Impacted Wisdom Teeth

By the age of 18, most adults have 32 teeth; 16 teeth on the top and 16 teeth on the bottom. Each tooth in the mouth has a specific name and function. The teeth in the front of the mouth (incisor, canine, and bicuspid teeth) are ideal for grasping and biting food into smaller pieces. The back teeth (molar teeth) are used to grind food up into a consistency suitable for swallowing.


The upper and lower jaws of most adults are large enough to hold only 28 teeth. Several problems are very likely to occur when 32 teeth try to fit into a mouth that is only large enough to hold 28 teeth. The four teeth that usually don’t fit are your third molars, also known as your “wisdom teeth.”

Why Should I Have My Wisdom Teeth Removed?

Wisdom teeth are the last teeth to erupt (come through the gum and become visible). When they align properly and the gum tissue around them is healthy, wisdom teeth do not have to be removed. Unfortunately, this does not usually happen. The extraction of wisdom teeth is usually necessary when the jaws are not large enough to allow the wisdom teeth to erupt completely. They may grow sideways, partially emerge from the gum, and even remain trapped beneath the gum and bone. Impacted teeth can take many positions in the bone as they attempt to find a pathway that will allow them to successfully erupt. When a tooth is not completely visible and  is covered by gum and/or bone, either partially or completely, it is referred to as an “impacted” tooth.

These poorly positioned impacted teeth can cause many problems. When they are partially erupted, an opening in the gum covering the teeth allows bacteria to get underneath and multiply, eventually causing inflammation which will ultimately progress to an infection. When wisdom teeth become infected they typically cause pain, swelling, and difficulty opening the mouth. Without treatment these infections may become severe, requiring hospitalization for more aggressive treatment. Damage to adjacent teeth in the form of a cavity in the second molar (i.e. the tooth in front of the wisdom tooth) is a common occurrence. Also, forward pressure from the erupting wisdom teeth may disrupt the natural or orthodontically created alignment of the teeth. The most serious problems occur when cysts or tumors form around impacted wisdom teeth, resulting in the destruction of the jawbone and healthy teeth. Removal of the cyst or tumor and associated impacted tooth usually resolves this problem. Once a clear lack of room is evident, early removal is recommended to avoid the above stated problems.

Oral and Radiographic Examination

With an oral examination and a panoramic x-ray of the jaws, Dr. Vecchione can evaluate the position of the wisdom teeth and determine whether there is enough room for them to erupt completely. Studies have shown that early evaluation and treatment will result in a superior outcome for the patient. Patients are generally first evaluated in the mid-teenage years by their Dentist, Orthodontist, or by an Oral Surgeon. Dr. Vecchione will review your x-ray in detail, emphasizing all considerations pertinent to your surgery. In general, the benefits of wisdom tooth removal usually outweigh the risks of the procedure.

Removal of Impacted Wisdom Teeth

In most cases the removal of wisdom teeth is performed in the office using I.V. General Anesthesia, with the patient unaware yet breathing on their own. Local Anesthesia (injections to make the surgical sites “numb”) is also administered while the patient is asleep in order to minimize the need for additonal intravenous anesthetic medications. The procedure is performed in an environment of optimum safety utilizing modern monitoring equipment and an appropriately trained staff. Patients are usually ready to walk out of the office within thirty minutes after the procedure is completed, and are to be driven home by a responsible adult.  

If you have any questions regarding the above general information, please do not hesitate to call us at (609) 520-0046.