Wisdom Teeth Extractions & Coronectomy
Wisdom teeth or third molars the last teeth to develop in your mouth. They are behind the second molars and complete development in mid teens to early twenties.
Why should I take out my wisdom teeth?
Wisdom teeth are commonly impacted (under the gum and or bone) because one’s jaw is too small. If they do erupt, wisdom teeth tend to erupt partially and are partially or completely covered by gum tissue. The space between the gum tissue and the wisdom tooth can be a trap for food and is a great environment for bacteria to grow leading to inflammation, pain and tenderness of the gum. This is called Pericoronitis. When the wisdom tooth is angled and abutting onto the 2nd molar, you can have a gum pocket behind your 2nd molar. This can cause gum disease because it is a food trap where bacteria can reside in. The bone loss behind the 2nd molar because of the wisdom tooth can lead to mobility of the 2nd molar and eventually lead to a loss in both teeth.
If the crown of the third molar is abutting (touching) onto the root of the 2nd molar, it can cause resorption of the 2nd molar roots and eventually loss of the 2nd molar.
Risk of Nerve Injury
Part of the maturation process of the tooth includes root development. The crown of a tooth is the tooth surface that you see in the mouth and the roots are the part in the bone. As the roots get larger, they can grow and wrap around the nerve inside the jaw. This nerve is called that inferior alveolar nerve and gives sensation to the lower lip, chin and cheek. When the nerve is touching or entangled in the root, it has a high risk of injury that can lead to permanent numbness of the lower lip, chin and cheek. It is best to remove the tooth before the roots get longer and reside in the close proximity to the nerve.
Cysts and Tumors around the wisdom teeth
Impacted teeth can have associated with cysts and tumors. Cysts and tumor can arise from the shell that surround the tooth when it is impacted (inside the bone) and these cysts and tumors can eat up the surrounding bone. The common cysts and tumors include dentigerous cyst, keratinizing odontogenic tumor, ameloblastoma and many more. These lesions can be devastating and in some cases lead to jaw fractures and may require procedures to remove part the jaw. Prevented by the removal of wisdom teeth at a younger age is recommended.
Why should I take out my wisdom teeth in my teens?
Extraction at an early age lowers the risk of nerve injury. The best time to take them out is when the roots are not fully grown and they are far away from the nerve.
As we get older our body has less capacity to regenerate bone. If the 2nd molar root is exposed after the extraction, the extraction socket may not fill with bone. This can lead to chronic gum disease. Studies have shown that bone healing is superior and more predictable at a younger age
We recommend removing wisdom teeth at an early age to minimize your risk and have optimal healing. Our dental specialists at Dental Implants & Oral Surgery of San Francisco are Oral and Maxillofacial Surgeons who are experts in wisdom teeth removal.
What happens if I have a high risk of nerve injury?
If your wisdom teeth roots are wrapped around the nerve, removing the entire tooth may leave you with injury to the nerve resulting in numbness of the lip, chin and cheek that maybe temporary or permanent. In order to reduce the risk, here at Dental Implants & Oral Surgery of San Francisco, we offer patients a procedure called coronectomy or partial tooth removal that lowers the risk of nerve injury. Part of the tooth is removed leaving the root intact. The root will either move up away from the nerve allowing the removal to be safe or bone will grow over the root allowing the back of the second molar to be kept hygienic. Our dental specialists are experts in wisdom teeth removal. Ask our dental specialists if coronectomy is the right procedure for you.
Wisdom teeth extraction
The first visit is a consultation with your surgeon. Our dental specialists will make an assessments through clinical and radiographic examination. Wisdom teeth surgery can be performed under Local anesthesia, laughing gas or sedation. The risks, benefits and alternatives of the surgery are discussed in depth and our dental specialists can answer your questions prior to the procedure. Please see the section of IV sedation for further information
What to expect
- Take your medications as prescribed with small sips of water.
- If you undergo sedation, be sure to have a responsible adult give you a ride home.
- If you are having sedation, have a responsible adult to give you a ride home.
At your appointment, be sure to inform us of any changes in your health since your first appointment, including any colds or the flu.
Some quick notes:
- Our hours are from Monday-Friday and some Saturdays are available by appointment.
- Cancellation requires 3 business days of advanced notice.
- We request that you be on time for your appointment.
- We will help you arrange transportation if needed.
- We will take excellent care of you during your treatment.