The way wisdom teeth need to be removed are different depending on if they are impacted and how impacted they are. Fortunately for you, your jaw does NOT need to be broken even for the most impacted and difficult wisdom tooth to be removed. We assure you, your jaw will be intact after the procedure is completed.
With that out of the way, we will explain how each type of impacted wisdom teeth are removed. That way you know what to expect going into the procedure. It will also rid your fear of thinking that your jaw may be broken (which it shouldn't). Although a broken jaw is a possible complication of extractions.
Table of Contents:
Removing fully erupted wisdom teeth
Extracting fully erupted wisdom teeth definitely do not need your jaw to be broken. The teeth are already fully grown and out of the gums. You can see them as clear as day so it is completely unnecessary to break the jaw to get them out. In fact, you can remove these just like any other teeth in the mouth.
How to remove fully erupted wisdom teeth:
Administer local anesthetic to numb the tooth.
Sever the periodontal ligament with a sharp instrument.
Elevate the tooth with an elevator.
Deliver the tooth with forceps.
Currette the socket.
Irrigate any debris in the socket.
Those are all of the steps that are required to extract a fully erupted wisdom tooth. As you can see, there is no jaw breaking in any of those steps. Wisdom teeth in this condition are the easiest ones to remove.
Did you see a broken jaw listed in there anywhere? What we're trying to tell you is that you should calm down because that is totally unnecessary and there is nothing to be worried about.
Removing partially impacted wisdom teeth
Removing partially impacted wisdom teeth are a step up in difficulty from the fully erupted ones but they still do not necessitate breaking the jaw. What makes them more difficult is because only a portion of the tooth has emerged out of the gums. This means that in order to expose the tooth so that it can be extracted requires cutting through the gums and possibly drilling away some bone.
How to remove partially impacted wisdom teeth:
Administer local anesthesia to the tooth and surrounding gums.
Reflect the gums with a scalpel and lay a flap.
Expose the tooth by peeling back the gums.
Drill away any bone that may be covering the rest of the tooth.
Elevate the tooth with an elevator.
Deliver tooth with forceps once it is loose enough.
Curette the socket to remove any infection.
Smooth down bony spicules with a bone file.
Irrigate the socket to remove debris.
Place stitches to close up the hole as best as you can.
If you compare the steps for a partially impacted wisdom tooth to a fully erupted one, it certainly requires more steps. This is because it is more complicated due to the fact that the tooth is not fully out of the gums. Nonetheless, it still does not require your jaw to be broken to have the tooth extracted. Although sometimes the tooth needs to be cut in half.
Removing fully impacted wisdom teeth
Fully impacted wisdom teeth are the most difficult teeth to remove because most or all of the tooth is encased within the bone. You often can't really see the tooth or can only see a tiny portion of it. In order to extract a tooth like this, you will need to cut through the gums and drill through all of the bone which encloses it.
Despite your vivid imagination, breaking your jaw is not required to remove full bony impacted wisdom teeth. That is excessive because you only need to drill away the bone which is covering the tooth. That amount of bone is about half an inch to an inch in surface area at most.
Perhaps if you were doing jaw reconstruction surgery, you would need to involve the whole jaw. However, for a single tooth you do not need to involve the entire jaw at all.
How to remove fully impacted third molars:
Administer local anesthesia to the jaw.
Reflect the gums and lay a flap using a scalpel.
Expose the tooth by peeling back the gums.
Drill away bone that may be covering the tooth.
Section the tooth into multiple pieces using a drill.
Elevate the pieces with an elevator.
Deliver loose pieces of tooth with a forcep.
Curette the socket to remove infection and granulation tissue.
Smooth down any sharp bony spicules with a bone file.
Irrigate the socket thoroughly to flush out debris.
Place stitches to close up the hole as best as you can.
For third molars in this condition, you will most likely need to section the tooth in order to get it out. What we mean by this is that you cut the tooth up into multiple pieces because that makes it easier to extract. These individual pieces have more favorable paths of removal that aren't locked in by bony undercuts.
Broken jaw as a consequence of extractions
Just to be clear it is never necessary to break your jaw in order to take out wisdom teeth... However, your jaw can be broken as a result of extracting wisdom teeth because it is a possible complication. Albeit it is a rare complication and does not happen very often but nonetheless it is possible.
Studies have shown that patients with osteoporosis and are on medications for it are at a higher risk for bone fractures. This includes possible complications with extractions as well.
According to the Canadian dental association, one of the most common site of occurrence for a jaw fracture following extraction of a wisdom tooth are vertically impacted lower wisdom teeth positioned at the inferior border of the mandible.
Risk factors for jaw fracture from extraction:
Anomalies in tooth morphology: long or bulbous roots, hypercementosis, and multi-rooted teeth
Pathoses: cysts, ankylosis, osteoporosis, and alveolar atrophy or very dense bone
Large elevators used as levers, rather than in a rotary fashion
Impacted teeth which require bone removal, particularly those that involve the inferior border of the mandible
Signs of jaw fracture from extraction:
Crunch or loud crack of bone breaking during procedure
Sudden loosening of the tooth or bone
Bone comes out tooth during extraction
Observable malocclusion, opening of the bite, separation of teeth, or step defect; Basically the bite will be off.
Radiographic evidence of fracture in mandible
Patient may complain of sharp pain at the time of fracture or may be completely asymptomatic
How to fix a broken jaw
If your jaw does indeed break during the procedure, you will need to repair it. The procedure or process to do it is referred to as reduction or reducing the fracture. There are typically two ways to do it: open reduction vs closed reduction.
Open reduction - your doctor will surgically expose the fracture site and manually place the bones back together. This will involve plates and screws to hold the jaw in place afterwards.
Closed reduction - your doctor does not need to surgically expose the fractured bones. This typically involves a braces like device that wires your mouth shut for a few weeks.
Yes, both procedures will require a hospital visit because there are no dentists that will do this as an outpatient service. It is a legitimate surgical procedure that requires professional intervention. In case you were wondering if the trend of drinking pineapple juice after wisdom teeth removal can fix this, it won't.
The Verdict
It is unnecessary to break the jaw regardless of the condition that the wisdom teeth are in. It doesn't matter how impacted they are because in order to remove them only requires drilling away the necessary bone to expose the tooth. That amount of bone is small in comparison to the entire jaw so if you were worried about your jaw breaking that would be an unwarranted concern.
With that said, your jaw can break as a result of taking out the tooth and not because it is needed to remove it. The reason is because a broken jaw is a possible complication of wisdom teeth removal. However, it is a very rare occurrence and most dentists will never get the chance to experience it in their lifetime.
To close this out, we just wish to emphasize that it is important to go for your biannual dental check ups because you can prevent possible complications like this. Your wisdom teeth start growing in approximately when you're college age. If your dentist anticipates it being a problem, you can have them removed before the tooth is fully grown. That can circumvent and avoid a lot of problems!
We're just checking but if you happen to be nearby in NYC, our office does offer wisdom teeth removal services in Long island City.
