Wisdom Teeth

By the age of 18, the average adult has 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 (incisors, 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 average mouth is made to hold only 28 teeth. It can be painful when 32 teeth try to fit in a mouth that holds only 28 teeth. These four other teeth are your third molars, also known as “wisdom teeth.”

Why Should I Have My Wisdom Teeth Removed?

Wisdom teeth are the last teeth to erupt within the mouth. When they align properly and gum tissue is healthy, wisdom teeth do not have to be removed. Unfortunately, this does not generally happen. The extraction of wisdom teeth is necessary when they are prevented from properly erupting within the mouth. 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.

These poorly positioned impacted teeth can cause many problems. When they are partially erupted, the opening around the teeth allows bacteria to grow and will eventually cause an infection. The result: swelling, stiffness, pain, and illness. The pressure from the erupting wisdom teeth may move other teeth and disrupt the orthodontic or natural alignment of teeth. The most serious problem occurs when tumors or cysts form around the impacted wisdom teeth, resulting in the destruction of the jawbone and healthy teeth. Removal of the offending impacted teeth usually resolves these problems. Early removal is recommended to avoid such future problems and to decrease the surgical risk involved with the procedure.

Should My Wisdom Teeth Come Out If I Haven’t Had Any Problems Yet?

Wisdom teeth that are completely erupted and functional, painless, cavity-free, surrounded by healthy gum tissue in a cleansable area may not require extraction.  However, they do require regular, professional cleaning, semi-annual check-ups, and periodic radiographs to monitor for any changes.

Many people believe that as long as they are not in pain, they do not have to worry about their wisdom teeth.  However, freedom from pain does not mean disease or problem free. In fact, wisdom teeth that come in normally may still be prone to disease, according to a study by the American Association of Oral and Maxillofacial Surgeons and the Oral and Maxillofacial Surgery Foundation. It is therefore important that your general dentist monitors the health of all your teeth during your semi-annual dental check ups.

In general, dental and medical professionals agree that wisdom teeth should always be removed in the following instances:

  • Pain
  • Infection
  • Gum Disease
  • Cavities (Decay) that cannot be restored;
  • Pathologies such as cysts and tumors
  • Crowding of nearby teeth, which can push them out of alignment
  • Interference with certain kinds of dental or orthodontic work
  • Over-eruption due to unopposed tooth

Oral and Radiographic Examination

With an oral examination and radiographic images of the mouth, Dr. McDonald can determine the position of the wisdom teeth and evaluate if there are existing problems or some that may develop in the future. Studies have shown that early evaluation and treatment result in a superior outcome for the patient. Patients are generally first evaluated in the mid-teenage years by their dentist, orthodontist, or an oral and maxillofacial surgeon.

All outpatient surgery is performed under appropriate anesthesia to maximize patient comfort. Dr. McDonald has the training, license and experience to provide various types of anesthesia for patients to select the best alternative.


In most cases, the removal of wisdom teeth is performed under intravenous sedation or general anesthesia with a local anesthetic. Local anesthesia with or without nitrous oxide/oxygen analgesia is also used on occasion.  These options, as well as the surgical risks (i.e., sensory nerve damage, sinus complications infection, alveolar osteitis-dry socket), will be discussed with you before the procedure is performed. Once the teeth are removed, the gum is sutured. To help control bleeding, bite down on the gauze placed in your mouth. You will rest  in the office under our supervision until you are dismissed to be taken home. Upon discharge, your postoperative kit will not only include postoperative instructions, a prescription for pain medication,  possibly  a prescription for antibiotics, and a follow-up appointment, but also several other home care items.

Our services are provided in an environment of optimal safety and sterility that utilizes modern monitoring equipment and staff who are experienced in anesthetic techniques.