Frequently Asked Questions
Wisdom Teeth
What are "impacted wisdom teeth"?
In dental terminology "impacted" means that a tooth has failed to emerge
fully into its expected position. This may occur either because there is not
room enough in the jaw for the tooth, or else because the angulation of the
tooth is improper.
Why do impacted wisdom teeth need to be extracted?
The precise reasons why a individual's wisdom teeth should be extracted
should be explained to them by their dentist, because each person's situation
is different. Some of the more common reasons are:
• Wisdom teeth, either partially or fully erupted, can often be very difficult
to clean effectively ("erupted" means that the wisdom tooth has, to some
degree, penetrated through the gums). This increases the risk of developing
dental problems such as tooth decay ("cavities"), periodontal disease
("gum disease"), or reoccurring infections.
• Tooth crowding. Wisdom teeth, as part of their efforts to come fully into
place, can put pressure on a person's other teeth and cause them to
become misaligned (crowded and shifted). The misalignment of a person's
lower front teeth, especially, is frequently blamed on pressure created by
a person's wisdom teeth.
• While not a common occurrence, cysts and tumors can develop in the
tissues associated with impacted wisdom teeth.
• The attempted eruption of a misdirected impacted wisdom tooth can
cause damage to a person's 2nd molar (the next tooth forward of the
wisdom tooth).
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At what age should wisdom teeth be extracted?
If a dentist can clearly tell that there are good reasons to remove a wisdom
tooth, it is usually best to go ahead and have it removed as soon as possible.
While there is no specific age by which a person's wisdom teeth should be
extracted, as a rule of thumb, the younger a person is when they have their
wisdom teeth extracted the fewer complications they experience. Usually,
a person's wisdom teeth should be removed in their later teens or early
twenties.
What are Dry Sockets?
Dry sockets are one of the most common problems people experience
following dental surgery. They are caused by the premature loss of a blood
clot in the empty tooth socket and affect approximately one out of five patients.
This seems to occur with greater frequency in people who smoke or are
taking birth control pills. While both jaws can be affected, they usually occur
in the lower jaw on the third to fifth day. They cause a deep, dull, continuous
aching on the affected side(s). Patients may first notice the pain starting in
the ear radiating down towards the chin. It frequently begins in the middle
of the night, and the Motrin medication usually doesn't help. Treatment
involves placing a medicated dressing in the "empty" tooth socket. This
will help decrease the pain and protect the socket from food particles. The
effectiveness in alleviating the pain lasts for 24-48 hours and usually will
require dressing changes every day or two for five to seven days. The
dressings are usually removed when you have been pain free for 2-3 days.
The dressing doesn't aid in healing. The only reason to place a dressing is
for pain control. If Motrin is controlling the pain, the socket will heal without
a dressing. An irrigation device will be given to you to help keep food
particles from lodging in the extraction site following removal of the dressing.
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What types of medications are administered?
During dental and oral surgical procedures, local anesthesia (Novocain)
is administered to block sensations. However, the anxiety that some people
have can be controlled by administering sedative drugs, such as Valium-type
medications. A sedated patient may remember the procedures, but will be
more relaxed. Additional medications such as agents similar to pentothal
are sometimes used to cause anesthesia, which places the patient more
deeply asleep.
How is the medication administered?
The sedative and anesthetic medications are typically given intravenously (IV).
Since the effects are so rapid by this means of administration, your doctor
can precisely give the correct amounts of the medications to make you
relaxed and comfortable. Also, if more medications are needed during the
procedure, the IV allows easy administration of additional medications.
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Is anesthesia safe?
The use of sedation and anesthesia in dentistry has a commendable record
of safety. This is due to the advanced training your doctor has and his/her
commitment to your overall health. It is important to advise your doctor of
all medications that you take as well as any changes in your health since
your last visit.
In most states a special permit is required to administer intravenous
medications. In order to qualify, your doctor had to provide evidence of
advanced training in anesthesia and often a site visit is required. The ability
to handle emergency situations as well as having specific emergency
medications and equipment is also mandatory.
How am I monitored during the procedure?
Depending on the depth of the sedation and anesthetic being used, as well
as your own medical condition, various monitors are used. These vary from
automatic blood pressure cuffs, to the use of pulse oximeters which through
a light sensor measure the oxygen concentration in your blood. Sometimes
an EKG may be used as well.The doctor along with at least one trained
member of the staff will always be with you and closely observe you
throughout your treatment.
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