Health Column: Weigh the wisdom: now or later in life

By Dr. Timothy McConnell, Dr. Randall Napier and Dr. Otto Slater

Wisdom teeth -- or third molars -- are the last teeth to erupt in your mouth. This generally occurs between the ages of 17 and 25, a time of life dubbed the “Age of Wisdom.” Quite commonly, there is not room in the dental arch for the wisdom teeth to erupt, setting the stage for problems later in life.

A tooth becomes impacted when there is insufficient space in the dental arch and its development is prevented by overlying tissues. Impacted teeth can be painful, infected, and may crowd or damage adjacent teeth.

More serious problems may occur if the sac surrounding the impacted tooth becomes filled with fluid and forms a cyst. As the cyst grows, it may permanently damage the jaw. Rarely, a tumor may develop from the walls of a cyst and a more-serious surgery may be required to remove it.

Not all problems related to third molars are painful or visible. Damage can occur without you knowing. As a patient ages, wisdom teeth roots elongate, removal becomes more difficult and complications are more likely. An estimated 85 percent of third molars will eventually need to be removed.

It isn’t wise to wait until your wisdom teeth start to bother you, and earlier removal of wisdom teeth results in a less-complicated healing process. Wisdom teeth should be removed by young adulthood to prevent future problems and optimize healing. Research shows that wisdom teeth in older patients creates a greater risk for periodontitis, which may affect your general health. Some insurance plans deny wisdom tooth coverage after age 18, so treatment before then can minimize cost to the patient and their family.

Before surgery, your oral and maxillofacial surgeon will discuss with you what to expect and answer your questions or concerns, and will discuss any illness you have and medications you are taking.

Patients may find wisdom tooth removal easy, depending on conditions including the position of the tooth and root development. Most wisdom teeth extractions are performed in the oral and maxillofacial surgery office under intravenous sedation. Your oral and maxillofacial surgeon will discuss the anesthetic option that is right for you.

Following surgery, you may experience some swelling and mild discomfort, which are part of the normal healing process. Cold compresses may help decrease the swelling, and prescription medication can help manage the discomfort. Your diet should be modified following surgery and progress to more normal foods.

Oral and maxillofacial surgery is a dental specialty that includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and aesthetic aspects of the hard and soft tissues of the oral and maxillofacial region. An oral and maxillofacial surgeon is a graduate of an accredited dental school who has completed an additional four or more years of training in an accredited, hospital-based oral and maxillofacial surgery residency program. To receive optimal care, a patient should select an oral and maxillofacial surgeon who is certified by the American Board of Oral and Maxillofacial Surgeons.

Doctors Timothy McConnell, Randall Napier and Otto Slater are oral and maxillofacial surgeons in Maryville and are members of the Blount Memorial Hospital active medical staff.

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