The Ultimate Guide to Wisdom Teeth: Everything You Need to Know for Optimal Oral Health
Welcome to Crisdental. I’m Dr. Michael Bratland. Today, we’re going to discuss wisdom teeth and how they’re managed.
As you can imagine wisdom teeth can be quite difficult to grasp; both in their existence and the need for management. Wisdom teeth are the third and final set of molars that people typically get in their late teens or early twenties and occasionally appear earlier. Typically, we provide comprehensive management options to best equip our patients to manage wisdom teeth and preserve/restore overall dental health. It is important to remain knowledgeable about wisdom teeth in order to reach and maintain optimal dental health, so I'm hopeful this information will provide you with guidance and increase understanding.
As mentioned above, wisdom teeth, also known as third molars, are the last set of teeth to develop in the human mouth. Most people have four wisdom teeth, with one located in each quadrant of the mouth: upper right, upper left, lower right, and lower left. These teeth usually emerge well after the tooth fairy has moved on (which might explain why they’re not always a blessing), between the ages of 17 and 25, which is why they are commonly associated with the transition to adulthood.
The exact reasons why we have wisdom teeth are not fully understood, but it is believed to be a remnant of our evolutionary past. It may also be the case that at one point we needed these teeth as our understanding of the importance of dental health back in the Flintstone’s days was nowhere near what it is today and these wisdom teeth served as a backup option for teeth that may have been lost. Today, wisdom teeth are considered to be vestigial organs or, unnecessary components to our functioning much like the appendix. Early humans had larger jaws and a different diet that consisted of tougher, coarser foods like roots, nuts, and raw meat. Their larger jaws accommodated the extra teeth, but as our diet changed and jaws became smaller over time, there often isn't enough space for the wisdom teeth to properly emerge. This lack of space can lead to several issues, which is why wisdom teeth often cause problems. Here are some common reasons:
Impacted wisdom teeth: When there isn't enough room in the jaw for the teeth to fully emerge, they may become impacted. This means they remain partially or fully trapped beneath the gum line or against the adjacent teeth. Impacted wisdom teeth can cause pain, swelling, and infection.
Crowding: If the jaw doesn't have enough space to accommodate the wisdom teeth, they may push against the adjacent teeth, causing crowding and misalignment of the other teeth.
Infection and decay: Wisdom teeth are located at the back of the mouth, making them harder to clean properly. This can make them more susceptible to tooth decay and gum infections.
Due to these potential issues, many dentists and oral surgeons recommend the removal of wisdom teeth, even if they are not causing immediate problems. The extraction is often performed before the age of 25 when the roots of the teeth are not fully developed, making the procedure less complicated.
However, not everyone needs to have their wisdom teeth removed. Some individuals have enough space in their jaws to accommodate the teeth without causing any problems. Regular dental check-ups and X-rays can help determine the positioning and potential risks associated with wisdom teeth.
To Remove or to Not Remove?
The process for determining whether wisdom teeth should be removed or not can be simple or more complicated depending on how a patient presents but, in general, here is a good process for making the determination. Here's an overview of the process you should go through with your dentist:
Dental Examination: During a routine dental check-up, your dentist will examine your mouth, including your wisdom teeth, using visual inspection and possibly X-rays. X-rays are particularly useful for evaluating the position, development, and alignment of the wisdom teeth, as well as the condition of the surrounding teeth and bone.
Symptoms and Complaints: If you are experiencing any symptoms related to your wisdom teeth, such as pain, swelling, or difficulty opening your mouth, it's important to inform your dentist. They will consider these symptoms along with their examination findings.
Evaluation of Impaction: If your dentist suspects that your wisdom teeth are impacted, meaning they are not able to fully emerge, they may recommend further evaluation. This could involve additional X-rays, such as panoramic or cone-beam computed tomography (CBCT) scans, which provide detailed images of your teeth, jaws, and surrounding structures. These scans help determine the exact position of the impacted teeth and assess potential risks.
Assessment of Alignment and Crowding: Your dentist will also evaluate the alignment of your existing teeth and assess whether the eruption of wisdom teeth could cause crowding or other orthodontic issues. They will consider factors such as the available space in your jaw and the position of the wisdom teeth in relation to neighboring teeth.
Examination of Oral Health: The overall health of your teeth and gums will be assessed, including checking for signs of tooth decay, gum disease, and infections around the wisdom teeth. These factors can influence the decision on whether extraction is necessary.
Individual Factors: Your dentist will take into account your age, general health, and any specific risk factors that may increase the likelihood of complications associated with wisdom teeth. For example, if you have a history of recurring infections or if your wisdom teeth are at a high risk of causing damage to neighboring teeth, extraction may be recommended.
Consultation and Recommendation: Based on the findings from the examination, X-rays, and consideration of individual factors, your dentist or oral surgeon will discuss the options with you. They will explain the potential risks and benefits of removing or keeping the wisdom teeth and provide their professional recommendation.
It's important to note that each case is unique, and the decision to remove wisdom teeth ultimately depends on the specific circumstances and professional judgment of the dentist or oral surgeon. If extraction is recommended, they will discuss the procedure, aftercare instructions, and any associated risks or complications with you.
What About Leaving Wisdom Teeth In?
We commonly associate wisdom teeth with being a problem but, are there any cases for them being left alone? There most definitely are.
Sufficient Space: If your jaw has enough space to accommodate the wisdom teeth without causing crowding or misalignment of other teeth, and they are erupting in a normal position, your dentist may determine that extraction is not necessary.
Proper Eruption: If your wisdom teeth are fully erupted, properly aligned, and functional, meaning they can be cleaned and maintained effectively, your dentist may consider leaving them in.
Healthy Surrounding Tissues: If the wisdom teeth are not causing any damage to neighboring teeth, gum tissue, or nearby structures, and there are no signs of decay, infection, or gum disease, extraction may not be immediately necessary.
Age and Development: In some cases, if you are older and your wisdom teeth have fully developed roots, the risks and complications associated with extraction may outweigh the benefits. In such situations, a dentist may recommend monitoring the teeth closely and addressing any issues that may arise in the future.
Personal Preference: Ultimately, the decision to remove or keep wisdom teeth may also depend on your personal preference, as long as there are no immediate risks or problems associated with them. Your dentist can provide guidance based on your individual situation, but the final decision rests with you.
It's important to note that even if your wisdom teeth are not causing problems now, regular monitoring and check-ups are necessary to ensure they remain healthy and do not develop issues in the future. Changes in the position or health of the wisdom teeth or surrounding tissues may require re-evaluation and possible extraction at a later stage.
How The Extraction Process Is More Complex With Wisdom Teeth
The extraction of wisdom teeth can differ from the extraction of normal teeth due to several factors, including the position, development, and potential complications associated with wisdom teeth. Here are some ways in which the extraction of wisdom teeth may differ:
Impaction: Wisdom teeth are more likely to be impacted, meaning they may be partially or fully trapped beneath the gum line or against neighboring teeth. Impacted wisdom teeth may require a more involved extraction procedure compared to fully erupted teeth. The extraction process may involve making an incision in the gum tissue and possibly removing a small portion of bone to access and remove the impacted tooth.
Positioning: Wisdom teeth are located at the back of the mouth, which can make them more challenging to access and extract. Their positioning can vary, including horizontal, vertical, tilted, or angled positions. The extraction process may require additional techniques, such as sectioning the tooth into smaller pieces or manipulating the tooth's position to facilitate removal.
Development and Root Formation: Wisdom teeth often have longer and more complex root structures compared to other teeth. However, the stage of root development can vary among individuals. If the roots are fully formed, extraction may be more complicated, as it may involve a more extensive surgical procedure to remove the tooth and minimize potential damage to surrounding structures.
Anesthesia and Sedation: Given the potential complexity and discomfort associated with wisdom tooth extraction, dentists or oral surgeons may recommend different types of anesthesia or sedation to ensure your comfort during the procedure. This can include local anesthesia (numbing the extraction area), intravenous (IV) sedation, or general anesthesia.
Post-Operative Care: The recovery process after wisdom tooth extraction may differ from that of normal tooth extraction. Due to the potential complexity and surgical nature of wisdom tooth removal, you may experience more swelling, discomfort, and a longer recovery period. Your dentist or oral surgeon will provide specific post-operative instructions, which may include managing swelling, using cold compresses, taking prescribed pain medications, eating a soft diet, and practicing proper oral hygiene.
It's important to note that not all wisdom tooth extractions are complex or require surgical intervention. In some cases, fully erupted and properly positioned wisdom teeth can be extracted similarly to other teeth. The specific approach and techniques used for extraction will depend on the individual case and the judgment of the dental professional performing the procedure.
In conclusion, wisdom teeth, the third molars in our mouths, have long been a subject of interest and concern. While their exact purpose remains somewhat of a mystery, their emergence during late adolescence and early adulthood can often lead to various dental complications. Impaction, crowding, infections, and oral health issues are commonly associated with these teeth. However, not all individuals require wisdom tooth extraction, as some may have enough space and healthy development to accommodate them without problems. The decision to remove or retain wisdom teeth is best made through a comprehensive dental examination, taking into account factors such as positioning, alignment, oral health, and individual circumstances. Regular monitoring by dental professionals is crucial to identify any potential issues and determine the most appropriate course of action. By understanding the nature of wisdom teeth and seeking professional guidance, individuals can ensure the long-term health and well-being of their oral cavity.
