Removal of wisdom teeth

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If the wisdom teeth are unable to take their proper position in their respective rows of teeth, a decision needs to be made as to whether to remove them.

Removing the wisdom teeth

Wisdom teeth (Latin: dentes sapientes) received their name during the Roman period as these teeth tend not to erupt through the mucous membrane of the gum until adulthood. Their appearance was therefore associated with a certain degree of worldly wisdom. Outside Western cultures, they are known by terms such as ‘youngest tooth’ in Indonesian, ‘chewing tooth’ in Thai or, in Japanese, oyashirazu, literally meaning ‘unknown to the parents’. This means that the wisdom teeth do not emerge until their offspring has left home.

People usually have 32 teeth, of which four are normally wisdom teeth. The wisdom teeth are actually the third molars. The first signs that they are emerging – i.e. calcification on the X-ray – are not detectable until around the age of 12 to 14. The age at which the teeth come through depends on the individual; it is usually between the 16th and 40th year of life after the skull bone has stopped growing. In some people, fewer or no wisdom tooth buds form; others actually have even more wisdom tooth buds (additional teeth). With regard to the form of the root and the root bud, wisdom teeth deviate from the norm more often than the other molars.

Wisdom teeth are often crowded out and unable to take their proper position in the mouth and in their respective rows of teeth.

The teeth are described as retained or impacted (‘entrapped’) when they are completely encased in the jawbone. Partially impacted teeth are those which have emerged only partially (or not at all) from the mucous membrane of the gum, but which are nevertheless connected with the oral cavity via the gap to the adjacent tooth. A tooth is said to be transposed if its axis or position deviates from the normal axis of eruption. In 80% of the population, one or several impacted wisdom teeth are present.

Whether wisdom teeth should be prophylactically extracted or removed only if and when they cause problems, must be assessed on a case-by-case basis. Prophylactic extraction of wisdom teeth refers to the (often surgical) removal of asymptomatic wisdom teeth in young adults in the population. These teeth should not be taken out before the completion of skeletal growth.

Depending on the patient’s preference, wisdom teeth can be removed either one side (left/right) at a time or all at once.

The removal process first involves carefully opening the mucous membrane covering the wisdom tooth and then cutting away the surrounding bone to expose the tooth. Depending on the position and degree of tilting, the tooth is carefully removed from the bone either in several segments or in one piece. The wound is then surgically sutured. The suture material is removed after about seven to ten days. The patient should avoid severe physical strain for two to three weeks and make sure he/she does not eat excessively hard food items during this period.

Depending on the position of the wisdom teeth and the patient’s condition, they can be removed under local anaesthetic, twilight sedation or general anaesthetic in our day-care unit. ‘Day-care’ refers to the fact that the patient can recover from the anaesthetic in a private single room.

If you have any questions, please do not hesitate to contact us.