Wis­dom teeth are the third and fi­nal set of mo­lars that most peo­ple get in their late teens or ear­ly twen­ties. Some­times these teeth can be a valu­able as­set to the mouth when healthy and prop­er­ly aligned, but more of­ten, they are mis­aligned and re­quire re­moval. Wis­dom teeth present po­ten­tial prob­lems when they are mis­aligned-they can po­si­tion them­selves hor­i­zon­tal­ly, be an­gled to­ward or away from the sec­ond mo­lars or be an­gled in­ward or out­ward. Poor align­ment of wis­dom teeth can crowd or dam­age ad­ja­cent teeth, the jaw­bone, or nerves. Wis­dom teeth that lean to­ward the sec­ond mo­lars make those teeth more vul­ner­a­ble to de­cay by en­trap­ping plaque and de­bris. In ad­di­tion, wis­dom teeth can be en­trapped com­plete­ly with­in the soft tis­sue and/or the jaw­bone or on­ly par­tial­ly break through or erupt through the gum. Teeth that re­main par­tial­ly or com­plete­ly en­trapped with­in the soft tis­sue and /or the jaw­bone are termed "im­pact­ed."

How Do I Know if I Have Wis­dom Teeth?

Ask your den­tist about the po­si­tion­ing of your wis­dom teeth. He or she may take an X-ray pe­ri­od­i­cal­ly to eval­u­ate for the pres­ence and align­ment of your wis­dom teeth. Your den­tist may al­so de­cide to send you to an oral sur­geon for fur­ther eval­u­a­tion. Your den­tist or oral sur­geon may rec­om­mend that your wis­dom teeth be ex­tract­ed even be­fore prob­lems de­vel­op. This is done to avoid a more painful or more com­pli­cat­ed ex­trac­tion that might have to be done a few years lat­er. Re­moval is eas­i­er in young peo­ple, when the wis­dom teeth roots are not yet ful­ly de­vel­oped and the bone is less dense. In old­er peo­ple, re­cov­ery and heal­ing time tend to be longer.

How Are Wis­dom Teeth Re­moved?

The rel­a­tive ease at which your den­tist or oral sur­geon can ex­tract your wis­dom teeth de­pends on their po­si­tion. Your oral health care provider will be able to give you an idea of what to ex­pect dur­ing your pre-ex­trac­tion ex­am. A wis­dom tooth that is ful­ly erupt­ed through the gum can be ex­tract­ed as eas­i­ly as any oth­er tooth. How­ev­er, a wis­dom tooth that is un­der­neath the gums and em­bed­ded in the jaw­bone will re­quire an in­ci­sion in­to the gums and then re­moval of the por­tion of bone that lies over the tooth.

The pros and cons of wis­dom tooth re­moval

Pros:

• Wis­dom teeth may be hard to ac­cess with your tooth­brush or floss. Over time, the ac­cu­mu­la­tion of bac­te­ria, sug­ars and acids may cause a cav­i­ty to form in the tooth. If it is not re­stored with a fill­ing, the cav­i­ty may spread and de­stroy more tooth struc­ture caus­ing se­vere con­se­quences to the tooth and sur­round­ing sup­port­ive struc­tures.

• Due to the dif­fi­cul­ty of keep­ing these teeth clean with your dai­ly home care (brush­ing and floss­ing), bac­te­ria and food de­bris re­main­ing on the wis­dom teeth may present a foul smell-caus­ing bad breath.

• A wis­dom tooth that is still un­der the gums in a hor­i­zon­tal po­si­tion (rather than a ver­ti­cal po­si­tion) may ex­ert pres­sure to the sur­round­ing teeth, caus­ing crowd­ing and crooked teeth. This al­so may oc­cur if there is not enough space in the mouth for the wis­dom tooth.

Cons:

• De­pend­ing on the size shape and po­si­tion of the tooth, re­moval can vary from a sim­ple ex­trac­tion to a more com­plex ex­trac­tion. With a sim­ple ex­trac­tion, there is usu­al­ly lit­tle swelling, bruis­ing and/or bleed­ing. More com­plex ex­trac­tion will re­quire spe­cial treat­ment which may re­sult in more bruis­ing, swelling and bleed­ing. How­ev­er, your den­tal pro­fes­sion­al will pro­vide you with post treat­ment in­struc­tions to min­imise these side ef­fects.

• Fol­low­ing an ex­trac­tion, a con­di­tion called "dry sock­et" may oc­cur. If the blood clot that formed in the ex­trac­tion area be­comes dis­lodged, it ex­pos­es the un­der­ly­ing bone. This con­di­tion is very painful, but re­solves af­ter a few days. It is pre­ventable by fol­low­ing the post treat­ment in­struc­tions pro­vid­ed by your den­tal pro­fes­sion­al.

• The longer you wait and the old­er you get, there is the po­ten­tial for more prob­lems to oc­cur. As you get old­er, the bone sur­round­ing the tooth be­comes more dense and dif­fi­cult to re­move. (web­md)