Wisdom teeth, also known as third molars are the last teeth to erupt. This occurs usually between the ages of 17 and 25. There remains a great deal of controversy regarding whether or not these teeth need to be removed. It is generally suggested that teeth that remain completely buried or un-erupted in a normal position are unlikely to cause harm. However, if these impacted teeth are in an abnormal position (a dentist can show you this on an x-ray), their potential for harm should be assessed.

What is an Impacted Wisdom Tooth?

A tooth becomes impacted due to lack of space in the dental arch and its eruption is therefore prevented by gum, bone, another tooth or all three. Lack of space occurs because our jaws have become smaller (through evolution), we do not loose teeth through decay as frequently as in the past, and our diet is such that our teeth do not wear down as much.

the Indications for Removing Wisdom Teeth?

Wisdom teeth generally cause problems when they erupt partially through the gum. The most common reasons for removing them are:

Decay

Saliva, bacteria and food particles can collect around an impacted wisdom tooth, causing it, or the next tooth to decay. It is very difficult to remove such decay. Pain and infection will usually follow.

Gum Infection (Pericoronitis)

When a wisdom tooth is partially erupted, food and bacteria collect under the gum causing a local infection. This may result in bad breath, pain, swelling and trismus (inability to open the mouth fully). The infection can spread to involve the cheek and neck. Once the initial episode occurs, each subsequent attack becomes more frequent and more severe.

Pressure Pain

Pain may also come from the pressure of the erupting wisdom tooth against other teeth. In some cases this pressure may cause the erosion of these teeth.

Orthodontic Reasons

Many younger patients have had prolonged orthodontic treatment to straighten teeth. Wisdom teeth may cause movement of teeth (particularly the front teeth) when they try to erupt and this will compromise the orthodontic result.

Prosthetic Reasons

Patients who are to have dentures constructed should have any wisdom tooth removed. If a wisdom tooth erupts beneath a denture it will cause severe irritation and if removed, the patient will need to have a new denture constructed as the shape of the gum would have changed.

Cyst Formation

A cyst (fluid filled sac) can develop from the soft tissue around an impacted wisdom tooth. Cysts cause bone destruction, jaw expansion and displacement or damage to nearby teeth. The removal of the tooth and cyst is necessary to prevent further bone loss. Rarely, tumors may develop within these cysts or the jaw may fracture spontaneously if the cyst grows very large.

Why Should an Impacted Wisdom Tooth be Removed if it Hasn't Caused any Trouble?

Impacted wisdom teeth are almost certain to cause problems if left in place. This is particularly true of the lower wisdom teeth. Such problems may occur suddenly, and often at the most inconvenient times.

When is the Best Time to Have my Wisdom Teeth Removed?

It is now recommended by specialists that impacted wisdom teeth be removed between the ages of 14 and 22 years whether they are causing problems or not. Surgery is technically easier and patients recover much more quickly when they are younger. What is a relatively minor operation at 20 can become quiet difficult in patients over 40. Also the risk of complications increases with age, and the healing process is slower.