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Wisdom Teeth


The average adult has thirty-two teeth by age eighteen; sixteen teeth on the top and sixteen teeth on the bottom. Each tooth in the mouth has a specific name and function. The teeth in the front of the mouth (incisors, canine and bicuspid teeth) are ideal for grasping and biting food into smaller pieces, while the back teeth, or molar teeth, are used to grind food up into a consistency suitable for swallowing. However, the average mouth is made to accommodate only 28 teeth. It can be extremely painful when 32 teeth try to fit in a mouth that holds only 28 teeth. The four other teeth are your Third Molars, also known as Wisdom Teeth.


Wisdom teeth are the last teeth to erupt within the mouth. When they align properly, and gum tissue is healthy, wisdom teeth do not have to be removed. Unfortunately, this does not generally happen. The extraction of Wisdom teeth is necessary when your wisdom teeth are prevented from properly erupting within the mouth. They may grow sideways, partially emerge from the gum, even remaining trapped beneath the gum and bone. Impacted teeth can take many positions in the bone as they attempt to find a pathway that will allow them to erupt successfully.

Angular, bony impaction of third molar (wisdom tooth).  

  Soft tissue impaction of third molar (wisdom tooth).


These poorly positioned impacted teeth can cause many problems. When they are partially erupted the opening around the tooth allows bacteria to grow and may cause an infection. The result can be swelling, stiffness, pain and illness. The pressure from the erupting wisdom tooth may move other teeth and disrupt the orthodontic or natural alignment of teeth. The most serious problems occur when tumours or cysts form around the impacted wisdom tooth, resulting in the destruction of the jaw bone and healthy teeth. Removal of the offending impacted tooth or teeth usually resolves these problems. Early removal is recommended to avoid such future problems and to decrease the surgical risk involved with the procedure.


With an oral examination and x-rays of the mouth, Dr. Khan can evaluate the position of the wisdom teeth and predict if there may be future or present problems. Studies have shown that early evaluation and treatment result in a superior outcome for the patient. Patients are generally first evaluated in the mid- teenage years by their dentist, orthodontist or oral surgeon.




Incision is made and overlying bone is removed, exposing crown of impacted tooth.  

  Tooth is extracted whole or surgically sectioned. The site is sutured closed.


To ease any discomfort and promote healing:

  • Use ice packs on the cheek for swelling, alternating on and off every thirty minutes.

  • Apply biting pressure with clean gauze to stop bleeding.

  • Eat soft foods and drink extra liquids.

  • Avoid hard or crunchy foods in the tender area.

  • Brush carefully the day after surgery.

  • Take prescribed medications and follow all instructions as directed.


Third molars, commonly referred to as wisdom teeth, are usually the last four of 32 teeth to erupt (surface) in the mouth, generally making their appearance between the ages of 17 to 25. They are located at the back of the mouth (top and bottom), near the entrance to the throat. The term “wisdom” stems from the idea that the molars surface at a time typically associated with increased maturity or “wisdom”.


In most cases, inadequate space in the mouth does not allow the wisdom teeth to erupt properly and become fully functional. When this happens, the tooth can become impacted (stuck) in an undesirable or potentially harmful position. If left untreated, impacted wisdom teeth can contribute to infection, damage to other teeth, and possibly cysts or tumors.


There are several types, or degrees, of impaction based on the actual depth of the teeth within the jaw:


Soft Tissue Impaction: The upper portion of the tooth (the crown) has penetrated through the bone, but the gingiva (gum) is covering part or all of the tooth’s crown and has not positioned properly around the tooth. Because it is difficult to keep the area clean, food can become trapped below the gum and cause an infection and/or tooth decay, resulting in pain and swelling.


Partial Bony Impaction: The tooth has partially erupted, but a portion of the crown remains submerged below the gum and surrounding jawbone. Again, because it is difficult to keep the area clean, infection will commonly occur.


Complete Bony Impaction: The tooth is completely encased by jawbone. This will require more complex removal techniques.


Reasons to remove wisdom teeth


While not all wisdom teeth require removal, wisdom teeth extractions are most often performed because of an active problem such as pain, swelling, decay or infection, or as a preventative measure to avoid serious problems in the future. If impaction of one or more wisdom teeth is present, and left untreated, a number of potentially harmful outcomes can occur, including:


  • Damage to nearby teeth: Second molars (the teeth directly in front of the wisdom teeth) can be adversely affected by impacted wisdom teeth, resulting in tooth decay (cavities), periodontal disease (gum disease) and possible bone loss.
  • Disease: Although uncommon, cysts and tumors can occur in the areas surrounding impacted wisdom teeth.
  • Infection: Bacteria and food can become trapped under the gum tissue, resulting in an infection. The infection can cause considerable pain and danger.
  • Tooth Crowding: It has been theorized that impacted wisdom teeth can put pressure on other teeth and cause them to become misaligned (crowded or twisted). This theory isn’t universally accepted by all dental professionals, and it has never been validated by any scientific studies.


Wisdom teeth examination


As with any dental procedure, your dentist will want to initially conduct a thorough examination of the wisdom and surrounding teeth. Panoramic or digital x-rays will be taken in order for your dentist to evaluate the position of the wisdom teeth and determine if a current problem exists, or the likelihood of any potential future problems. The x-rays can also expose additional risk factors, such as deterioration or decay of nearby teeth. Early evaluation and treatment (typically in the mid-teen years) is recommended in order to identify potential problems and to improve the results for patients requiring wisdom teeth extractions. Only after a thorough examination can your dentist provide you with the best options for your particular case.


What does the removal of wisdom teeth involve?


Wisdom teeth removal is a common procedure, generally performed under local anesthesia, intravenous (IV) sedation, or general anesthesia by a specially trained dentist in an office surgery suite. The surgery does not require an overnight stay, and you will be released with post-operative instructions and medication (if necessary), to help manage any swelling or discomfort.