Dr. Howard A. Israel
Diplomate, American Board of Oral & Maxillofacial Surgery

Wisdom Teeth:

Third molars (wisdom teeth) are a common cause of pain and swelling.  An impacted wisdom tooth occurs when there isn't enough room in the mouth for the eruption of the third molar tooth to a normal functional position.  If a wisdom tooth erupts and becomes a functional tooth, there is usually no need for this tooth to be extracted.  However, this is often not the case and impacted wisdom teeth can cause serious problems.  The following are common indications for the removal of wisdom teeth:

1.  Infection - when a wisdom tooth fails to erupt into a normal position, it sets up an environment that makes the individual very susceptible to infection.  Bacteria are constantly being pumped into the area of the impacted wisdom tooth.  The altered anatomy caused by the failure of the tooth to erupt properly makes it impossible to remove this bacteria with normal oral hygiene measures.  This can result in an acute infectionresulting in pain and swelling.  Without appropriate and rapid treatment, the infection can spread quickly causing potentially serious complications. 

2. Chronic infection - some people do not have any symptoms associated with impacted wisdom teeth. However, the bacteria will eventually cause damage to the adjacent second molar tooth. This will result in decay or significant periodontal bone loss ultimately jeopardizing the functional second molar tooth

3. Cysts - when a tooth erupts into the oral cavity, there is a membrane that covers the top part of the tooth. This membrane disappears when the tooth eventuall erupts into a normal functional position. However, with impacted teeth, this membrane remains and given enough time, this membrane can begin expand, creating a cyst that grows in size and destroys the surrounding jaw bone. A cyst in the jaw bone requires treatment as soon as possible. Failure to treat this condition increases the risk of damage to surrounding structures, jaw fracture and nerve injury.4. Tumors - although this is rare, the cells of the cystic membrane can form jaw tumors. Both cysts and tumors associated with impacted wisdom teeth can expand slowly and not cause any symptoms. It is not uncommon for the first symptoms to occur when the cyst/tumor has reached a large enough size to cause pain and swelling. Unfortunately the later the diagnosis, the more difficult the treatment.

Early diagnosis and treatment of impacted wisdom teeth is very important to both your oral
and total body health.

Contact Info:

Dr Howard Israel
NY Presbyterian Hospital
Weill-Cornell Medice

525 East 68th Street
Suite F2132
New York, NY 10065

P: (212) 746-5175

F: (212) 746-8400