Let’s talk about wisdom teeth…
For most of us, the decision to remove wisdom teeth is considered in the late teens or twenties. Usually the concern is the risk of movement or crowding in the front teeth from the impacted 3rd molars. We all like to think we are making an informed decision based on what we have heard from others or read online. Like anything else, however, there is both accurate and inaccurate information available on the internet.
Fortunately, a task force was convened by the American Association of Oral and Maxillofacial Surgeons in March of 2007. They reviewed current literature with regard to all issue’s wisdom tooth related. My intention on this blog spot is to wade through the jargon and give you the best interpretation of what they report. Hopefully, this will guide you in your decision-making process!
Q: Can you tell if an erupting wisdom tooth is going to be impacted? And if so, can you tell which way it will try to erupt?
While it is impossible to determine if a third molar will be able to erupt all the way, usually a seasoned clinician can make an accurate estimate if the wisdom tooth will be impacted or not. How it would erupt is harder to determine. It boils down to evaluation of the amount of space left for another tooth behind the 2nd molar. There is nothing guaranteeing that a fully erupted wisdom tooth is free of problems either. These erupted 3rds can have as many or even worse consequences over time.
Q: Can wisdom teeth hurt the teeth in front of them?
Absolutely. The presence of impacted third molars adversely affects the gum and bone of the 2nd molars directly next to them. A lot of times we observe localized gum disease reducing bone levels in the area and creating pain, swelling and inflammation. Also, an occurrence known as “external resorption” can happen were the actual tooth structure of the 2nd molar is eroded away. These areas can also turn into “food traps” and potentially the adjacent molar can develop a cavity.
Q: Can the act of taking 3rd molars out cause problems in itself?
Yes. Any surgery has inherent risk of unwanted problems. The more common ones associated with 3rd molar removal are pain and swelling. Less common problems include “dry socket” and temporary numbness and taste loss in the area. In rare circumstances, the loss of sensation and taste can be permanent. Also, if the surgery to remove the wisdom teeth is very difficult, it is not uncommon to have jaw issues and pain after surgery. These usually subside with time, but can become a chronic problem if not dealt with correctly.
Q: What is dry socket?
Dry Socket is a slang term for a condition known as alveolar osteitis. It basically means inflammation of the boney tooth socket where a tooth was removed. It can be very painful and is commonly caused by improper post-surgery care and smoking too soon after teeth are removed. Although this problem can happen with any extraction, it is common with wisdom teeth because of how hard it can be to keep the areas clean after surgery.
Q: (The million dollar question) Do impacted wisdom teeth eventually cause crowding in the front teeth over time?
I am going to quote the paper on this because of how much debate there is on this very topic. “Despite good intentions, we are not able to explain, predict, or prevent dental crowding, no matter what the cause. While it is likely that third molars play a role in the etiology of crowding, they are only one factor to consider in making a clinical decision about third molar management. Therefore, it is prudent for clinicians to educate patients that the cause of dental crowding is multi-factorial and, while third molars may play a significant role in some patients, the current state of knowledge does not allow us to identify with accuracy who is at risk.”
It is my opinion that there are many reasons to remove wisdom teeth, but I do not believe dental crowding to be one of them.
Although this Q&A is not comprehensive, I do hope it will find those in need of accurate information. As always if more discussion is warranted, please give our office a call and schedule a consultation appointment!