Is wisdom tooth extraction necessary?

Wisdom tooth removal is a common procedure, performed mainly because the large molars become impacted and put the other teeth at risk. However, opinions differ on whether wisdom teeth have to be extracted if they don’t seem to be affecting the gums or causing problems with the rest of the teeth. Most dentists would suggest removing any wisdom teeth at the slightest hint of impaction, to avoid complications, but there are those who believe that the trauma of the operation leads to more problems than it solves, and that if they don’t appear to be causing trouble, they should be left in place. So, is wisdom tooth extraction really necessary?

How do my wisdom teeth become impacted?

There’s no real medical reason for your wisdom teeth becoming impacted, it’s just a mixture of genetics and bad luck, unfortunately. As mankind evolved, the third molar became superfluous, but that didn’t stop them growing in anyway. Because we don’t really need them, it’s often thought that removal is the best course of action, whether they are problematic or not.

Wisdom teeth can become impacted in various different ways; mesial, vertical, horizontal, and distal. In each case the tooth is sitting at an undesirable angle and has failed to break through the surface tissue correctly. No one really knows why this happens, but it has been suggested that it’s simply a lack of space at the back of the mouth. Thanks to modern science, the level of tooth loss in today’s humans is much lower than it was hundreds of years ago, suggesting that missing teeth left space in the mouth for the wisdom teeth to come through. As dental technology progresses, we are losing less teeth, and leaving no room for extra ones to grow in.

Should wisdom teeth be removed if they are impacted?

As mentioned above, there are two schools of thought on the subject, but the molars are so large that they tend to be troublesome if they are not dealt with. If you are unsure whether your wisdom teeth are properly erupting, make an appointment to see your dentist, or talk to someone at the Pearl Dental Clinic, they can assess your situation and suggest further treatment. It’s also worth noting that some wisdom teeth can take months to fully erupt – longer in some cases, so even if they seem to be impacted, they may just be taking their time. It’s common for the patient to experience some pain or discomfort as the molars start to break through, this shouldn’t be cause for concern unless it becomes severe, then you should seek assistance as soon as possible, rather than wait for your regular check-up, any kind of very painful toothache requires immediate attention.

An x-ray is usually necessary to locate the problem tooth, and your dentist should be able to tell whether they are still erupting or if they are impacted. It’s not just impactions that cause difficulties either, if even a small section of the gum line remains in place over the tooth, bacteria can gather beneath it and lead to infection – which is the biggest problem with wisdom teeth.

Even a fully erupted wisdom tooth can prove problematic, it can change the weight distribution between the jaws, and crowd the front teeth together as it forces its way into the mouth. Ignoring a wisdom tooth that is altering the pressure patterns on the other teeth can sometimes lead to more obvious changes, such as twisted teeth or serious orthodontic problems.

Should I get my wisdom teeth removed anyway, just to be on the safe side?

Not necessarily, it can be difficult to tell whether your wisdom teeth will cause problems as time passes, so there is a certain amount of guesswork involved. If your dentist examines your teeth, but determines that there is no risk of disease, they will probably choose to leave them in place and just monitor your condition for signs of infection. Some surgeons might decide that prevention is better than the cure, and the teeth should be removed, even if they don’t pose an immediate risk to the health of the patient. Having said that, there is no real proof that says extracting healthy wisdom teeth is beneficial, because they are so large, the trauma to the gum line is more extensive, and this can inhibit the healing process.

Tooth extractions have their own list of complications, and wisdom teeth removals carry even more risk. If the impacted molar has been pressed into the tooth in front of it, the invasive surgery might cause lasting damage to the root of the neighbouring tooth, leaving it open to infection and decay. Furthermore, the extraction site might prove difficult to clean because it’s so far back in the mouth, you can’t always get a good view of the gums behind the other teeth.

Removal could be avoided if it’s infection that is the issue, you dentist may feel that the tooth is not doing any physical damage to the rest of the mouth; its eruption has just exposed it to bacteria. In this case, they might choose to prescribe you some antibiotics or antiseptic mouthwash to kill the infection. Of course, this might not work, and extraction may be the only option left, but it could be worth the risk if there’s a chance of saving a healthy tooth.