Wisdom Teeth Wisdom

Wisdom Teeth

Wisdom Teeth get their name because they usually arrive about the time of adulthood (17-21 years of age). These teeth are sometimes recommended for early removal. Let’s discuss the conditions under which their removal may be recommended.

As you might expect the wisdom teeth perform a valuable service. Unfortunately, however, they very often do not fit properly in the mouth. Sometimes the wisdom teeth and the jaw which supports them just simply don’t match. They may come in crooked, only partially emerge or get trapped (impacted). When this happens, it can lead to other more serious, uncomfortable and costly problems.

Removal of wisdom teeth is often necessary when any of the following conditions occur:

  • When wisdom teeth only partially erupt. Pockets around these teeth provide an opening for entry of bacteria which lead to infection. Such an infection is not only painful but can also cause swelling and general illness.
  • When impacted wisdom teeth continue to form without adequate room. This development can place tremendous pressure on adjacent healthy teeth and thus damage them.
  • When a cyst or tumor forms in the area of wisdom teeth. Such an unwanted occurrence can destroy adjacent teeth, their roots or bone.

When Should Wisdom Tooth Removal be Done Early?

The wisdom of removing wisdom teeth before they cause trouble has long been debated. In only a small percentage of people do they grow in straight and healthy. The human jaw has been steadily decreasing in size for millenniums and few people have a jaw large enough to accommodate four more teeth in the back of the mouth.

While some specialists say. “Don’t bother them until they bother you,” most believe it is better to get malpositioned wisdom teeth out when you are young and healthy, since they are likely to cause trouble eventually.

Both sides have good reasons for their views. The “don’t bother them” school cites the cost and discomfort of pulling teeth, some of which will never cause trouble. Those who advocate removal note that as patients age the surgery becomes more difficult, the complications more numerous and the recovery more prolonged.

Controversy Over Wisdom Tooth Extraction

In an effort to resolve the controversy the National Institute of Health held a conference in 1979. It was agreed that straight healthy wisdom teeth should be left alone and that those that are diseased or causing trouble for other teeth should be removed. But the main issue, whether impacted but otherwise healthy wisdom teeth should be pulled to prevent trouble was never resolved.

No such study had begun before 1979 conference, and despite the panel’s recommendation none have been started since. Such a study would follow large numbers of people for many years to see what happens to their impacted wisdom teeth. Experts now have only on e small study from which to judge; in it, most other 60-to 70- year- olds who still had their wisdom teeth had no evident disease in their impacted teeth.

Not unexpectedly, American Association of Oral and Maxillofacial surgeons recommends early removal of impacted wisdom teeth.

Here at Almaden Dental Associates we recommend that each case be evaluated individually