Wisdom Teeth Extractions

Molars typically begin erupting by age 6, while wisdom teeth usually develop around age 16. Often, we need to extract wisdom teeth for a number of reasons involving, pain, infection, overcrowding, and swelling. In many cases, wisdom teeth do not grow in properly and often do not erupt properly or become impacted, requiring them to be extracted.

We must examine your mouth and x-rays to determine if your teeth are impacted or will not grow in properly. To avoid potential problems later in life, most dentists will choose to remove impacted wisdom teeth. Most patients continue to have normal bites and well functioning jaws without them. Typically we remove wisdom teeth after the roots have formed, usually by age 16-18.

Impacted Canines

Humans have four canines, also called “eye teeth” - two on the upper jaw and two on the lower jaw. After wisdom teeth, canines are the second most likely teeth to become impacted (not properly emerging through the gums, and instead growing in slanted, sideways, or blocked within the jaw). Canines are prone to becoming impacted because they are among the last teeth to erupt. Some patient may have extra teeth, and these teeth may directly block the canines and cause them to become impacted or overcrowded.

Impacted canine teeth must be approached differently than impacted wisdom teeth because impacted wisdom teeth are not considered functional, and they are typically extracted. Canines, on the other hand, are important for biting, maintaining alignment of the rest of the teeth, and for the overall appearance of the smile. Instead of extracting impacted canines, we usually help guide them into place. Surgery to treat an impacted canine may involve an extraction of the teeth crowding the canine. This will help create space for the canine to properly erupt. The canine can then be guided into place using a special bracket.

Canines typically erupt between ages 10-13. As part of orthodontic examinations beginning at age 7, your child’s dentist will determine if treatment will be required to prevent impacted canines. They do this by documenting the number of teeth and monitor their growth and alignment.

Bone Grafting

In cases where the jaw bone is damaged or has receded, bone grafting is performed in preparation prior to a dental implant or restoration. These restorations require sufficient jaw bone volume for optimal chances of success. Jaw bone volume can be insufficient for a number of reasons, some of which include:

• Periodontal (gum) disease and infections - progressively attacks gum tissue and will eventually damage the jaw bone if left untreated
• Tooth extraction - it is estimated that following a tooth extraction, patients will loses 40-60% of the bone surrounding the tooth site, within three years
• Injury - blows to the jaw or other dental injuries can cause the jaw to recede

Since bone does not grow on trees, bone is harvested from another part of the patients’ body. The extraction and grafting sites are numbed with local anesthetic and small incisions are made to access the bone. The bone is then harvested and then anchored to the grafting site. Both sites are then closed with sutures. Eventually, the new bone will fuse with existing bone and encourage new bone growth.