Wisdom Teeth: A guide for parents & patients

Typically, we each get three sets of molars during our lifetime; the first molars arrive around age 6, the second molars at age 12 and the third molars begin during the mid to late teens or early twenties.  Since this time is traditionally associated with the onset of maturity and becoming wiser, we refer to third molars as wisdom teeth. They are usually the last teeth to develop and are located in the back of your mouth, behind your second molars.

Oral And Radiographic Examination

With an oral examination, Dr. Azzopardi, Dr. Moores, Dr. Chames, Dr. Kissoondial, Dr. Haskins and Dr. Coke will take x-rays and may use specialized imaging tools to get a clear picture of the positioning of your wisdom teeth.  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 the recommendation of their dentist or orthodontist.

Wisdom Teeth Removal

The removal of wisdom teeth is a routine procedure in our office, but it probably doesn’t feel that way to you. Most people prefer to be unaware of the experience of having their wisdom teeth removed and usually decide to have an IV anesthetic. The length of your surgery depends on a variety of factors including the type of impaction, the position of your teeth and the number of teeth being removed.  However, most wisdom teeth extractions can be performed in about an hour.   During that time, you will be kept comfortable with anesthesia. Once the surgery is complete, you will rest and continue to be monitored under our supervision until you are ready to be taken home.  

Anesthesia

Anesthesia is an important part of every oral surgery procedure. We offer solutions to eliminate anxiety while maintaining maximum patient comfort and safety. Utilizing gentle medications that are well tolerated and quickly metabolized, allows for a safe and comfortable procedure, with a quick and smooth recovery.  We will make you comfortable before, during and after your procedure.

Family sitting on a coach


The Day of Treatment

If you are a minor, you will need to have a parent or legal guardian with you at the time of removal. Make plans to have them stay with you for the rest of the day following  your  surgery.

Should I Have My Wisdom Teeth Removed?

If your wisdom teeth properly erupt into alignment and the surrounding 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 inadequate space prevents the teeth from erupting.  If you do not have enough room in your mouth for your third molars to fully erupt, a number of problems can occur.

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Impacted Wisdom Teeth: A Common Condition

Rest assured, this is a very common condition that we treat regularly in our office.  Impacted wisdom teeth should be removed before their root structure is fully developed. Early removal is recommended to avoid future problems and to decrease the surgical risk involved with the procedure.

When inadequate space prevents the teeth from erupting into proper position alignment for chewing and cleaning they are called impacted. Impactions occur when wisdom teeth come in at the wrong angle or simply because your mouth is not large enough to accommodate another set of molars. That’s why 9 out of 10 people find themselves with at least one impacted wisdom tooth that requires extraction.

Side-by-side images of a mouth X-ray showing impacted teeth and a digital graphic highlighting impacted teeth

types of Impactions

  • Soft Tissue Impaction: There is not enough room to allow the gum tissue to retract for adequate cleaning of the tooth.
  • Partial Bony Impaction: There is enough space to allow the wisdom tooth to partially erupt. However, the tooth cannot function properly in the chewing process and creates cleaning problems, among others.
  • Complete Bony Impaction: There is NO space for the tooth to erupt. It remains embedded in the jaw bone or if even partially visible requires complex surgical techniques for removal. The impacted wisdom tooth may also be in an unusual position and difficult to remove. This situation can also arise when the shape or size of the jaw bone and other facial structures make the removal of this tooth significantly more complex.
A representation of a wisdom tooth impacted by soft tissueSoft Tissue
An example of a wisdom tooth with a partial bony impactionPartial Bony
An illustration of a wisdom tooth completely impacted by boneComplete Bony

Symptoms

Impacted wisdom teeth don’t always cause symptoms. Pain free does not mean disease free. However, when an impacted wisdom tooth becomes infected, damages other teeth or causes other dental problems, you may experience some of these signs or symptoms:

  • Red or swollen gums
  • Tender or bleeding gums
  • Jaw pain
  • Swelling around the jaw
  • Bad breath
  • An unpleasant taste in your mouth
  • Difficulty opening your mouth

POTENTIAL PROBLEMS

Poorly positioned impacted wisdom teeth that are not removed have the potential to cause problems throughout your life and should not be ignored.

  • Impacted teeth may grow sideways, partially emerge from the gum tissue, and even remain trapped beneath the gum and bone. They can take many positions in the bone as they attempt to find a pathway that will allow them to successfully erupt.
  • When they partially erupt, the opening around the teeth allows bacteria to grow and will eventually cause an infection. The result: swelling, stiffness, pain, and illness.
  • The pressure from the erupting wisdom teeth may move other teeth and disrupt the orthodontic or natural alignment of teeth.
  • The most serious problem occurs when tumors or cysts form around the impacted wisdom teeth, resulting in the destruction of the jawbone and healthy teeth.
A representation of a pericoronitis infection on a wisdom tooth

Infection:

The most frequent clinical problem we see is pericoronitis, (a localized gum infection). Without enough room for total eruption, the gum tissue around the wisdom tooth can become irritated and infected, resulting in recurrent pain, swelling, and problems with chewing and/or swallowing.

An example of a cyst formation on a wisdom tooth

Cyst Formation:

Non-infectious diseases may also arise in association with an impacted wisdom tooth. Cysts are fluid-filled “balloons” inside the jaw bone that develop as a result of impacted teeth and slowly expand destroying adjacent jaw bone and occasionally teeth. They can be very difficult to treat if your wisdom teeth are not removed in your teenage years. Although rare, tumors can be associated with the delayed removal of wisdom teeth.

An illustration of teeth crowding caused by a wisdom tooth

Possible Crowding:

Impacted wisdom teeth may contribute to crowding of your teeth. This is most noticeable with the front teeth, primarily the lower front teeth and is most commonly seen after a patient has had braces. There are a number of factors that cause teeth to crowd after braces or in early adulthood. Retained, impacted wisdom teeth may be a contributing factor. Unless you have an active problem when you see the oral surgeon, the reason for removal is primarily to prevent long-term damage to your teeth, gums and jaw bone.

A visual of a wisdom tooth damaging an adjacent tooth

Damage to Adjacent Teeth:

If there is inadequate room to clean around the wisdom tooth, the tooth directly in front, the second molar, can be adversely affected resulting in gum disease, bone loss around the tooth, and/or decay.

When It Comes To Wisdom Teeth, Timing Is Everything

As wisdom teeth develop, the roots become longer and the jaw bone denser. When it is necessary to remove impacted wisdom teeth in your thirties, forties or beyond, the post-operative course can be prolonged and there is a higher complication rate. Treating these complications is often more difficult, the healing may be slower and the chance of infection can be increased.

If your impacted wisdom teeth are not removed in your teenage years or early in your twenties and they are completely impacted in bone, it may be advisable to wait until a localized problem (such as cyst formation or localized gum disease and bone loss) develops.

In general, you will heal faster, more predictably and have fewer complications if treated in your teens or early twenties.

Ready to Improve Your Smile?

Call us with any questions or to make an appointment.

Novi: 248-476-0800 Livonia: 734-427-3366 Sterling Heights: 586-323-7700 South Lyon: 248-486-9202

Patient Reviews for Wisdom Teeth Extraction

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Oakland Oral Surgery & Dental Implant Center

5 out of 5 stars based on 128 Wisdom Teeth Removal reviews.

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Thank you for your kindness and professionalism!

- Jennifer and Zoie M

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My Dr, dental assistant, front office staff, were great! My dr was very caring and my dental assistant was awesome 🥰

- JAQUITA F

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Wonderful office. Wouldn’t go elsewhere.. thank you for your wonderful care Dr Chames and staff

- Mackenzie K

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Clean, organized and 5 star care! The girls are always so friendly and go above and beyond to take care of patients!

- Colleen G

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Patient Review

Dr. Kissoondial performed my son's wisdom teeth extraction surgery. He made us feel very comfortable and informed as to what was going to happen during the surgery and what to expect during the recovery. We had a really great experience. My son had minimal pain after the surgery which he described as soreness. There was almost no swelling either. We chose the general anesthesia for the procedure. I know that most of the teens might be afraid of getting their first IV but let me assure you that my son stated it felt just like a small pinch for a second and it was absolutely nothing to worry about. Dr. Kissoondial has an excellent bed side manner and we highly recommend him to anyone searching for a caring, talented oral surgeon. His entire staff was professional and very friendly.

- Martina C

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