Dental Education Lecture: Early Extraction of Upper Wisdom Tooth

Fig.1	Fig.2	Fig.3
Fgi.4	Fig.5	Fig.6

We discussed necessity to remove bottom wisdom tooth as early as possible in last lecture.  The wisdom tooth is usually of no use. It causes a lot of troubles.  Its roots keep growing whether it comes into our mouth or not.  The top wisdom tooth is no exception.

Mr. Green is in his forties and finally agrees to have two top wisdom teeth pulled (#1,16 in Fig.1).  Fig.1 shows top teeth from #1 to #16.  Extraction of #16 is quite difficult, because it has three long roots (R in Fig.4).  C in Fig.4-6 is abbreviation of crown.  Arrowhead in Fig.4-5 points the junction of the crown and the root.  You may realize how long the roots are.

Extraction of the other upper wisdom tooth is more difficult (Fig.5,6).  One of three roots is broken.  In addition, the jaw bone surrounding this tooth is broken.  One piece of the jaw bone comes out with the tooth (Fig.5 B1), the other comes out by itself (Fig.5 B2).  Bone fracture increases bleeding, making extremely difficult to retrieve broken root tip (R in Fig.5,6).  As shown in Fig.1, the top wisdom teeth are located in the back of our mouth.  The oral surgeon cannot see the tinny tiny root tip directly in the socket.  Anyway, it is more difficult to take out long rooted wisdom teeth.

It is also difficult to clean the wisdom teeth well.  Tartar can be found in the back surface of the wisdom teeth  (brown stuff: arrowhead in Fig.4 and 5).  Tartar in turn can cause severe gum disease (infection: double arrowheads in Fig. 5).  This is one of several reasons that we have to take these teeth.

In science, the back surface of any tooth is called distal (D in Fig.3).  Fig.2 shows how we get to Fig.3 from Fig.1.  We blow up the wisdom teeth and the teeth immediately in front of them in boxed areas and bring these two areas together (arrows in Fig.2). #2 and #15 are the teeth immediately in front of the wisdom teeth (Fig.3).  The surface in the front of the wisdom teeth is called mesial (M).

In brief, we need to remove wisdom teeth as soon as possible.

Xin Wei, DDS, PhD, MS 1st edition 07/15/2009, last revision 10/03/2009