Get Wise About Your Wisdom Teeth

This post answers the following questions

1) When will wisdom teeth generally begin to form as four third molars?
2) What is hypodontia?
3) What are the types of impacted wisdom teeth?
4) How long does it take for stitches to dissolve?
5) What is pericoronitis?

Even though many parents, especially those of teenagers, might debate whether age actually does bring with it wisdom, growing older does guarantee the arrival of a person’s wisdom teeth.

For most people, their wisdom teeth will generally begin to form as four third molars sometime between the ages the 17 and 25. The majority of adults will develop four wisdom teeth, however, some may develop less (a condition known as hypodontia), while others may more develop more, at which point the are called supernumerary teeth.


Unfortunately, in most cases an adult’s wisdom teeth don’t help them chew a little easier. When wisdom teeth begin to form, they can become impacted, which means they develop sideways in the mouth. In cases of impacted wisdom teeth, your dentist with probably recommend their removal.

Types of Impacted Wisdom Teeth

Any wisdom tooth that fails to fully erupt from the gum line is considered impacted, and falls into one of the following categories:

Mesioangular. The most common type of impacted wisdom tooth, mesioangular impaction means the tooth has developed at an angle that faces forward towards the front off the mouth. This type of impaction ranks as the hardest to remove from the upper jaw, but also ranks as the easiest type to remove from the lower jaw line.

Vertical. Occasionally a wisdom tooth forms at the right angle, but fails to fully erupt from the gum line. With a vertical impaction, a perfectly normal tooth must be removed to prevent infection around and under the gum line where the tooth partially emerged. Since vertical impaction doesn’t negatively affect the health of surrounding teeth, you can elect to not have this type of tooth removed. However, partially erupted teeth can collect bacteria, which could lead to an infection called pericoronitis.

Distoangular impaction. A distoangular impaction only occurs in approximately six percent of adults, and means the tooth has formed at a backward angle, pointing in the direction of the rear of the mouth.

Horizontal impaction. The least common type of impacted wisdom tooth, a horizontal impaction occurs when a tooth forms sideways at a 90 degree angle. While uncommon, a horizontal impaction does pose the greatest threat to the health of your teeth, as the tooth can begin to grow into the roots of your second molar.

In instances where you suffer from any of the above impactions, oral surgery is required to remove the tooth.

Tooth Extraction

The majority of wisdom tooth extractions will take place at either a dentist’s or oral surgeon’s office. However, in instances where a patient has all four of their wisdom teeth removed during one procedure, the surgery may take place in a hospital, especially if the patient has a high risk of complications.

Prior to undergoing the procedure, your dentist will administer a local anesthetic that will numb the area surrounding the impacted tooth. However, patients who need to have multiple teeth removed or who suffer from acute dental anxiety may receive a general anesthetic from their dentist. Unlike a local, a general anesthetic will cause the patient to sleep throughout the procedure. So you remain prepared for the surgery, the dentist may recommend that you don’t eat or drink anything for 12 hours prior to the procedure so that nothing in your system interferes with the anesthetic.

Once the procedure begins, your dentist will cut open the gum tissue that surrounds the tooth and remove any bone that obscures the tooth. Your dentist will then cut away any gum tissue that connects the tooth with the jaw line and then remove the tooth. In some instances, your dentist may elect to cut the tooth into smaller pieces to make the extraction easier.

After removal, you may need stitches to help the wound close. Some types of stitches will dissolve in about a week, while others will require a return visit to the dentist’s office.

Timothy Lemke blogs about oral health issues for Dr. Jared Doman, a Longview WA dentist at Smiles Dental.

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