The wisdom tooth is also known as the third molar and it is given such a name because it erupts when the individual is beyond 17 years old, and supposedly wise enough. Due to this late eruption there often is no space left for it to come out properly into the mouth so it becomes impacted. A wisdom tooth may be impacted in various ways: it may be trapped under bone and gum tissues, and may disrupt any structure adjacent to it causing some pain and destruction.
When pain symptoms are felt or as soon as it poses a problem, a surgery will be required to remove the tooth. Allowing the tooth to remain in the mouth will cause the patient a lot of pain and may cause further destruction. To avoid this problem, wisdom tooth extractions are performed. This is so much different from a normal extraction because the tooth is positioned a different way and may be covered by gum and bone.
Wisdom tooth extractions are not simple procedures and if you are preparing for your surgery, this is how it is done:
Step 1: Local Anesthesia: The first step of wisdom tooth extractions is the administration of local anesthesia. It may be conveniently supported by a mandibular blocking technique, which renders the entire quadrant numb. Anesthesia is used to numb the area, so that the procedure can come along as comfortably as it should for the patient.
Step 2: Gum Incision: If the tooth is covered by gum tissue, the soft tissue is incised and reflected away from the bone to expose it. Sometimes an impacted tooth is going to be covered just by soft tissue.
Step 3: Bone Reduction: If the tooth is also covered by bone, the position of the impacted wisdom tooth is approximated through the use of the x-ray, and that portion of bone on top of the tooth is drilled. It is removed to permit access to the tooth.
Step 4: Tooth Sectioning: Inasmuch as the dentist or surgeon would like to remove the impacted wisdom tooth in one piece, it is often not possible because it is positioned in such a way that makes it impossible. To remove the tooth it will need to be sectioned. The tooth will have to be cut into smaller fragments so that it can be pulled out piece by piece.
Step 5: Bone Filling and Socket Irrigation: Fragments of teeth, bone and tissue may be left in the socket and when left there it can disrupt healing, so the mouth should be irrigated with water or saline solution. This will regulate bleeding and will initiate tissue and bone healing. The bone may also present some sharpness due to the drilling, so they have to be filled.
Step 6: Suturing: To protect the extraction site from infection and to initiate proper tissue healing, the gum is replaced on top of the bone and then sutured. The dentist may or may not use an absorbable suture, if not the sutures are removed a week after when the tissues have healed.
Wisdom tooth extractions are performed with the aid of dental radiographs, usually a panoramic xray, so that the surgery can be performed with reference to the adjacent structures.