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43570 Garfield Clinton twp., MI 48038

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ToExtractornotExtractTheBigDecisionAboutYourChildsWisdomTeeth

Your child's permanent teeth come in gradually, starting just as they begin losing their primary ("baby") teeth and not ending until late adolescence or early adulthood. That's when the third molars or "wisdom teeth" close out the process.

Because of their late arrival, wisdom teeth have a high potential for dental problems. With a greater chance of crowding or obstruction by other teeth, wisdom teeth often get stuck fully or partially below the gums and bone (impaction) or erupt out of position. In one study, 7 in 10 people between the ages of 20 and 30 will have at least one impacted wisdom tooth at some time in their lives.

It's not surprising then that wisdom teeth are among the most extracted teeth, to the tune of about 10 million per year. Besides those already diseased or causing bite problems, many are removed preemptively in an attempt to avoid future problems.

But wisdom teeth usually require surgical extraction by an oral surgeon, which is much more involved than a simple extraction by a general dentist. Given the potential consequences of surgical extraction, is it really necessary to remove a wisdom tooth not creating immediate problems?

That's not an easy question to answer because it's often difficult to predict a wisdom tooth's developmental track. Early on it can be disease-free and not causing any problems to other teeth. But as some researchers have found, one in three wisdom teeth at this stage will later develop disease or create other issues.

For many dentists, the best approach is to consider extraction on a case by case basis. Those displaying definite signs of problems are prime for removal. But where there are no signs of disease or other issues, the more prudent action may be to keep a watchful eye on their development and decide on extraction at some later date.

More than likely, your dentist will continue to have an ongoing discussion with you about the state of your child's wisdom teeth. While extraction is always an option, wisdom teeth that aren't yet a problem to dental health may be best left alone.

If you would like more information on treating wisdom teeth issues, please contact us or schedule an appointment for a consultation.

By David A.Susko DDS, PC
December 23, 2015
Category: Dental Procedures
Tags: wisdom teeth  
ExtractingWisdomTeethNowMayPreventDentalProblemsLater

The reason for extracting a tooth may be all too obvious — the tooth is too decayed or damaged to attempt saving. The reason for extracting a wisdom tooth, on the other hand, may not be so apparent: from the perspective of pain or reduced function, you may not notice a thing. Our recommendation to remove a wisdom tooth is based primarily on what may be occurring out of view below the gum line and its potential threat to adjacent teeth.

Teeth grow and develop below the gum line in the jaw, and then push their way through the gums as they appear in the mouth (eruption). After a normal eruption, the enamel-covered crown is visible above the gum line; the remaining tooth root (about two-thirds of the tooth’s length) resides below the gum line. Because wisdom teeth, or third molars, erupt rather late between ages 17 and 25, they may lack the room to erupt properly due to crowding from other teeth that have already erupted. This can cause the wisdom tooth not to erupt fully through the gums, leaving the crown trapped below the gum line, a condition known as impaction. For the tooth, impaction increases the chances of infection, cyst formation and gum disease around it.

An impacted wisdom tooth can also cause problems for the adjacent teeth as well. The impacted tooth may begin to press against the roots of other teeth; the resulting pressure can damage the other roots, increasing the risk for disease or future tooth loss. A person may not even know they have this problem since there’s often little to no noticeable pain or symptoms.

It may seem counterintuitive, but the best time to remove a wisdom tooth is when it’s not causing immediate problems. There will be, however, signs found during examination (particularly x-rays or CT scan) that future problems are in the making. By extracting an impacted wisdom tooth at the appropriate time, we can avoid more serious problems in the future and improve oral health.

If you would like more information on wisdom teeth and your oral health, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Removing Wisdom Teeth.”

By David A.Susko DDS, PC
October 19, 2015
Category: Dental Procedures
Tags: wisdom teeth  
RemovingWisdomTeethnowmayPreventDentalProblemsLater

Teeth damaged by decay, periodontal (gum) disease or trauma are often removed (extracted) if they’re deemed beyond repair. But there’s another reason we may recommend an extraction: a tooth is causing or has the potential to cause problems for other teeth and your overall oral health.

Some of the most frequent cases of “preventive extraction” involve the third molars, or wisdom teeth, located in the very back of the mouth. They’re usually the last permanent teeth to come in, which is related to some of the problems they can cause. Because they’re trying to come in among teeth that have already erupted they don’t always erupt properly, often at abnormal angles or not fully erupting through the gums, a condition called impaction.

Impacted or misaligned wisdom teeth can put pressure on adjacent teeth and their roots, which can cause root resorption that damages the second molar. They can also increase the risk of periodontal (gum) disease in the gum tissues of the second molars, which if untreated can ultimately cause teeth and bone loss.

Because of current or possible future problems with wisdom teeth, we often consider removing them at some early point in the person’s dental development. Such a consideration shouldn’t be undertaken lightly, since wisdom teeth extraction is often complex and fraught with complications, and it usually requires a surgical procedure.

That’s why we first conduct a comprehensive examination (including x-ray or other imaging to determine exact location and possible complications) before we recommend an extraction. If after careful analysis an extraction appears to be the best course, we must then consider other factors like planned orthodontics to determine the best time for the procedure.

Once performed, a wisdom tooth extraction can resolve existing problems now and reduce the risks of gum disease or malocclusions in the future. When it comes to wisdom teeth, removing them may be in your or your family member’s best interest for optimal dental health.

If you would like more information on wisdom teeth, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Wisdom Teeth.”

By David A.Susko DDS, PC
December 05, 2012
Category: Dental Procedures
Tags: wisdom teeth  
7FAQsAboutImpactedWisdomTeeth

“Impacted wisdom teeth.” The term alone sounds ominous. What are wisdom teeth, why do they become impacted, what is the best way to treat them? These are questions people often ask.

What are “wisdom teeth” anyway?
Your third molars, located in the very back of your jaws, are your wisdom teeth. Most people have four of them.

Why is their name associated with wisdom?
They usually begin to come in when a person is 17 to 25 years old, a time when he or she can be said to begin to reach an age of wisdom.

Doesn't everyone get wisdom teeth?
While some people have more than four, others have fewer, and some have no wisdom teeth at all. Some people have wisdom teeth that can be seen in x-rays but do not erupt (grow up through their gums) and become visible.

What does “impacted” mean?
In normal usage, the term “impact” means “influence or effect.” In dental vocabulary, it means that a tooth is affecting another tooth or a nearby structure such as gums, nerves or blood vessels. Often an impacted wisdom tooth grows sideways into an adjacent tooth instead of growing upwards to come through the gums normally. This may be caused by a lack of room in your jaw for your third molars.

What kinds of problems can impacted wisdom teeth cause?
A wisdom tooth can impact the gum tissues surrounding nearby molars, leading to infection called “periodontal disease” (from the root words for “around” and “tooth.”) They can also cause root resorption in adjacent teeth, a process by which the tooth’s roots are slowly dissolved and eaten away.

What are the symptoms of impacted wisdom teeth?
Sometimes impacted teeth are asymptomatic — you feel nothing, even though damage is being done to gums and teeth surrounding the wisdom teeth. That's why it's a good idea to have regular checkups even if you are feeling no pain. Other times, impacted teeth can lead to acute inflammation and infection in surrounding gum tissues that is very painful.

Should I proactively have my wisdom teeth removed if they are not giving me any trouble?
Not necessarily but your wisdom teeth need to be evaluated. Generally speaking, however, it's better to remove wisdom teeth early, before they begin to cause dental problems. By the time a wisdom tooth starts to hurt, its neighboring teeth may already be in big trouble. In addition, younger people's wisdom teeth have undeveloped roots that make them easier to remove with fewer complications.

Contact our office for a full assessment and consultation about your wisdom teeth. You can also learn more by reading the Dear Doctor magazine article “Wisdom Teeth: To Be Or Not To Be?

By David A.Susko DDS, PC
February 08, 2012
Category: Dental Procedures
Tags: wisdom teeth  
TheConsequencesofanImpactedWisdomTooth

Anytime you have a tooth that does not erupt (surface) correctly but rather stays submerged below the gum you have a problem. Sometimes this situation can cause significant pain, while other times it can be totally pain-free. When this occurs to a wisdom tooth (third molar), you have what is commonly referred to as an impacted wisdom tooth. This generally occurs when there is insufficient room in the mouth, and the wisdom tooth “impacts” or butts up against an adjacent tooth.

Third molars come in typically between the ages of 17 and 25, when a moderate amount of “wisdom” is supposedly achieved. Most people have four wisdom teeth; however, it is possible to have more or less. The key to not having issues generally depends upon one main factor: having adequate space for them to grow and erupt into proper position.

The most common consequence of having an impacted wisdom tooth is gum (periodontal) disease and damage to adjacent healthy teeth. This makes removing the impacted tooth so important. Another problem with impacted wisdom teeth is that they can affect other adjacent structures like gum, bone, nerves, blood vessels and sinuses. They can also become cystic, a condition in which the submerged tooth is surrounded by a closed sac or membrane that can cause possible infection and loss of bone.

We stress the importance of routine dental exams between the ages of 17 and 25 to catch problems with wisdom teeth before they start. The best time to remove a wisdom tooth is when it is not causing problems and the sooner and younger you are the better!

To learn more about the symptoms and treatment options of impacted wisdom teeth, continue reading the Dear Doctor magazine article “Wisdom Teeth.” Or, you can contact us today to schedule an appointment to discuss your questions.



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