OC HIGH: STUDENT NEWS AND VIEWS : Tooth or Consequences : It is a cruel twist that they are called wisdom teeth; what they bring teens has nothing to do with intellectual growth. Try grief and pain. : Tooth or Consequences

We sit in classrooms 30 hours a week, labor over homework until the midnight hours and madly cram for tests. We don’t need wisdom teeth to prove our intelligence. And frankly, we don’t need the aggravation they bring us. Still, they emerge. Usually at the ripe old age of 15 to 20.

And, to add injury to insult, most of us will have these symbols of newly found “wisdom” yanked. Why? Because they wreak havoc in jaws and, as it turns out, they are useless.

Wisdom teeth, also known as the third molars, were not always purposeless.

Back in the Stone Age, you couldn’t grab a Big Mac or pick up processed food in your grocer’s freezer--you had to hunt for your food. And that food was not as “chewer friendly.” So the wisdom teeth provided caveman with a larger surface for grinding dinner into swallowable bits.

But it is not the fact that wisdom teeth are now obsolete that encourages our dentists to remove them; it is the problems they create in the back four corners of our jaws.

As a matter of fact, the four wisdom teeth, which most adults and teen-agers have, can be rather demonic.

The most common problem is that the jaw is just too small to accommodate them. A wisdom tooth may become impacted, or stuck under another tooth, or ram into an adjacent tooth. This can raise, shift and twist teeth, resulting in malocclusion.

Malocclusion is a condition in which the top and bottom teeth do not fit together when biting down. It can hinder chewing and personal appearance, not to mention reversing the work of any past orthodontics.

Wisdom teeth can also increase the chance of gum disease because their position makes them difficult to clean and floss properly. These pearly whites can also lead to temporomandibular joint dysfunction. This condition is caused by an imbalance between the jaw joint and its muscles, resulting in jaw clicking and ear pain. Wisdom teeth are also prone to decay, even if they remain under the gum.

If you are a likely victim of any of these problems, a dentist or orthodontist will refer you to an oral surgeon. An oral surgeon is a specialist in tooth extraction as well as other dental operations. The oral surgeon will set you on your way to having your wisdom teeth pulled.

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The first step of the process is the consultation. Typically a half-hour visit, the consultation is the time for a patient--and a parent, if the patient is under 18--to meet with the doctor before the surgery to discuss procedures and alternatives. Besides having your blood pressure and pulse taken and your medical history reviewed, the oral surgeon will look at your dental X-rays and make a diagnosis.

Although one wisdom tooth may be causing all the problems, oral surgeons frequently recommend having all four wisdom teeth extracted. This is because those other wisdom teeth could come back to haunt you later in life. “If you have all four out, you only have to go through the pain and the anesthesia once,” said Rex Moody, an oral surgeon in Mission Viejo.

Nonetheless, it is your parents’ and your duty to weigh the risk and decide how many wisdom teeth to part with.

The next step on the road to wisdom tooth extraction is surgery.

You may be biting your nails or chattering your teeth on the day of surgery, but try to relax. Don’t turn to coffee or snacks to soothe your frayed nerves. No food or drink can be ingested six hours before surgery because of the anesthesia.

It seems silly to think about what you will wear to your wisdom tooth extraction, but it is important. Plan to wear a loose-fitting, short-sleeved shirt that makes it easy for your blood pressure to be taken. Do not wear contact lenses if you will be under general sedation.

Once in the operating room--usually in the office of the oral surgeon--you will have your blood pressure and pulse checked. A pulse oximeter will be hooked onto your finger. This is a harmless and painless device that simply reads your pulse and measures the oxygen in your blood by shining a light into your finger. The pulse oximeter helps the oral surgeon monitor your condition throughout the surgery.

If you think you will look like a firefighter wearing a gas mask during all this, think again. Oral surgeons seldom use gaseous anesthesia now. Many prefer intravenous methods for giving anesthesia because it is easier to control and has fewer side effects than its gaseous counterpart. Unfortunately, that means you’ll have to endure the pinch of the needle. Don’t despair. It will only be a little pinch because “the needle is smaller than that for a blood test,” Moody said.

It’s time to operate.

The oral surgeon will probably sedate you with Valium. Within 90 seconds, your eyelids will become heavy and your speech slurred. Next, Brevital probably will be used to make you fall asleep. Brevital is a light anesthesia that works within 30 seconds but still allows you to breath and swallow by yourself. After you are sedated, the oral surgeon will further anesthetize your gums with Lidocaine, and then you will be ready to have your wisdom teeth extracted.

Chris Bowers, a 17-year-old junior at Capistrano Valley High School in Mission Viejo remembered it this way: “One minute you are asleep, and the next minute you are awake with holes in your mouth.”

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The procedure is not so simple for the oral surgeon. The manner in which those teeth are yanked depends on their depth below the gum.

If the wisdom tooth has poked through the gum, forceps will be used to wiggle the tooth. With some coaxing, the bone that holds the wisdom tooth will lean open, and the tooth will fall out.

Teeth that are still hiding under the gum take more time and effort to remove. The oral surgeon will first make an incision in the gum over the wisdom tooth and lean the gum back. Then a small drill will be used to make a trough around the tooth. Lastly, an elevator, a tool that raises the tooth, is used to position the tooth for easy removal.

But what if a tooth is sideways or stuck under another tooth? The oral surgeons will use the same procedure as for a tooth still under the gum, except they will section the tooth. In other words, a drill will be used to cut the tooth into halves or thirds and each portion will be removed separately. “Sectioning a tooth reduces the risk to adjacent teeth and to the jaw,” said Moody, a 16-year veteran of oral surgery.

The whole procedure lasts roughly 30 minutes. Plan to have someone drive you home and, to be on the safe side, do not drive or play sports for 24 hours after surgery. And plan to rest the remainder of the day. Bowers said: “I laid in bed all day. I almost felt like I was sick because when I’d sit down and get up, I would see big patches of black.”

Count on some pain, too. The lower wisdom teeth, near the masseter muscle, are a greater source of that irritating feeling than the upper wisdom teeth. “Any time you deal with a muscle attachment there will be more swelling and stiffness,” Moody said.

To bring that pesky pain to its knees, eat some soup or soft foods like yogurt or ice cream when you come home so that you can take Tylenol or prescription pain pills. Don’t make the mistake of taking these medications on an empty stomach--it could add to your discomfort by making you nauseous. Ice should also be applied soon after surgery. This will reduce swelling.

Bleeding is expected because it is a signal your body is healing. Biting down on gauze or tea bags for 30 minutes will generally stop the bleeding. If the bleeding persists, call the oral surgeon.

You are exempt from brushing your teeth on the day of the surgery. Continue your brushing routine and rinse with salt water the following day.

Several complications may be involved with having your wisdom teeth pulled. Some people experience cold-like symptoms. This is because the roots of the upper wisdom teeth sit near or in the sinuses. Removing the wisdom teeth can put pressure on the sinus or even make a hole in it. The cold that develops as a result will pass in two to five days.

Numbness of the teeth, lower lips and chin occurs in 1% to 2% of cases, Moody said. This is because the lower wisdom teeth, near the mandibular nerve, can traumatize the nerve. Sensation will return within six weeks in most cases. Teen-agers are seldom afflicted because their roots are shorter and less tangled in the nerve.

The last complication is called the dry socket. A dry socket is a condition in which the blood clots continue to be dislodged and a hole exposing the bone is left open in the mouth. Smokers are particularly vulnerable to this painful problem. Doctors can treat this condition with medicated packs for the gums.

Now for the financial damage: The price of wisdom tooth extractions ranges from $150 to $300 per tooth. The cost is dependent on the depth of the tooth beneath the gum. In addition, general anesthesia costs range from $150 to $250.

After a follow-up visit with your surgeon, you will finally be free of the wrath of your wisdom teeth.

Give yourself a pat on the back for your bravery and revel in the knowledge that you have lived through yet another experience that has made you--admit it--a little wiser.