My lower wisdom teeth are still in and are completely horizontal under the gums and growing sideways toward my normal teeth. The x-ray looks really strange seeing a row of teeth growing up and then at the end one tooth growing 90* sideways. So far there has been no need to remove them and I hope I never do.
Elsewhere,
You might do well to read this. I found it very informative:
http://www.oralfacialsurgeons.com/mainsite/procedures/wisdom.html
WISDOM TEETH:
IMPACTED WISDOM TEETH
When a wisdom tooth is blocked from erupting or coming into the mouth normally, it is termed impacted. A tooth may be only partially impacted; meaning it grows in crooked and breaks through the gum only partially, or may fail to break through at all and thus remains totally impacted. Serious problems can develop from partially impacted teeth, such as pain, infection, and crowding of, or damage to, adjacent teeth. For totally impacted teeth, more serious problems can occur if the sac that surrounds the impacted tooth fills with fluid and enlarges to form a cyst. This enlargement can hollow out the jaw and result in permanent damage to the adjacent teeth, jawbone and nerves. If a cyst is not treated, a tumor may develop from the walls of the cyst and a more involved surgical procedure may be required for removal. Many problems with wisdom teeth can occur with few or no symptoms, so there can be damage without your knowledge. It is important to know that as wisdom teeth develop their roots become longer and the jawbone denser. Thus, as a person grows older, it becomes more difficult to remove wisdom teeth and complications can become more severe. In addition, as people age there is an increased chance of the symptoms mentioned above. For these reasons, the surgeon may recommend the removal of wisdom teeth even if they are not yet causing obvious problems, particularly for young adults.
TREATMENT OF IMPACTED WISDOM TEETH
Treatment of impacted wisdom teeth involves their removal using special surgical techniques appropriate for each individual case. An oral and maxillofacial surgeon is a dentist with specialized training in the removal of wisdom teeth. The removal of wisdom teeth can be performed on an outpatient basis, either in the dental office, or in some cases, in a hospital setting. If the tooth is impacted, an incision is made in the gum tissue and the tissue is turned back so the tooth can be seen, If bone is covering the tooth, it may need to be removed in order to expose and extract the tooth. The tooth may be removed whole, or in some cases it may be cut into sections, and each section is then individually removed. Usually the surgical procedure will take about an hour, although this varies according to each case. After surgery you will spend some time "in recovery" before going home. In most cases normal activity can be resumed within a few days depending on the degree of impaction and the number of teeth removed.
If it is recognized that you do not have enough room in your mouth for your third molars to erupt, it is advisable to have them removed as soon as it is recognized. In some patients it is as early as 11 or 12 whereas in others it may not be until 17 or 18 years of age. You will heal faster, with more predictable final healing, and have fewer complications than an older patient.
What If I Don't Have Them Removed Now? Many people, especially in years past, were told to take a "wait and see" approach to wisdom teeth. Many who did not have adequate room developed localized problems previously mentioned. The problem with this approach is that if it is necessary to remove wisdom teeth in your thirties, forties, fifties, or beyond, it is clearly more difficult for you as the patient. The post-operative course is usually prolonged and there is a higher complication rate. Treating these complications is more difficult than with a younger patient. If you do not have your impacted wisdom teeth removed in your teenage years or early in your twenties, it may be advisable to wait until or unless a localized problem (such as cyst formation or localized gum disease and bone loss) develops and then treat the affected area only. This is because the predictability of healing decreases with age and the likelihood of infection and delayed healing increases.
If I Decide to Do It, When Should I Have Them Removed? There is probably never a good time to undergo an elective procedure such as wisdom teeth removal. We recommend that the surgical appointment doesn't conflict dramatically with school activities. The most 'popular' times for wisdom teeth removal is during the summer (August is always very busy) and school vacations. If you live at or near home, any time you have a long weekend is also good. The bottom line is that with adequate preparation, any time will work for most people if they have planned accordingly in advance.
What Happens On the Day They're Removed? First of all, you need to decide if you will be sedated or 'go to sleep'. Most people clearly prefer to be unaware of the experience when they have their wisdom teeth removed. You will be provided with appropriate anesthesia options for you at your consultation.
On the day of your procedure, you will take medications to help minimize post-operative pain and swelling. We ask that a parent or responsible adult accompany you to the office and plans to stay with you the rest of the day. Your procedure will take about an hour and you will probably be in the office for 1-2 hours. Our surgical assistants will review your post-operative instructions. When you leave the office you will be comfortable and drowsy. Most patients prefer to go home and rest with no other physical or scholastic activities planned for a few days.
All outpatient surgery is performed under appropriate anesthesia to maximize your comfort. The doctors of University Oral and Maxillofacial Surgeons have the training, license, and experience to provide various types of anesthesia to allow patients to select the most appropriate alternative. These services are provided in an environment of optimum safety, utilizing modern monitoring equipment and staff experienced in anesthesia techniques.
What Happens Afterwards - - - What Will I Feel Like? Most of the time you will want to maintain a low profile for a few days. We ask that you follow your post-operative instructions closely as they will make you most comfortable during the first few days following your procedure. Please allow the time to let your body begin healing before resuming an active social, academic, or athletic schedule. Most patients feel like they are over the hump in 3-5 days.
Are There Any Problems? As with any medical procedure, there can be complications or an unanticipated result that you should be aware of:
There is a nerve which supplies feeling to the lower lip, chin, and tongue which is frequently very close to the roots of the lower wisdom teeth. Having these teeth out between the ages of 12 and 18 usually provides shorter roots so that the nerve is not so close to the roots of these teeth. Occasionally, when the teeth are removed, especially in older patients, the roots have grown longer and become closer to the nerve itself. This nerve can become irritated in the process of removing the tooth. When local anesthesia wears off, you may experience a tingling or numb sensation in the lower lip, chin, or tongue. Should this occur, it is usually temporary and will resolve gradually over a period of weeks or months. RARELY, it can result in a permanent alteration of sensation similar to the feeling of local anesthesia. We feel that you should be aware of this before consenting to surgery.
The upper wisdom teeth are situated close to your sinuses, and their removal can result in a communication between your mouth and the sinus. Once again, if the teeth are removed at an early age, the root formation is minimal, and this complication is very unlikely to occur. Should this occur, it will usually close spontaneously. We may give you special instructions to follow if this is apparent at the time of surgery. The doctors of University Oral and Maxillofacial Surgeons prefer that you don't blow your nose for two or three days following the surgery. You can wipe your nose, but don't blow your nose. If you have to sneeze, you should sneeze with an open mouth into a tissue - - you should not create any pressure in the sinus area, which may dislodge the healing blood clot. If you sense a communication occurring after the surgery, please contact the office. RARELY, an additional procedure may be necessary to close the communication.
Occasionally, food particles or bacterial by-products can cause irritation in the extraction site(s). This is frequently referred to as a "dry socket". Patients who smoke and women taking birth control pills may be at higher risk for this to occur. You can usually tell that this is happening because you start to have a strange taste in your mouth, and you start to have pain on the teeth in front of where the third molar was removed, as well as pain radiating toward your ear. This pain usually occurs on the third or fourth evening following surgery. If this happens, take your pain medication as needed, and in the morning call the office to arrange to come in for treatment. Adequate treatment may require several visits to the office to inspect the extraction sites and to place small "dressings" in the sockets to minimize your discomfort. For this reason, we urge you to be available for follow-up visits for at least ten days following your surgery. Remember, if after three or four days you feel increased pain, swelling, or develop a fever, contact the office as you may require attention.
The most common problem encountered following surgery of any kind is infection. This usually requires an office visit and clinical examination. Many times, just placing you on an antibiotic for one week will take care of the infection. RARELY, will it require drainage of the infected area, which may have accumulated near the surgical site, and even more rarely do the patients need to be admitted to the hospital for intravenous antibiotics and further surgical drainage.
Other temporary problems you may experience in the postoperative period include stiffness of the jaws, chafing around the corners of your lips, facial bruising, and blood oozing from the extraction sites. The postoperative instruction sheet we will provide should answer many of the questions related to these more common concerns. If not, don't hesitate to call the office.
What Does It Cost - - -And Does Insurance Cover It? Because of the different types of impacted wisdom teeth, along with different anesthesia options, it is impossible to give you a realistic estimate of what our services will cost until we have reviewed your x-rays. Every insurance company has a different policy regarding the extent of coverage for a given surgical procedure. We encourage you to check with both your medical AND dental insurance carrier to determine your coverage and out of pocket liability.
What If I Have Questions Before Surgery? We recognize that having your Wisdom teeth out is NOT something you really want to do. We also realize that with an active schedule there is never a really good time to have this done. If this information, combined with information you receive at your consultation appointment doesn't answer all of your questions, please call the office to speak to one of our Patient Care Coordinators.
Sincerely, sKally
