When it comes to wisdom teeth, early evaluation and careful diagnosis is crucial. In most instances, wisdom teeth need to be removed to avoid the initiation of problems with other adjacent structures like gum tissues, cheek, jaw and other teeth. The ideal ages for evaluation and treatment are between 18-24. The sooner wisdom teeth are evaluated, the better. It is important to understand that not all wisdom teeth need to be extracted. I still have mine. They are all fully erupted and functional and I have no intentions of parting with them.
Wisdom teeth are the third and final set of molars that most people get in their late teens or early twenties. Sometimes these teeth can be a valuable asset to the mouth when healthy and properly aligned, but more often, they are misaligned and require removal.
Wisdom teeth present potential problems when they are misaligned – they can position themselves horizontally, be angled toward or away from the second molars or be angled inward or outward. Poor alignment of wisdom teeth can crowd or damage adjacent teeth, the jawbone, or nerves. In addition, wisdom teeth can be entrapped completely within the soft tissue and/or the jawbone or only partially break through or erupt through the gum. Teeth that remain partially or completely entrapped within the soft tissue and /or the jawbone are termed “impacted.” Wisdom teeth that only partially erupt allows for an opening for bacteria to enter around the tooth and cause an infection, which results in pain, swelling, jaw stiffness, and general illness. Partially erupted teeth are also more prone to tooth decay and gum disease because their hard-to-reach location and awkward positioning makes brushing and flossing difficult.
The Effect of Wisdom Teeth on Second Molars
Wisdom teeth that are crowded or impacted can cause potential damage to adjacent second molars (the tooth in front of the wisdom tooth). If misdirected wisdom teeth are erupting adjacent to a second molar, resorption of the root or decay in the crown of the second molar can develop which will cause the second molar to either need a root canal or become extracted. This is the worst case scenario if both molars have to be lost. If found early enough the second molar can be saved with root canal treatment. Better yet, if evaluated between the ages of 18-24, the need for extraction of the wisdom tooth can be determined and the second molar would never have any insult.
What justifications are given for wisdom tooth extractions?
- Valid reasons to extract wisdom teeth.
◦Pericoronitis / Infection associated with a wisdom tooth.
◦Complications associated with tooth decay.
◦Periodontal disease (gum disease).
◦Pathology (cysts, tumors) associated with a wisdom tooth.
◦Chronic pain or discomfort.
◦Risk of damage to adjacent teeth / Root resorption