By the time your teen is 18 or so, chances are that all 32 of her adult teeth have come in, including the third molars, more commonly known as wisdom teeth. “Not everyone has wisdom teeth or gets all four of them because the number and size of teeth, as well as jaw size, is genetic,” says Mario E. Ramos, DMD, a pediatric dentist in Midland Park and national spokesperson for the American Academy of Pediatric Dentistry. “As long as your child’s jaw is large enough to accommodate them with enough room to clean them properly, they don’t need to be removed.”
THE RIGHT TIME
Great news, right? But there are definitely times when they need to come out. The most common reason? “There isn’t enough space in the mouth,” says oral surgeon Manaf Saker, DMD, who’s board-certified in oral and maxillofacial surgery and anesthesiology at Ridgewood Oral Surgery and Implant Center in Glen Rock and Ramsey. “Wisdom teeth also may be partially or fully impacted, meaning they’re not erupting properly.” Impacted teeth may come in partially, be trapped within the jaw, crowd other teeth (not ideal if your kid just finished wearing braces!) or harbor bacteria because they can’t be cleaned easily.
By age 14 or 15, your kid’s dentist will take a panoramic X-ray (which goes all the way around the jaw) to evaluate the position and projected path of wisdom teeth. Most kids have wisdom teeth taken out between the ages of 15 and 17 after the jaw is done growing but before the roots are fully formed, says Saker. In addition, there’s less risk of complication if they’re removed before age 25 when the bones become denser.
WHAT TO EXPECT
Don’t stress: Most dental and some medical insurance plans offer at least partial coverage. An oral surgeon typically performs the procedure. In most cases, local anesthesia such as Novocain or laughing gas is used, or general anesthesia for complex cases. Surgery usually takes about 45 minutes. Though it’s decided on a case-by-case basis, it’s usually recommended to do all extractions at once. “The downtime is generally the same, whether you’re having two or four wisdom teeth removed,” says Saker.
Recovery usually takes at least a few days, so plan surgery over a weekend or school break, suggests Ramos. Afterwards, kids need to rest, drink plenty of fluids and eat a soft diet for a few days (don’t let your kid use a straw, which can dislodge clots and cause a painful condition called dry socket). Icing helps reduce swelling, which usually peaks on days three to five. Pain, which is usually at its worst on the day of surgery, can be managed with medications such as acetaminophen or ibuprofen, or a prescription pain killer. Typically, patients are back to most of their activities within a week.
—Arricca Elin SanSone is a New York-based health and lifestyle writer.