Our wisdom tooth is the third molar and it is called “wisdom tooth” because it erupts when the person is over 17 years old and supposedly wise enough. And because of this late eruption there is often no space left for the wisdom tooth to come out properly making it impacted.
A wisdom tooth becomes impacted when it is trapped under bone and gum tissues and disrupts structure adjacent to it causing the pain that patients feel.
When there is unrelenting pain due to impaction of the wisdom tooth or teeth, the patient will be required to undergo surgery to remove the tooth. This is because if the impacted wisdom tooth remains the patient will still be in a lot of pain and may cause even further destruction.
The solution to pain from wisdom teeth is to have wisdom tooth extraction performed. Wisdom tooth extraction is much different from a normal tooth extraction because the wisdom tooth to be extracted is positioned a different way and may be covered by gum and bone.
Wisdom tooth extraction procedure
Step 1: Local Anesthesia
The first step of wisdom tooth extractions is the administration of local anesthesia. It may be conveniently supported by a mandibular blocking technique, which renders the entire quadrant numb. Anesthesia is used to numb the area, so that the procedure can come along as comfortably as it should for the patient.
Step 2: Gum Incision
If the tooth is covered by gum tissue, the soft tissue is incised and reflected away from the bone to expose it. Sometimes an impacted tooth is going to be covered just by soft tissue.
Step 3: Bone Reduction
If the tooth is also covered by bone, the position of the impacted wisdom tooth is approximated through the use of a dental x-ray, and that portion of bone on top of the tooth is drilled. It is removed to permit access to the tooth.
Step 4: Tooth Sectioning
Inasmuch as the dentist or surgeon would like to remove the impacted wisdom tooth in one piece, it is often not possible because it is positioned in such a way that makes it impossible. To remove the tooth it will need to be sectioned. The tooth will have to be cut into smaller fragments so that it can be pulled out piece by piece.
Step 5: Bone Filling and Socket Irrigation
Fragments of teeth, bone and tissue may be left in the socket and when left there it can disrupt healing, so the mouth should be irrigated with water or saline solution. This will regulate bleeding and will initiate tissue and bone healing. The bone may also present some sharpness due to the drilling, so they have to be filled.
Step 6: Suturing
To protect the extraction site from infection and to initiate proper tissue healing, the gum is replaced on top of the bone and then sutured. The dentist may or may not use an absorbable suture, if not the sutures are removed a week after when the tissues have healed.
Wisdom tooth extractions are performed with the aid of dental radiographs, usually a panoramic xray, so that the surgery can be performed with reference to the adjacent structures.