When Four's a Crowd

If you’re between the ages of 16-25 years, a discussion about your wisdom teeth should take place.  Wisdom teeth, a third set of molars, appear in the very back of each area of your mouth:  Upper left, lower left, upper right, and lower right.  In a few patients, enough space exists for these molars to move into place.  But most commonly, they just don’t belong, or they’re not lined up correctly. Wisdom teeth can lay entirely on their sides or lean at various angles into the neighboring teeth.

When evaluating wisdom teeth, Dr. Ho, Dr. Patel, and Dr. Kwan consider four general classifications. A panoramic x-ray provides a vital tool for determining the classification of each wisdom tooth.  It’s even possible one patient may display one of each type:

• Erupted:  This simply means the tooth moved through the surface of the gums just like your other teeth.  Eruption generally doesn’t occur before age 16, but can happen at nearly any age after that. It may have adequate space for its position.
• Soft Tissue Impaction/Partially Erupted:  The top of the tooth has emerged from the bone although excessive gum tissue usually covers it. Food trapped in the gum flap can lead to decay and infection.
• Partial Bony Impaction  – The majority of the tooth sits below the jawbone level, although it’s beginning to emerge. A large flap of gum lies over this tooth and leaves it prone to infection and decay as mouth bacteria slip into the area.
• Complete Bony Impaction  – In this case, the tooth has not broken the surface and remains entirely encased in the bone.  While the risk of infection is low, a small percentage of these will form a cyst in the jaw.  This hollow space can expand and result in fracture of the jaw.

Wisdom teeth causing pain and infection give a clear warning sign that treatment needs consideration. But some problems can also slowly develop without your awareness.  If you’re an adult with wisdom teeth, be sure they’re evaluated periodically for changes using a panoramic x-ray.

If you need to consider wisdom teeth removal, Dr. Ho, Dr. Patel, and Dr. Kwan can discuss options with you.  Various forms of sedation offer anxiety-reduction that puts this minor surgical procedure within reach of every patient that needs it.