I worked in an emergency clinic for a little bit, and we saw the most pain stemming from wisdom teeth. Pain not just in the patient’s late teenage years or early twenties, from the pressure of the erupting teeth which causes the classic wisdom tooth discomfort, but later in life – when this tooth that is so far back there and hard to clean becomes severely decayed or develops gum disease because it is next to impossible to practice good hygiene around some of them.
Now if your wisdom teeth come in just fine and there is enough room to accommodate them, not inducing crowding or any malocclusion (misalignment of the bite), and if you can keep them clean and they don’t seem overly susceptible to dental disease, we can leave them. I usually elect to leave them if you are into your 30s and haven’t had a major problem yet, because our ability to make new bone decreases after our teenage years so we see a lot more healing complications and bony defects in the form of periodontitis when wisdom teeth are extracted later in life. However, if we see dark staining leading to decay, or angry, inflamed tissue which can easily become infected or lead to localized periodontitis (gum disease) that lead to a generalized gum disease affecting more teeth, we will need to make a decision and that decision is usually to extract those teeth.
Extraction of wisdom teeth is a routine process and can be done with your general dentist and in many cases with an oral surgeon. Each case is different and your dentist will have to evaluate the angulation of the teeth, whether they are in function, your age, and what type of anesthesia you will need. I have taken out many without any more anesthesia than some local anesthetic, meaning the dental needle and lidocaine, and some with nitrous in conjunction with our local anesthetic and some with a sedative, nitrous, and of course a local anesthetic. We have a phenomenal doctor that comes to the office, should we have a more involved case, and he can put you to sleep so you can wake up refreshed and ready to go home when the procedure is over. It won’t be so bad! Let’s do this!