Wisdom teeth

Authored By: Greg Johnstone
Reviewed By: Robert V. Fontanesi, DDS 
Wisdom Teeth Challenges vs. Advantages

Wisdom teeth molars typically develop at age 10 and may begin to surface any time during adolescence or in a person’s twenties. In many cases, wisdom teeth (also known as third molars) may become impacted against adjacent teeth, preventing them from surfacing. Impacted wisdom teeth may become painful and problematic, at which point they are often extracted through minor oral surgery.

Dentists are keenly aware of the disadvantages of keeping wisdom teeth, some of which include the potential shifting of surrounding teeth, jaw pain, and interruptions with normal sinus functionality. Yet, the decision to extract is your dentist’s.

To Extract or Not to Extract?

Dentists previously determined whether to extract wisdom teeth using the only diagnostic tool they had at their disposal: a dental examination. 
Dentists may use one or more dental technologies during a dental examination to diagnose the necessity for a wisdom tooth extraction (such as panoramic and digital X-rays). These technologies can help determine candicacy for extraction and the best means to approach the procedure. They are also used to help identify additional risks that may impact your dentist’s approach to the procedure, such as the anatomical features of the tooth and surrounding structures. 
The complication risks associated with extraction for people over 35 are greater than those of younger candidates. People over 50 faced with extraction are at a greater risk of complications because the bone fuses to the teeth as we age. There is also a risk of numbness in the extraction area.
Ultimately, if you wait to remove wisdom teeth until there is cause for medical concern, the risk for all complications increases. Today, dentists often recommend removing potentially problematic wisdom teeth by age 18.

Wisdom Teeth Extraction

The removal of wisdom teeth prior to eruption involves a surgical procedure that is far from a simple extraction. Some general dentists have the skill required to remove impacted or un-erupted wisdom teeth; however, most people require the services of an oral surgeon. In fact, many patients prefer to be asleep or heavily sedated for the procedure. Thus, dentists performing wisdom teeth removal must have the equipment and skill necessary to sedate or provide general anesthesia to patients (see sedation dentistry).
The risks involved with extracting a wisdom tooth include, but are not limited to:

  • Pain
  • Bleeding
  • Swelling
  • Persistent sinus opening
  • Lower lip numbness

Wisdom Teeth Challenges vs. Advantages

Authored By: Greg Johnstone
Reviewed By: Robert V. Fontanesi, DDS 
Wisdom Teeth Basics 
The dental community knows more than ever before about the consequences of not extracting impacted wisdom teeth. If impacted wisdom teeth are not extracted, the following may occur:
Teeth Shifting: Impacted wisdom teeth may shift surrounding teeth, causing bite irregularities and pain.
Bone Loss and Jaw Expansion: Impacted wisdom teeth may play a role in bone loss and expansion of the jaw.
CongestionWisdom teeth may contribute to sinus congestion and headaches.
Cysts and Tumors: Impacted wisdom teeth may be a factor in the development of bone destroying tumors or cysts, including cyst formation in the surrounding gum tissue.
Gum Tissue Irritation: Gum tissue surrounding impacted wisdom teeth tends to be more susceptible to gum irritation. If wisdom teeth do not fully erupt and become crooked, it may become difficult to adequately clean the gums.
Periodontal Pockets, Cavities and Bone Loss: Difficulty cleaning gums makes it easy for debris to be lodged, creating the perfect setting for bacteria. The resulting bacteria may produce periodontal pockets, create cavities and lead to bone loss.
Changes in Orthodontia and Dentures: For children, wisdom teeth may adversely affect the results of orthodontia. For the elderly, wisdom teeth may undermine the functionality of dentures.

The Advantages of Keeping your Wisdom Teeth

Wisdom teeth have advantages as well. For example, they can provide support for a dental bridge, or fill in the space left by a missing molar. Furthermore, some scientists believe that wisdom teeth may serve as a future stem-cell source for the development of new teeth.