A wisdom tooth extraction, scientifically termed odontectomy, is the surgical removal of an impacted tooth, different from the normal tooth extraction. It involves the incision of gum tissue, the reduction of bone, and the sectioning of the tooth into smaller fragments. It is a surgical procedure that is performed under local or general anesthesia, and may be carried out by a general dentist or an oral surgeon

If you are about to receive the surgery, you probably have some questions about the procedure:

Should all wisdom teeth be removed?

No, not all wisdom teeth have to be surgically removed because not all wisdom teeth are impacted. The wisdom teeth erupt last into the mouth, when a person is between the ages of 17 to 21 years old. By that time, all of his other teeth have already erupted so when not enough space is left for the third molars of wisdom teeth to occupy, they become impacted. When the wisdom teeth erupt normally, they will not at all require wisdom teeth extraction.

What are the different types of impaction?

An impacted third molar or wisdom teeth may be classified according to the position it takes in the mouth. First it is classified according to its orientation: vertical when it assumes a position that is parallel to the adjacent second molar, horizontal when it assumes a position that is perpendicular to the long axis of the erupted second molar, mesioangular when it is diagonally tipped towards the second molar and distoangular when it is diagonally tipped away from the second molar. Another classification is made according to its depth within the bone: whether it is as the level of the occlusal plane of the second molar, set below the level of the second molar’s occlusal plane, or found below the level of the second molar’s neck. Finally, they can be classified according to coverage: either it is full exposed; partially covered by gum, bone or both; or fully covered by gum, bone or both.

Are wisdom teeth extraction procedures painful?

Ideally, a wisdom teeth extraction should proceed comfortably and painlessly for most patients. An anesthetic solution is deposited before the procedure is begun so the area is numb. Any pain and discomfort during the procedure will depend on the following things: presence of dental infection that may neutralize the effect of the anesthesia, proximity to nerves, low pain threshold of patient and so many others. When the case is ideal, the extraction should proceed positively.

Is it ideal to have all four impacted molars to be able taken out at once?

It not ideal but it is done, but it is performed with the patient’s consent and with proper health considerations. The surgical removal of a wisdom tooth may proceed differently per tooth and per patient. Sometimes the procedure may go as fast as  a few minutes, but it can go for hours for others. When multiple extractions are required, it is important for the dentist to consider the health of the patient, the total number of anesthesia to be used, the length of the procedure and the capacity of the dentist to perform the multiple extraction. It is planned this way because recovery after surgery is not easy, in fact it is more uncomfortable than the surgery itself. By having the extraction done in one session, the patient is limited to one excruciating recovery period instead of two, three or four.