For most patients, their first experience with the field of oral and maxillo-facial surgery is for the removal of wisdom teeth or third molars to allow adequate room for permanent teeth. Wisdom teeth are the teeth furthest to the back of the mouth of the upper and lower jaws and they are the last teeth to form. Wisdom teeth get their common names because they often emerge from the gums at the age of our "wisdom" during the late teens and early twenties. They are linked to a time long ago when human beings has a different diet, significantly larger jaws, and a higher rate of early tooth loss. While some people do not develop wisdom teeth at all, for those who do, wisdom teeth can cause serious problems. A common problem with wisdom teeth is that they remain impacted. This means the developing teeth are trapped under the gum line because the jaw is simply not large enough to accommodate them. Not only can impacted teeth cause sever pain, they continually try to emerge, but impacted teeth can also become infected thus causing the formation of cysts and tumors within the jaw bone. Another frequent problem with wisdom teeth is their predisposition to infection and decay. Even if the tooth breaks partially through the gum surface, bacteria can become trapped under the flap of gum tissue. And because the teeth are in an area of the jaw that is hard to clean, they are prone to cavities and periodontal diseases which can also endanger the adjacent second molars. The gradual pressure of developing wisdom teeth is thought to crowd adjacent teeth causing them to shift. This is why younger individuals will want their wisdom teeth removed prior to completion of orthodontic treatment. It is generally easier to remove the wisdom teeth of younger patients because the teeth are not yet fully developed and the bone around the molars is still soft. The ideal age for removal is between the ages of 15 and 18. As we grow older the roots of the wisdom teeth lengthen. Roots of upper wisdom teeth may grow towards the sinus cavity while those in the lower jaw can approach deep nerves in the jaw itself. Patients considering wisdom teeth removal will be pleased to learn the procedure will most often be performed in the surgeon's office using intravenous sedation of "twilight" anesthesia. This is an extremely safe anesthesia where the patient is not fully unconscious but remain unaware of any discomfort associated with the procedure. The actual surgery lasts 30 to 45 minutes and patients should have made prior arrangements to have someone drive them to and from the office. A patient will experience discomfort for two to three days after surgery and diet will be limited to soft foods or liquids during this period. Most people who have wisdom teeth extractions on a Friday are back to their normal routine by Monday. Younger patients normally recover faster. If you are wondering if you or your child are candidates for wisdom teeth removal, please consult your family dentist or orthodontist. Panoramic x-rays are needed to determine the status of wisdom teeth and it is recommended that everyone have such a radiograph taken preferable during the teenage years. Please don't hesitate to contact the staff of Dr. Mark A. Piper if you have any questions or would like to schedule a consultation.