Wisdom teeth or third molars sometimes need to be extracted because they do not fit into the available space in the mouth. This can lead to crowding of teeth or gum infections. An OPG x-ray will reveal the relationship of the wisdom teeth to their surrounding structures.
Wisdom teeth are the last teeth to erupt usually between the ages of 17 and 25 years. They develop behind the 2nd molar tooth and have no deciduous predecessor. With sufficient space they erupt into a favourable position in alignment with the other dentition. However, if they are impacted an x-ray will assist your dentist in assessing their potential for harm.
A tooth becomes impacted due to lack of space in the dental arch in its eruption path. It is therefore impeded by gum, bone or another tooth. Lack of space occurs because our jaws have become smaller through evolution and the size of our teeth has not decreased much.
Wisdom teeth generally cause problems when they erupt partially through the gum. The most common reasons for removing them are:
Saliva, bacteria and food particles can collect around an impacted wisdom tooth, causing it, or other teeth to decay. It is very difficult to remove such decay. Pain and infection will usually follow.
When a wisdom tooth is partially erupted food and bacteria collect under the gum causing a local infection. This may result in bad breath, pain, swelling and trismus (inability to open the mouth fully). This infection can spread to involve the ear, cheek and neck. Once the initial episode occurs, each subsequent attack becomes more frequent and more severe.
Pain may also come from the pressure of the erupting wisdom tooth against other teeth. In some cases this pressure may cause the erosion of these teeth.
Many younger patients have had prolonged orthodontic treatment to straighten teeth. Wisdom teeth may cause movement of teeth particularly the front teeth when they try to erupt and this will compromise the orthodontic result.
Patients who are to have dentures should have any wisdom tooth removed. If a wisdom tooth erupts beneath a denture it will cause severe irritation and if removed, the patient will need to have a new denture constructed, as the shape of the gum will have changed.
A cyst (fluid filled sac) can develop from the soft tissue around an impacted wisdom tooth. Cysts cause bone destruction, jaw expansion and displacement or damage to nearby teeth. The removal of the tooth and cyst is necessary to prevent further bone loss. Rarely, tumours may develop within these cysts or the jaw may fracture spontaneously if the cyst grows very large.
Impacted wisdom teeth are almost certain to cause problems if left in place. This is particularly true of the lower wisdom teeth. Such problems may occur suddenly, and often at the most inconvenient times.
It is now recommended by specialists that impacted wisdom teeth be removed between the ages of 14 to 22 years, if it predicted that they are likely to cause harm at some time in the future. Surgery is technically easier and patients recover much quicker when they are younger. What is a relatively minor operation at 20 can become quite difficult in patients over 40. Also the risk of complications increase with age, and the healing process is slow.
Generally, no. Surgery in the presence of infection can cause infection to spread and become more serious. Firstly, the infection must be controlled by local oral hygiene, antibiotics and sometimes the extraction of the opposing wisdom tooth.
Some pro’s of removing wisdom teeth:
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