Do I Really Need to Have My Wisdom Teeth Removed?

Winter break is approaching, and for a lot of high school and college students, this may mean it’s time to have their wisdom teeth removed.  Does everyone need to have their wisdom teeth removed?  Not necessarily.  There are many criteria that dentists evaluate to determine whether or not a patient’s wisdom teeth need to be removed.  There are also different criteria that we use to determine when they should be removed.  As with any type of medical procedure, there are risks and benefits, and we always weigh the risks vs. benefits to determine if the procedure is right for each specific person.

What are wisdom teeth?

Wisdom teeth are the third set of permanent molars in an adult mouth.  The first molars come in, or erupt, at about age 6-7 years, so they are also referred to as 6 year molars.  The second molars erupt at about 12 years of age and are also called 12 year molars.  If third molars erupt at all (many do not; instead they stay hidden under the gums), it’s typically between ages 18-25, so they’ve earned the nickname “wisdom teeth”.

Who can keep theirs?

Unfortunately, not many people fall into the category of those who can keep their wisdom teeth with minimal risk of future problems.  In order to keep wisdom teeth with the least risk of cavities and gum disease, people need to have:  1) very large jaws with enough room for the wisdom teeth to fully erupt (come through the gums into the mouth), 2) wisdom teeth that are erupting in the correct alignment with the rest of the teeth, and most importantly, 3) great oral hygiene.  The average adult jaw does not have enough space behind their second molars for another molar to naturally reach the correct position for chewing and proper cleaning.

What are the risks of keeping them?

Assuming wisdom teeth have enough space and do come into their correct position behind the second molars, they are located in an area that is very difficult to keep clean.  Even the best brushers and flossers have trouble reaching the back of a wisdom tooth.  This leads to an accumulation of plaque and bacteria and food debris, which in turn, leads to tooth decay and gum disease.    This accumulation of bacteria also predisposes the adjacent second molar to both cavities and gum disease.

When wisdom teeth do not have enough space to fully erupt into the appropriate location, several problems can occur.  If the location of the tooth causes it to be partially covered by gum tissue, there is a very high risk of pericoronitis, an inflammation of the gum tissue that surrounds and often lays over the top of the tooth.  Because this partial covering creates a pocket where plaque and food can collect, painful inflammation easily develops, and can even lead to an infection.

When wisdom teeth are positioned at an angle, they are unable to erupt into the mouth (this is referred to as “impacted”) and can damage the adjacent jaw structures, as well as any adjacent teeth.  When this occurs, often both the second and third molars have to be extracted.

Why take them out preventively?

If your dentist determines that you are at risk for any of the problems noted above, she will recommend preventive extraction of the wisdom teeth and refer you to an oral surgeon.  This prevents potential pain and suffering from problems with the wisdom teeth themselves, and also protects the second molars from the higher risk for cavities and gum disease associated with the presence of wisdom teeth.

Why so young?

Teeth form from the biting surface down toward the roots.  At age 18, a wisdom tooth is much smaller than it is at age 25.  Earlier extraction of wisdom teeth means the removal of a much smaller tooth.  This results in smaller surgical site, smaller extraction sockets, quicker healing, and lowest risk of future infections.  Later extraction, after the tooth has fully formed roots, leaves the patient with a larger surgical site, a larger socket, and longer healing time.

Still have questions about your wisdom teeth?

Call our office at 940-382-1750 to set up a consultation with Dr. Chowning.  He will evaluate your wisdom teeth using 3D imaging technology to determine whether or not you (or your child) need to have your wisdom teeth removed.

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