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In this blog, we will continue our educational series of what entities can be seen on a dental x ray…in this case, a panorex.
The image above shows a full complement of 28 teeth.
What we’re going to focus on in this image are the wisdom teeth.
There are four present…one at each corner of the mouth.
• The two wisdom teeth on top look as though they are fully impacted…this means that they are located within the jaw bone and are not visible in the oral cavity…if I were to look in the mouth and try to see them, I wouldn’t be able to (they are hidden underneath the gum).
• The lower wisdom teeth have tried to erupt into the oral cavity; however, there is not enough room for them to fully erupt. The back of them are caught underneath the bone. These are known as partially impacted wisdom teeth. The upper wisdom teeth are fully impacted.
This is a good time to review the three main reasons to remove wisdom teeth:
1. Crowding – Even if there is no room for the wisdom teeth to grow in, they will do their best to try to do so. This means that they may put pressure on the other teeth which may result in some crowding.
2. Infections – Many times if the tooth is partially impacted, there is a piece of gum tissue growing over it. This is called an Operculum.
If bacteria and food debris accumulate beneath this flap of gum tissue and cannot be cleaned away, it quite often leads to a local infection.
For additional information about Operculums and their associated issues, please see the blog series “Pericoronitis,” posted on July 21st, 31st and August 11th of 2015).
In addition, partially impacted teeth often have deep pockets associated with them. It may be worthwhile to re-read the blog on deep pockets, “Periodontal Disease….What exactly is it?” posted on March 2nd, 2012. If a deep pocket is present, like an operculum, food and debris will accumulate and if not debrided may result in an infection.
3. Cavities – This is a bit difficult to explain, but here it goes: An impacted wisdom tooth may be angled and grow in such a way that it actually starts to ‘eat away’ at the tooth in front of it (the second molar). This occurs quite often. The result is a large cavity in the second molar…so large, that usually the affected tooth needs to be extracted, in addition to the wisdom tooth.
Ideal time to have wisdom teeth removed
The best time to have the wisdom teeth removed is when they are not causing a problem. This is usually during the age of adolescence (17-19).
The reason is that at adolescence, the wisdom teeth are easy to remove (even if they are fully impacted) and also their healing is quite rapid…the older one is, the longer it takes to heal.
It is routine to check how a patient is healing after having their wisdom teeth removed…this is known as a post-op check.
This is usually done two weeks after the teeth were taken out. Often when I check a patient of adolescent age, it hardly looks as if any procedure was done at all…individuals at that age heal very quickly.
It would be nice if people wouldn’t get wisdom teeth, or if they did get them that there would be enough room in the jaws to accommodate them. However, it is not often that either of the above occur…they are usually present and most of the time there isn’t enough room for them…and unfortunately, they do cause the problems discussed above.
If you have any questions regarding wisdom teeth removal, please do not hesitate to contact our office. Learn more about wisdom tooth removal and extraction.
Dental Questions or Concerns? Give Us a Call!
Based in Brampton, Ontario, Dr. Robert Axelrad has been practicing gentle and pain-free dentistry for over two decades. Over this time he has removed his fair share of wisdom teeth for his trusting patients! Feel free to call us today at (905) 791-3867 for any wisdom tooth or dental question you may have, as we are always happy to hear from you.