The wisdom tooth is the third molar. Most people have one in each quadrant of the mouth. However, it is not uncommon to find individuals with less than 4 wisdom teeth.
Because this tooth usually erupts when the person is about 18-21 years of age, it is called the wisdom tooth. In reality, the tooth is often non-functional or even problematic.
When there is insufficient space in the jaw for the tooth to emerge fully, the wisdom tooth may get trapped under the gum and bone. Partial eruption makes the tooth susceptible to gum infection which may result in recurrent bouts of pain and swelling. Left alone for long periods, chronic gum infection can lead to fibrous growths or cyst formation.
In certain cases, the tooth may be slanted against the next tooth - the second molar. The resulting gap between the two teeth traps food and promotes bad breath as well as decay.
Wisdom tooth surgery is usually carried out to save the second molar or stop the recurrence of gum swelling. In some individuals, the eruption of their wisdom teeth coincides with the appearance of their front teeth being pushed together. Wisdom tooth surgery is also performed to allay fears of crowding/overlapping front teeth, though there is no strong evidence to prove that the crowding front teeth is the direct result of pressure from erupting wisdom teeth.
There are various categories of wisdom tooth impaction. Below are some of the most common positions that impacted lower wisdom teeth may end up.
The depth of the impaction will affect the degree of difficulty in removing the tooth, but angulation also plays a part. Generally, vertical impactions are easy to deal with while horizontal and disto-angular impactions are challenging. I have successfully removed wisdom teeth in all the above categories.
Most wisdom teeth in the upper jaw can be extracted without surgery. Wisdom teeth in the lower jaw are usually more troublesome. Most dental practices are only equipped to provide local anaesthetic. For relatively simple cases, local anaesthesia, delivered by injection, is usually sufficient.