Whether or not your patients need to have their wisdom teeth removed can sometimes be a difficult question. Many times the third molars cause distinct clinical problems and there is an urgent need to have them removed. Other times the symptoms can be more subtle and it is not obvious if the third molars are causing the problems. And there are times when they appear totally asymptomatic, yet they can be causing or have the potential to cause serious problems.
Pericoronitis tends to be the most common acute problem caused by erupting third molars that necessitates their removal. If they are able to erupt fully, then they don’t need to be removed unless they become carious or cause occlusal trauma of the buccal mucosa or opposing gingiva. When the third molars remain partially erupted, they are more susceptible to caries or can develop a chronic pericoronitis, and usually should be removed.
Third molars can sometimes cause less obvious problems as they develop and try to erupt. Patients have complained of pressure in the jaws, a foul odor in their mouth, headaches, earaches and/or ringing in the ears. Also, impacted third molars can have cysts developing around their crowns or they can be erupting into the distal aspect of the second molars, causing resorption of the root.
In all cases, a thorough clinical and radiographic examination is necessary to determine if the third molars are causing or are likely to cause problems, and whether or not any or all of them should be removed. Once this is accomplished, I review the findings with your patient (and parents if they are minors), as well as discuss the potential risks and complications of any necessary surgery. I explain everything thoroughly and make sure to answer all questions. All patients have the option of having surgery “awake or asleep.” It can be done with local anesthesia alone or with intravenous general anesthesia. Prescriptions are given for antibiotics and analgesics, as indicated. Post-operative instructions are given written and verbally to the patient and any escort.
The thought of having their wisdom teeth removed can be a scary situation for your patients, however, we try to make it as comfortable as possible.
I will be glad to discuss any specific cases with you regarding your patients.
Please do not hesitate to contact me at (631) 499-7266.