Currently, research and clinical experience indicate elective extractions of wisdom teeth for the majority of young adults. However, visiting your dentist for a wisdom teeth evaluation is the wisest decision you can make.
For those looking for a trivia question, there are usually 32 teeth present in the human mouth. The last of these teeth to erupt are third molars. They are nicknamed wisdom teeth, due to their delayed eruption during young adulthood, when an individual is “wiser.” While some parents would beg to differ with the the nickname, they routinely ask, is it wise to have your wisdom teeth removed as a preventative measure?
The American Dental Association recommends that each individual have their wisdom teeth evaluated between the ages of 16-19. This typically includes a panoramic radiograph of the head and an intraoral exam. The radiograph and exam allows your dentist to interpret if all four wisdom teeth are indeed present, their position, presence of periodontal (gum) issues and cavities and level of impaction.
Why Wisdom Teeth Can Lead to Problems
Long ago, the human jaw was much larger, allowing more room for wisdom teeth which aided in grinding dense plants. Since then, our diet has changed and wisdom teeth have become a vestigial part of the body, meaning they had a function at one point in time, but they no longer serve a purpose (like the appendix). In my experience, the large majority of young adults need their wisdom teeth extracted because they simply do not have enough room in their mouths. This lack of space leads to impaction: when a tooth does not fully erupt to its normal height. Wisdom teeth can become impacted, or “blocked”, by the jaw bones themselves, gum tissues and neighboring teeth.
Impacted teeth occur across a wide spectrum, but one thing they have in common is they are a nightmare to keep clean. Food and bacteria become caught in the tooth and gingival tissues which can result in severe pain and infection including:
- Pericoronitis — an infection and inflammation of the surrounding gum tissues
- Dental abscess — infection from long standing cavities
- Cavities and bone loss of the neighboring second molars
- Cysts within the jaws and rarely
- Benign tumors
If your dentist recommends extracting wisdom teeth, you commonly will want to have the procedure done before the roots have completely formed, usually late teens to early twenties. The procedure itself is usually a minor surgery that can be done under local anesthesia. For more apprehensive patients, nitrous oxide or “laughing gas”, oral sedation (ex. Valium) or IV/conscious sedation can be used. Your general dentist may elect not to perform wisdom teeth extractions and refer you to an oral surgeon, especially if you require IV/conscious sedation.
Reasons NOT to Have Wisdom Teeth Removed
Reasons not to not have your wisdom teeth removed include:
- The patient has enough room and can adequately clean the tooth and gum tissues
- The tooth is completely impacted and covered by the bone and gum tissue (Let sleeping dogs lie!)
- Roots have completely formed near or around the inferior alveolar nerve (which supplies all of the lower teeth, chin and lip)
- Medical concerns
- Patient’s age is a large determining factor
Typically, if the patient is older than their mid to late-twenties, we do not perform elective wisdom teeth extractions. At this point, roots have completely formed and the jaw bones are denser which can complicate surgery leading to delayed healing and very rarely jaw fracture or numbness.
Do you live in the Canton, Ohio, area and need a wisdom tooth evaluation? Contact Mercy Dental Service for more information.