Wisdom Tooth Extraction

Wisdom tooth extraction refers to the surgical removal of wisdom teeth, whether they are impacted and have not fully erupted into the oral cavity or have completed eruption, for various reasons. In addition to a normal tooth extraction, the surgical removal of wisdom teeth is called wisdom tooth extraction surgery.

Even if wisdom teeth form, they may erupt incompletely or inadequately into the mouth, or they may remain impacted within the tissue and not erupt at all. Wisdom teeth with completed root formation can be partially impacted within the tissue, as well as completely impacted within the tissue. Furthermore, the degree of impaction of wisdom teeth can vary, as can their position within the tissue, and they are classified differently accordingly. Different degrees of eruption and positional differences within the tissue also affect the ease or difficulty of wisdom tooth extraction. Wisdom teeth whose crown portion is partially or totally under soft tissue are called soft tissue impacted wisdom teeth. If the crown portion is partially or totally within the bone and there is bone retention that will hinder tooth extraction, these wisdom teeth are classified as bony impacted wisdom teeth.

The surgical extraction of wisdom teeth for various reasons and indications can be stated as follows:

• Infection. Partially erupted wisdom teeth create a suitable environment (medium) for bacterial retention around the surrounding soft tissue. In this case, they cause a painful infection called pericoronitis around the soft tissue. The acute infection is controlled with antibiotics, and wisdom tooth extraction surgery is performed. However, if the tooth extraction is not performed and the patient is not treated after antibiotic use, the pericoronitis case may recur painfully in the future. However, it is not clear when the recurrence will occur.

• Cyst formation. When wisdom teeth cannot erupt, they can be a source of infection as well as cause cyst formation. Cysts can be small in volume, as well as large and voluminous cysts that can spread in the jawbone to the area including adjacent teeth. In this case, surgical procedures are performed to remove the cyst along with the wisdom tooth extraction.

• Decay formation in the adjacent tooth due to the wisdom tooth. Impacted wisdom teeth can cause decay formation at the points where they are adjacent to the 2nd molars. At the same time, in cases where they cause the root surface of adjacent teeth to be exposed, the exposed root surfaces are less resistant to decay formation. It is very beneficial to remove impacted teeth to prevent the loss of the 2nd molar teeth.

• Decay formation in the wisdom tooth. Extraction of impacted and decayed wisdom teeth is necessary.

• Orthodontic reasons. Extraction of wisdom teeth is necessary, especially in cases where distalization, that is, backward movement of molar teeth with orthodontic forces, is desired.

• Need for orthognathic surgery. Extraction of wisdom teeth is necessary at least 6 months before orthognathic surgery procedures. Especially in lower jaw orthognathic surgery procedures, the healing of the wisdom tooth region, which coincides with the bone incision, after extraction is very important for the success of the orthognathic surgery procedure.

The wisdom tooth extraction approach varies according to the classification of tooth impaction. In mucosal retention tooth extractions, the soft tissue covering the crown portion of the wisdom tooth is elevated with an incision, and the extraction surgery procedure is completed by closing the incision/flap surfaces with sutures.

The extraction of bony impacted wisdom tooth extractions is one step more complicated than mucosal retention teeth. In this procedure, the bone tissue that prevents the impacted tooth extraction is removed. If necessary, the tooth is abraded or the crown-root portion is separated with an incision, and the extraction is performed. After the procedures, the wound surfaces are closed with sutures, and the surgical procedure is completed.

• If pain and infection are present, the etiological (causative) factor is eliminated, and the patient's recovery is ensured.

• Decay and resorption damage that may occur in the roots of the adjacent tooth are prevented. If damage has occurred in the adjacent tooth, its progression is prevented, and rehabilitation of the existing damage is provided.

• Cyst formation is prevented, and if there is an existing cyst, the cyst is removed along with the tooth extraction.

• Decayed and inflamed wisdom teeth can also cause bad breath. The cause of the odor is eliminated.

• In the case of pericoronitis (inflammation in the soft tissue wall of the wisdom tooth), mouth opening and closing functions are restricted. After extraction, the patient is relieved, and the jaw opening and closing function returns to normal.

• Orthodontic distalization tooth movements are performed more easily in line with the specialist's plans.

The fact that physician fees in Turkey are lower compared to European countries and the USA makes wisdom tooth extractions more economical. Surgical extractions are priced according to the degree of difficulty and prices vary between €350 and €750.