Do I Need to Remove my Wisdom Teeth?

extracted tooth in forceps

The emergence of wisdom teeth, those notorious late bloomers in the dental world, often sparks a flurry of questions. The most pressing of them all: “Do I need to remove my wisdom teeth?” The answer, like many things in life, isn’t black and white. Let’s delve into the world of wisdom teeth, their purpose, potential complications, and the factors that influence the decision to keep or extract them.

What Are Wisdom Teeth?

Wisdom teeth, or third molars, are the final set of molars that typically appear between the ages of 17 and 25. Historically, these teeth were essential for our ancestors who had a diet that required more chewing and grinding. However, as human diets evolved and became softer, the functional necessity of these teeth diminished. Today, with smaller jaw sizes and refined diets, the room for these teeth to grow properly has become limited for many individuals.

Why Might They Need Removal?

Several factors might necessitate the extraction of wisdom teeth:

Impaction: 

Often, there isn’t enough space in the mouth for wisdom teeth to emerge properly, leading to impaction.This lack of space can result in the teeth being trapped within the jawbone or gums. There are several types of impactions based on the orientation of the tooth: mesial (angled forward, towards the front of the mouth), vertical (grows straight but gets trapped), horizontal (lies sideways, parallel to the jawline), and distal (angled backward, towards the back of the mouth). Impacted wisdom teeth can significantly affect oral health. They can lead to pain, swelling, and infection in the surrounding gum tissue. Over time, cysts or tumors might form around the impacted tooth, potentially damaging the jawbone and neighboring teeth. Additionally, because of their awkward positioning, impacted wisdom teeth can be harder to clean, making them more susceptible to decay and gum disease. 

Overcrowding: 

The emergence of wisdom teeth often comes at a time when the mouth has already accommodated the full set of adult teeth. As these latecomers attempt to find their place in an already populated dental landscape, they can exert pressure on adjacent teeth, leading to a domino effect of shifting positions. This pressure can cause the front teeth to become misaligned or overlapped, disrupting the natural alignment and bite. Overcrowding not only affects the aesthetics of one’s smile but can also pose functional challenges. Misaligned teeth can be harder to clean effectively, increasing the risk of decay and gum disease. Additionally, overcrowding can lead to uneven wear patterns on teeth or issues with the temporomandibular joint.

Tooth Decay: 

The location of wisdom teeth makes them harder to reach and effectively clean with regular brushing and flossing. As a result, food particles and bacteria can easily accumulate around these teeth, leading to plaque buildup. When plaque isn’t promptly or adequately removed, it can harden into tartar, creating a breeding ground for bacteria. This environment is conducive to the development of cavities, commonly known as tooth decay. Additionally, if a wisdom tooth is partially erupted or misaligned, it can create pockets and crevices where bacteria can thrive, further elevating the risk of decay. Not only can the wisdom tooth itself become decayed, but its proximity to the second molar can also put the neighboring tooth at risk. Regular dental check-ups and meticulous oral care are crucial to mitigate the risks associated with wisdom teeth and tooth decay.

Gum Disease: 

The emergence of wisdom teeth can introduce a host of challenges for gum health. Due to their posterior location in the mouth, they are often more difficult to clean thoroughly, leading to an accumulation of plaque along the gumline. When this plaque isn’t effectively removed, it can progress to gingivitis, the initial stage of gum disease, characterized by redness, swelling, and bleeding. Furthermore, if a wisdom tooth is only partially erupted, it can create pockets in the gums, which become havens for bacteria. These bacterial colonies can exacerbate gum inflammation and, if left unchecked, advance to a more severe form of gum disease called periodontitis. Periodontitis can lead to gum recession, bone loss, and even tooth loss. The potential link between wisdom teeth and gum disease underscores the importance of regular dental visits and diligent oral hygiene practices, especially during the years when wisdom teeth are emerging.

Cysts or Tumors: 

While wisdom teeth are a natural part of our dental anatomy, their emergence can sometimes be accompanied by complications, notably the formation of cysts or tumors. When a wisdom tooth is impacted, or unable to fully emerge from the gums, a sac of fluid called a cyst can develop around its crown. Over time, this cyst can enlarge, leading to potential damage to the surrounding bone, teeth, and tissue. In rare instances, these cysts can evolve into benign tumors that may necessitate surgical removal. Though the occurrence of tumors linked to wisdom teeth is infrequent, the potential for such complications, coupled with the risk of cyst formation, emphasizes the importance of regular dental evaluations. Monitoring the progression and position of wisdom teeth through X-rays and examinations can help in early detection and intervention, preventing more severe complications down the line.

Reasons to Retain Wisdom Teeth

While the above complications might make extraction seem like the default choice, there are valid reasons to keep wisdom teeth:

  • No Current Issues: If they’ve fully emerged, are aligned correctly, and aren’t causing problems, extraction might not be immediately necessary.
  • Functional Use: For some, wisdom teeth are as functional as any other molar.
  • Natural Dental Evolution: Some individuals prefer to let nature take its course, intervening only when absolutely necessary.

Making the Decision

So, how do you decide? The key lies in regular dental check-ups. Dentists can monitor the growth and positioning of wisdom teeth, using X-rays to predict potential future complications. If there’s a likelihood of problems, a dentist might recommend proactive extraction. However, if the teeth are healthy and well-positioned, they might suggest a wait-and-see approach.

In Conclusion

The decision to extract wisdom teeth is a blend of individual circumstances, dental health, and potential future complications. While many opt for removal as a preventive measure, others retain their wisdom teeth without issues. The best approach is to stay informed, maintain regular dental check-ups, and consult with professionals. After all, wisdom teeth might be the last to arrive, but they deserve the same thoughtful consideration as the rest of your pearly whites.

Dr. Sisko

Dr. Gerald Sisko graduated from Ohio State University College of Dentistry in 1987. He is an active member of the American Dental Association, the Ohio Dental Association, and the Akron Dental Society where he is currently holding a council position. He has had the honor and distinction of being awarded “TOP DENTIST” in Akron and Cleveland as well as Northeast Ohio for the last several consecutive years.

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