?

We have four sets of teeth based on their shapes. Our incisors are the front teeth, which help us cut into our delicious foods and showcase our beautiful smiles. Our canines are our longest teeth in our mouths and they are the cornerstones of the dental arches separating our front teeth from our back teeth. Next are the premolars, which based on their shape are somewhere in between the front teeth and the back teeth (molars). Premolars allow us to chew and grind our food. Lastly, our molar teeth are our largest teeth by surface area and they allow us to be able to grind and dismantle food particles before they are swallowed. During our dental development, each of our teeth come into our mouths at different ages. The last of these teeth to come in are our third molar or our wisdom teeth that usually come into our mouths during our late teens and early twenties. Because this time of adolescence is called the age of wisdom, these teeth are called wisdom teeth.  

What are impacted wisdom teeth and what are the associated problems with impacted wisdom teeth?

Impacted wisdom teeth are wisdom teeth that do not have adequate space to grow into the mouth and as a result, they get stuck in the jaw behind the second molars.  Impacted wisdom teeth are associated with a number of problems. 

They can put pressure at the back of the second molars and as a result cause jaw pain or in some cases damage the roots of the second molars, a condition called root resorption. 

They can frequently get infected or result in gum tissue inflammation or bone loss around the back of the second molar tooth. They can also result in cavities for the wisdom tooth or the tooth in front of it (second molar). 

In rare cases, it is possible for impacted wisdom teeth to cause cysts in the jaw bone, which will require a major surgery to be removed. 

There is also some evidence that wisdom teeth can contribute to crowding (overlapping) of the front teeth. 

Do all wisdom teeth require to be extracted?

No. Just like any other medical condition, impacted wisdom teeth need to be evaluated by your dentist or oral surgeon in a case by case basis and recommendation for extraction or retention of your wisdom teeth should be made based on all available information. These include the degree of impaction, health of adjacent tissue, proximity (or closeness) to nerve that runs in the lower jaw (called the inferior alveolar nerve), age of the patient, and other factors.

When is the ideal time to have wisdom teeth extracted?

Mid to late teens and early twenties is the ideal time for wisdom tooth surgery. 

Is it best to be awake or be sedated (put to sleep) for the wisdom tooth extraction procedure?

Wisdom tooth extraction is a surgical procedure. Unlike routine dental extractions, wisdom tooth surgery is associated with a degree of complexity that in most patients is not well tolerated with local anesthetic (freezing) alone. Although in some cases it is possible to perform the procedure with local anesthetic, it is highly recommended to be sedated (put to sleep) for the procedure. When you get sedated for wisdom tooth surgery, you are completely asleep during the entire procedure and do not have any recollection of the procedure afterwards. 

What is the recovery like after wisdom tooth surgery?

For most people, recovery is about 3-5 days. During the first two days after surgery is when majority of pain exists around the jaw region. The pain medications that will be prescribed will help take this pain away. At about days 2 and 3, the swelling from the surgery reaches its maximum. It usually takes 1-2 additional days for the swelling to fully resolve. Applying ice packs starting immediately after surgery, will go a long way in managing and minimizing the discomfort from surgery and swelling after surgery.