Wisdom Teeth

Wisdom teeth, also called third molars, are the last permanent teeth to develop and usually appear between the late teens and mid-20s. They can erupt normally in some people, but often there is not enough room in the jaw for them to come in properly. When wisdom teeth do not align or erupt fully, they can affect adjacent teeth and the surrounding gum and bone.

Because wisdom teeth can contribute to crowding, decay, gum disease and other oral health problems, providers evaluate them proactively during routine dental exams. Early assessment helps determine whether monitoring or intervention is the best option for long-term oral health. Imaging and clinical findings guide individualized recommendations to protect the bite and periodontal tissues.

An impacted wisdom tooth is one that cannot erupt into its proper position because it is blocked by bone, gum tissue or another tooth. Common causes include limited jaw space, the angle of eruption, and genetic factors that influence tooth size and jaw development. Late eruption also increases the chance that a wisdom tooth encounters resistance and becomes partially or fully trapped beneath the gum.

Impactions are often described as soft tissue when covered by gum or bony when covered by bone, and they can be angled toward the neighboring molar, away from it, or lying horizontally. The exact position and relationship to nearby structures are determined with radiographs or CBCT imaging. That detailed view helps clinicians predict potential problems and plan treatment safely.

Problems with wisdom teeth commonly present as pain or pressure at the back of the mouth, swelling of the gums, difficulty opening the jaw, or persistent bad taste and bad breath associated with infection. Some patients notice recurrent infections or inflamed gum tissue around a partially erupted tooth, which can make chewing and cleaning difficult. Others develop decay on the wisdom tooth or on the adjacent second molar because the area is hard to reach with routine home care.

Not all problematic wisdom teeth cause clear symptoms, so asymptomatic impactions may still be found on routine X-rays during dental checkups. Because silent pathology such as cysts or resorption of nearby roots can occur, clinical and radiographic monitoring is important. Your dental team will explain findings and recommended next steps based on the degree of risk and current symptoms.

Removal is generally recommended for wisdom teeth that are causing pain, infection, damage to adjacent teeth, cysts or recurrent gum disease. In some cases, clinicians recommend removal before problems develop if imaging shows a high likelihood of future complications or if third molars are likely to interfere with orthodontic outcomes. The timing often depends on age, the degree of impaction and the patient’s overall oral health.

Decisions about extraction are individualized and made after a careful clinical exam and review of radiographs. Younger patients often experience easier extractions and faster recoveries because roots are less developed and bone is more adaptable. Your dental provider will discuss the benefits and risks of removal versus monitoring so you can make an informed choice.

Evaluation begins with a thorough dental exam and a review of symptoms, followed by imaging such as a panoramic radiograph or cone beam CT when more detail is needed. Imaging shows the tooth’s orientation, depth of impaction, root development and the proximity of important structures like the inferior alveolar nerve and the maxillary sinus. These findings are essential for surgical planning and risk assessment.

During the consultation, the clinician will assess medical history, current medications and any factors that could affect healing or anesthesia. Based on the exam and images, you will receive clear recommendations about whether to remove the tooth, what type of anesthesia or sedation may be appropriate, and what to expect before, during and after the procedure. This collaborative approach ensures safe, personalized care.

Most wisdom tooth extractions are performed with local anesthesia to numb the area, and many patients also choose nitrous oxide, oral sedation or IV sedation for additional comfort. For bony impactions the surgeon makes a small incision in the gum and may remove a portion of bone or section the tooth to allow safe removal with minimal trauma. The procedure length varies from a short outpatient visit for an erupted tooth to longer surgical appointments for complex impactions.

After the tooth is removed the site is cleaned and the gum is sutured as needed to promote healing and reduce the risk of complications. Your care team will provide specific post-operative instructions about pain management, oral hygiene and activity restrictions. If an oral and maxillofacial surgeon is required for complex cases, your general dentist can coordinate the referral and share imaging and treatment plans to ensure continuity of care.

Initial recovery typically involves two to three days of peak swelling and discomfort that can be managed with prescribed or over-the-counter pain medication, rest and cold compresses. Patients often experience mild bleeding for the first 24 hours and should follow instructions such as avoiding rinsing forcefully, not using straws and keeping the head elevated to support clot formation. Eating soft foods and staying well hydrated helps the tissues heal more comfortably.

Good oral hygiene is important but should be gentle around the extraction site until healing is sufficient; you will be advised when to resume normal brushing and rinsing. Smoking and vigorous activity should be avoided for a period after surgery to lower the risk of dry socket and other complications. A follow-up appointment will confirm proper healing and address any concerns that may arise.

As with any surgical procedure, wisdom tooth extraction carries potential risks such as infection, prolonged bleeding, dry socket (alveolar osteitis), and swelling. Nerve-related complications are uncommon but can occur, including temporary or rarely persistent numbness of the lower lip, chin or tongue when nerves are located close to the roots. Upper wisdom teeth can occasionally create a communication with the maxillary sinus, which is usually managed with careful surgical technique and postoperative measures.

Risk is reduced through thorough preoperative assessment, appropriate imaging and skilled surgical technique, but patients should be aware of warning signs such as uncontrolled bleeding, rising pain, fever or persistent numbness. Prompt contact with the dental office is important if concerning symptoms develop so that complications can be identified and treated quickly. Informed consent includes a discussion of these risks and the steps taken to minimize them.

A range of anesthesia and sedation options are available to make extraction comfortable, including local anesthesia, nitrous oxide (laughing gas), oral sedatives, IV sedation and general anesthesia for selected cases. The choice depends on factors such as the complexity of the extraction, medical history, anxiety level and patient preference. Safety is prioritized through a preoperative review of medical conditions, medications and fasting guidelines when sedation or general anesthesia is planned.

Your dental team will explain the benefits and expectations for each option, including recovery time and the need for a responsible adult to accompany you when sedatives are used. A formal discussion during the consultation allows the provider to recommend the most appropriate approach for a calm, safe experience. Coordination with an oral surgeon and trained clinical staff ensures sedation is delivered and monitored according to accepted standards.

Removing wisdom teeth that are problematic can prevent future issues such as recurrent infection, damage to adjacent teeth and periodontal disease around the back of the mouth. However, not all third molars require extraction; some erupt fully in a functional position and can be maintained with good hygiene and regular monitoring. The long-term impact depends on individual anatomy, oral hygiene, and how the wisdom teeth relate to surrounding structures.

Regular checkups and periodic imaging allow your dental team to track the status of wisdom teeth and intervene if new risks emerge. Preserving healthy teeth is always a priority, and when removal is recommended it is intended to protect overall oral health and function. For personalized advice and consistent follow-up care in Port Elgin, patients may consult the team at Saugeen Shores Family Dentistry to review options and a tailored plan.