Wisdom tooth extraction, also called removal, is a surgical procedure to take out one or more wisdom teeth. These are the four permanent adult teeth located at the back corners of your mouth on the top and bottom. Typically, they erupt (grow in) sometime between the ages of 17 and 25.

Wisdom teeth are the last permanent teeth to appear or erupt in the mouth. These teeth usually come through the gums between the ages of 17 and 25. They may come through partially or not at all. Some people's wisdom teeth never come through. For others, wisdom teeth appear just as their other molars did, causing no problems.

Many people have impacted wisdom teeth. These teeth don't have enough room to appear in the mouth as usual.

An impacted wisdom tooth may:

• Grow at an angle toward the next tooth, the second molar.

• Grow at an angle toward the back of the mouth.

• Grow at a right angle to the other teeth, as if the wisdom tooth is "lying down" within the jawbone.

• Grow straight up or down like other teeth but stay trapped within the jawbone.

If a wisdom tooth, also known as a third molar, doesn't have room to grow, it can become impacted. If an impacted wisdom tooth causes pain, infection or other dental problems, you'll likely need to have a dentist or an oral surgeon remove it. Some dentists and oral surgeons recommend removing your wisdom teeth, even if they aren't causing problems. That's because these teeth can lead to problems later in life.

Evaluation may include clinical examination, plain x-rays, and possibly computed tomography (CT) scan, and laboratory testing such as white blood cell (WBC) count and erythrocyte sedimentation rate (ESR). Evaluation should determine whether there is persistent disease and whether or not reconstruction for dental prostheses is possible.

Treatment should be directed toward elimination of any active or persistent disease, and reconstruction, if possible. Treatment may include additional surgery to remove diseased tissue, antibiotic use, or hyperbaric oxygen therapy (HBO). Once healthy tissues have been restored, reconstructive surgery may be possible to prepare for dental implants or other prosthetic restoration. When this is not possible, disability may result from the missing teeth.

In most cases, the removal of wisdom teeth doesn't cause long-term complications. But you may need surgery to remove impacted wisdom teeth. Often, this surgery is performed with anesthesia to make you sleep and make you more comfortable during the procedure. This surgery involves cutting the gum tissue and taking out some bone around the teeth to remove them safely.

Rarely, surgical complications can include:

• Painful dry socket, or exposure of bone when the blood clot after surgery is lost from the site of the surgical wound. This site also is known as the extraction socket. Your body will heal a dry socket on its own. During this time, you will take medicines to reduce pain.

• Infection in the extraction socket from bacteria or trapped food particles. This usually occurs around two weeks after the procedure.

• Damage to nearby teeth, nerves, jawbone or sinuses.

• Nerve and blood vessel damage.

None

• These ratings apply only to bone loss through trauma or disease such as osteomyelitis, and not to the loss of the alveolar process as a result of periodontal disease, since such loss is not considered disabling

• For VA compensation purposes, diagnostic imaging studies include, but are not limited to, conventional radiography (X-ray), computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), radionuclide bone scanning, or ultrasonography.

• Separately evaluate loss of vocal articulation, loss of smell, loss of taste, neurological impairment, respiratory dysfunction, and other impairments under the appropriate diagnostic code and combine under 38 CFR 4.25 for each separately rated condition.