Wisdom tooth is the last tooth, which erupts in our mouth. Its time of eruption is from 18-25 years of age, therefore called the wisdom tooth since by this age a person is mature enough to be termed wise.
Treatment options depend on the positioning of the tooth and space available in bone:
If the wisdom tooth has erupted completely and in an absolutely normal position –If such tooth gets infected or requires treatment then it is considered as a normal tooth and can be filled or root can be treated as per the requirement.
If it is partly in the bone and partly visible in the mouth-In such cases careful analysis of the x-ray of the tooth is a must to determine whether there are chances that the tooth might erupt normally or not. If there are no favorable chances then extraction (Removal) of the tooth is advised .If it seems that that tooth might erupt normally then we just cut the portion of gums covering top of the tooth so that oral hygiene can be maintained in that area.
If the tooth is completely inside the bone and causing problems then extraction (Removal) of the tooth is advised.
Wisdom teeth appear when all teeth have already erupted and bone growth also is complete. So most of the time there is no adequate space for the tooth to erupt in a normal position. This is the root cause of all problems.
Sometimes it erupts only partly. In such cases a portion of gums and bone keep covering a part of the tooth. Food gets continuously trapped there leading to gum problems. Since it is the last tooth it becomes increasingly difficult to clean. This vicious cycle keeps worsening the condition. In some cases the tooth is completely inside the bone but lying or erupting in an abnormal direction. This might put excessive pressure on the adjacent tooth and may lead to other gum problems also.
If this tooth erupts completely in a normal position then it is a boon but if not then in no way it enhances your biting efficiency. It is just acting as a source of infection and must be removed. This fact might relax you a bit that whenever we make complete dentures for a patient we never replace the wisdom teeth in these dentures. This explains that the rest of the teeth are strong enough to bear the functional load.
When the tooth is partly or completely under bone then a slight portion of bone is cut to get access to the tooth and remove it. All this procedure is done under local anesthesia so that there is no pain during the treatment. After the procedure slight pain, swelling and difficulty in mouth opening are the common problems, which can be minimized with proper medicines and follow up of post extraction instructions. Proper sterilization of instruments and minimum amount of bone cutting ensures that post-procedural complications are minimum. Sutures are placed to enhance healing which needs to be removed in a week’s time.