Do Wisdom Teeth need to be removed?

But they aren’t bothering me! And for many patients their third molars, typically called wisdom teeth, can remain in place for their lifetimes. However, that is not always the case. The last teeth to erupt, and the furthest back in our mouth, Drs. Hochberg and Diora tell us that many times these teeth present problems that can impact adjacent teeth and even your overall oral health.

This set of molars, which are usually seen when patients are in their late teens or early twenties, don’t always come through the gumline fully, can erupt in a crooked manner, or they may even remain buried under the gumline. While this may not cause you discomfort at the moment, there is the potential for the development of problems down the road, causing the need for removal when it’s a more complicated and difficult procedure for the patient. The reason? As we age, the bone that surrounds the newly formed teeth becomes denser and hardens. And the roots are well formed, making them more challenging to remove.

When our wisdom teeth come in straight, upper and lower teeth are in good alignment, and the jaw has adequate room, our third molars serve to help in chewing. But these strong teeth also make us work a bit harder. While it’s said that they are called wisdom teeth due to the age at which they form, maybe part of their name is due to the fact that we need to be wise to properly care for them. Why? They are difficult to reach and clean properly when brushing and flossing. This is why so many patients who retain their wisdom teeth need fillings or crowns down the road in order to maintain them. And when the tooth is partially impacted (not completely erupted through the gum) there is often a space between the tooth and gums giving bacteria an open door policy that sets the site for infection. When the tooth is fully impacted (completely embedded in the bone) it often rests on the roots of adjacent teeth. The impacted tooth pushes on the root and can cause the healthy tooth next to the wisdom tooth to shift or can cause it to decay. When teeth shift and your occlusion, bite, is impacted, TMJ (temporomandibular – jaw) discomfort can develop. Also, impacted teeth must be regularly monitored if not removed.  Cysts can develop, and until the problem is advanced, is only detectable through x-ray. This creates voids in the surrounding bone and can also damage the roots of the adjacent tooth.

So, when you visit your hygienist at Colony Square Dental Associates, it is important that Dr. Hochberg or Dr. Diora take an x-ray to monitor your wisdom teeth. They can evaluate the growth and positioning of the teeth as they mature and continue to observe them. If they recommend removal of the teeth they will explain the reasons for their concern. Whether the tooth is fully erupted, partially impacted, or fully impacted, will help determine whether our doctors can provide for your care in the office. If not a referral to an oral surgeon will be made. In this case we will advise the surgeon’s office of our concerns, and when available, a current x-ray will be sent to their office. Either our doctors or the oral surgeon will explain the details of the procedure and what to expect. As each patient’s needs, due to the location and position of the tooth, varies, each patient will respond differently to treatment. And, age matters. Younger patients have less bone density and the roots are not fully developed – oftentimes a consideration in choosing to remove wisdom teeth when young when it’s apparent that positioning will cause problems down the road.

Be diligent about your teeth – all your teeth. It’s the wise thing to do. After all, oral health is part of overall wellbeing. Have regular dental cleanings and examinations so your wisdom teeth don’t outsmart you!

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