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DO I REALLY NEED TO REMOVE MY WISDOM TEETH?

By: Jacques Doueck, D D S



I was prompted to write this article because of two adult patients who suffered severe damage, infection, and swelling because they delayed taking out wisdom teeth .One of them actually broke his jaw because of a wisdom tooth that should have been removed long ago. The patient, 48 years old, lost both teeth and the fractured jaw forced him to eat baby food for six months. The other patient was 65 years old and had to have the wisdom tooth and the adjacent molar removed.

Keeping your wisdom teeth past your twenties may not be so wise after all, according to the results of a seven-year research study by the American Association of Oral and Maxillofacial Surgeons (AAOMS). Keeping poorly positioned wisdom teeth puts you at higher risk of developing infections of the gums and jaw bone.

Of course, it would be foolish for a dentist to recommend that everyone should remove their wisdom teeth. We consider many factors, such as proximity to the cheek, whether the tooth is impacted, and the condition of the bone, gums and teeth. Once a well thought out decision is made, postponing wisdom teeth removal may be more complicated and require a longer recovery period with damage to adjacent teeth, sinus, and jaw bone that may not be easy to repair.

If you do not have enough room in your mouth for your wisdom teeth, they can cause a multitude of problems, such as:

   Infection – Without enough room for the wisdom tooth to come in, the gum tissue around the wisdom tooth can become irritated and infected, resulting in recurrent pain, swelling and problems with chewing and swallowing.

   Damage to Adjacent Teeth – If it is difficult to clean around the wisdom tooth, the tooth directly in front of the wisdom tooth, the second molar, can be affected, resulting in gum disease (bone loss), cavities and root canal.

   Cysts – Cysts are fluid-filled “balloons” inside the jawbone which are associated with impacted wisdom teeth and slowly expand, destroying adjacent jawbone and occasionally adjacent teeth. Although rare, certain tumors can be associated with impacted teeth. Both of these conditions can be very difficult to treat.

If a wisdom tooth is completely horizontal, the chances of bone disease are so high that we can predict with pretty good probability that in 10 or 20 years that person will have gum and bone problems that will pose a risk to other teeth.

A wisdom tooth that comes only part way through the skin leaves a person open to high risk of decay and infection. A wisdom tooth is very difficult to clean, even when it looks like it is in a good position, because it is far back against the upward curve of the jawbone. Sometimes you can’t even get a toothbrush back there.

The longer you wait, the higher the risk of complications. There is risk of infection, some risk of jaw fracture, cavities and root canal on the adjacent teeth, gum disease and more. Delaying wisdom tooth removal may result in many serious complications, such as numbness of your lip for a couple of years or even for life due to nerve damage when the tooth is pulled.

So before you refuse your dentist’s advice to remove your wisdom teeth because you feel like “it doesn’t hurt,” consider all the risks and potential long term consequence.

Wisdom Teeth FAQ

Q. Do wisdom teeth cause crowding of the front teeth?

A. No. A 20-year study showed that crowding occurs with or without the wisdom teeth. So this is not a reason to remove your wisdom teeth.

Q. Should wisdom teeth be removed routinely even if there are no problems?

A. No. Removal of wisdom teeth is a surgery, and we don’t want to put our patients through surgery unless there is a high risk of damage by keeping them. X-rays and visual exam allow us to help patients with this important decision.

Q. What is the best age to have your wisdom teeth removed?

A. Usually between 16 and 18 years old. Without a doubt, younger patients (teenagers) heal faster, in a more predictable fashion and with fewer complications than older patients.

Q. What if I don’t have them removed now?

A. The problem with taking a “wait and see” approach is that if it becomes necessary to remove a wisdom tooth in your thirties or beyond, it is much more difficult for you as the patient and the potential complications are much greater.