Wisdom teeth extractions are a fairly common procedure. Wisdom teeth can cause problems as they are trying to protrude through the gums. When a wisdom tooth is impacted, it means the tooth is coming in at an angle. This can cause pain, the tooth can come in unevenly, or the tooth may emerge only partially.
When a wisdom tooth only emerges partially a flap of skin, called an operculum, may form over the tooth. This can make the tooth hard to clean, and pieces of food may be caught under the skin. This makes it easy for an infection, called pericoronitis, to develop.
Impacted teeth and wisdom teeth that can potentially cause infections need to be removed. Extractions can range from a single tooth, to removing all four wisdom teeth at once.
The procedure can vary based on the behavior of the tooth. Generally the gum tissue around the wisdom tooth is opened and the tooth is loosened by gripping it tightly and wiggling it back and forth until it can be lifted out of the gums. Sometimes, however, a tooth may be impacted so tightly that it cannot be simply lifted out of the gums. In cases like this the tooth will be broken up into pieces before being removed. Depending on the incision and extraction site, sutures may be needed to close the area. Soluble sutures will dissolve on their own, and therefore do not need to be removed after the area heals.
Extraction Site Preservation
When removing a tooth it is important to consider what will be done with the empty space after that tooth is removed. Wisdom teeth are in the back of the mouth, so that site will heal on its own with no complications. If it is necessary to remove another tooth, plans must be made.
When a tooth is removed and nothing is done with the extraction site, the jaw bone will degenerate and change shape during healing, and can cause your teeth to shift. Dental implants or dental bridges are possible solutions.
Bone grafting is where bone is built up to accommodate a dental implant or other restorative device. Bone grafting is a common procedure that is used frequently for dental implants and other periodontal procedures. Cadaver bone fragments from bone banks are a very safe source for bone donation.
Osseous Surgery – Pocket Reduction
Enlarged gum pockets between the tooth and the gum line are common after having advanced gum disease. The gaps can put the teeth at future risk for tooth and gum disease, as they become one more place that plaque and bacteria can collect. Pocket reduction surgery is designed to thwart the after effects of periodontal disease and restore your mouth to a healthy state.
The goal of periodontal surgery is to gain access to the tooth root and clean the damaged areas. Removing the plaque and decayed gum tissue leaves a pocket between the gum and the tooth. Even if the gum returns to its original position, the pocket is present. The pocket requires more frequent cleanings as they are difficult to reach with regular brushing and flossing.
Once the swelling from the periodontal treatment has subsided, the dentist may need to suture the gum. The goal is to create a space large enough to reach through daily oral hygiene, but small enough that it does not become a breeding ground for plaque and bacteria.