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Although not everyone needs to have their wisdom teeth pulled, for most of us, the day comes when these teeth — located at the very back of the mouth, top and bottom — will cause a problem and need to be removed. This is because most jaws are too small to fit four fully erupted wisdom teeth, also called third molars. Even when the teeth fit, they’re usually so far back in the mouth that it’s extremely difficult to keep them clean, which can lead to gum disease or tooth decay.

Wisdom teeth are typically the last teeth to develop, coming in between the mid-teenage years and the early twenties. If they grow in completely, chew well, don’t show signs of decay or gum disease and don’t cause pain, they don’t need to be removed.

When wisdom teeth are impacted

In some cases, wisdom teeth aren’t able to break all the way through the gums. Impacted wisdom teeth can cause infection and other oral health problems. Signs that you might have an impacted wisdom tooth include pain, bleeding and swelling of the gums.

But just because you can’t see your wisdom teeth doesn’t mean they’re impacted: In 10 to 25 percent of Americans, one or more third molars never grow. Your dentist or oral surgeon can assess and diagnose impacted wisdom teeth using X-rays. He or she will discuss with you whether there’s room for them to erupt and how difficult it will be to have them removed, should that become necessary.

It’s best to remove impacted wisdom teeth before their root structure is fully developed. In some patients, that’s as early as age 12 or 13, and in others not until the early twenties. The American Association of Oral and Maxillofacial Surgeons has conducted studies that show the best time to have third molars evaluated by an oral surgeon is by the time a patient is a young adult. Problems with impacted teeth come up more frequently after age 30.

About the Center for Oral Surgery & Dental Implants: Our five oral surgeons — Dr. Richard Panek, DDS; Dr. Julie Billups, DDS; Dr. Emily Van Heukelom, DDS; Dr. Roseanna Noordhoek, DDS; and Dr. Justin Pisano, DDS — provide the highest quality care to patients in Grand Rapids and the surrounding areas. Services include dental implants, Teeth-in-an-Hour, bone grafting, wisdom tooth extractions and replacement of missing teeth. We also treat facial trauma and perform jaw surgery, including for TMJ. The Center for Oral Surgery & Dental implants has two offices, both of which are fully equipped for ambulatory anesthesia and oral, maxillofacial and dental implant surgery. Office locations: 4349 Sawkaw Drive NE, Grand Rapids, MI 49525 and 158 Marcell Drive, Suite B, Rockford, MI 49341.

We provide the highest quality care to patients in Grand Rapids and the surrounding areas. Services include dental implants, Teeth-in-an-Hour, bone grafting, wisdom tooth extractions and replacement of missing teeth. We also treat facial trauma and perform jaw surgery, including for TMJ

The SARS-COV-2 viral pandemic has changed most aspects of our work and home lives. Dentists are on the frontlines of possible exposure to the SARS-COV-2 virus that causes COVID-19 disease. Recent case studies have identified the likelihood that the virus is most commonly being transmitted via aerosols. Dentists have the highest risk of exposure to asymptomatic carriers of the virus due to working in the mouth. Not only that, common dental procedures produce aerosols suspended in the air that could contain the virus from asymptomatic carriers.

High cost advanced PPE (personal protective equipment) like n95 masks and face shields are used to protect the dental team. However, once aerosols are generated, they can circulate thru space and pose a risk to unprotected individuals. Containing and controlling aerosols is a major focus in dentistry. Many dentists are using enhancements to their HVAC (heating, ventilation, air conditioning) systems to help filter out potentially disease-causing aerosols. Stand-alone HEPA filtration units incorporating UV light disinfection (air purifiers) are the easiest way of improving air quality. Most of these units however do not have uniform regulatory certification of efficacy. They may have undergone consumer product testing, but none have certified the ability to fully capture and kill SARS-COV-2 virus.

One can assume that a HEPA filter would trap the most likely sized aerosol particle that could carry the SARS-COV-2 virus 99.9% of the time. Like n95 masks however, the HEPA filter does lose efficiency over time. The UV light will deactivate virus but this depends on the speed of airflow and how much UV contact time is necessary for kill. The analogy is driving your car thru the carwash at 30 miles an hour. How clean will it really get?

In addition to stand-alone air purifier units, there are other options that could be used to improve air quality. HVAC contractors can install powered HEPA filters to existing systems. These improvements can run from $3000-$8000 per unit. However, improving filtration can be as simple as changing to higher quality filters on the HVAC unit.  The American Society of Heating and Air-Conditioning Engineers (ASHRAE) created Standard 52.2-2017 to describe Minimum Efficiency Reporting Value (MERV). It is possible to purchase MERV 12-16 filters that can be a significant improvement over most common furnace filters.

Added filtration will require more frequent filter changes and some filters (especially dirty filters) will reduce the efficiency of heating and cooling because of lowering airflow. A common problem with insufficient airflow is a frozen AC coil within the HVAC unit. This will cause lack of cooling and water pooling around the HVAC unit. An inconvenience, but easily remedied.  More dangerous is low flow during the heating season which can cause a crack in the furnace leading to Carbon Monoxide poisoning.

Before doing any modifications, contact your local HVAC service provider. For more information on air quality, go to ASHRAE: https://www.ashrae.org/technical-resources/filtration-disinfection

The links below contain more technical information regarding advanced filtration: https://www.energyvanguard.com/blog/understanding-filter-ratings-merv-fpr-and-mpr

https://www.energyvanguard.com/blog/unintended-consequences-high-merv-filters Dr. Panek is a private practice Oral & Maxillofacial Surgeon practicing in Grand Rapids, MI.