Wisdom teeth, officially referred to as third molars, are usually the last teeth to develop. They are located in the very back of your mouth, next to your second (or twelve year) molars and near the entrance to your throat. Third molars are usually completely developed between the ages of 15 and 18, a time traditionally associated with the onset of maturity and the attainment of “wisdom”.
Why Do We Even Have Wisdom Teeth?
Anthropologists theorize that back in the “cave days” our diet was much coarser than it is today. Also, there were not any dentists around to help us keep and maintain our teeth, and finally, there was not any fluoride in the water. So by the time we reached our late “cave teens”, we most likely had already lost several of our teeth due to trauma or decay. With the loss of adjacent teeth, the third molars now had space to erupt into our mouths, and therefore actually served a purpose – to replace lost teeth and help us chew better.
In modern times we have great general dentists to help us keep our teeth, a softer diet, and fluoride in our water. So we tend to keep most, if not all, of our teeth. Therefore, wisdom teeth commonly do not have enough room to erupt fully into our mouths. Even if the wisdom teeth do fully erupt, their posterior location makes it extremely difficult to keep them clean and healthy over the course of a lifetime. Removing wisdom teeth later on in life is much more difficult, the recovery period is longer and less predictable, and most importantly, wisdom tooth removal later in life is associated with increased risks and complications.
Why Should I Have My Wisdom Teeth Removed?
Wisdom teeth commonly do not have enough room to properly erupt into our mouth where they can become fully functional and cleansable teeth. This lack of space can result in a number of harmful effects on your overall dental health. When a tooth cannot erupt into proper alignment, we call it impacted, which simply means “stuck” in an improper position. There are several types, or degrees, of impaction:
- Soft Tissue Impactions – There is adequate jaw bone to allow the wisdom tooth to erupt, but not enough room to allow the gum tissue to be properly positioned and attached to the tooth. This causes tremendous problems because it is not possible to keep the area clean. Infection commonly occurs, resulting in swelling and pain.
- Partial Bony Impactions – There is enough space to allow the wisdom tooth to partially erupt, but it cannot function in the chewing process. The tooth remains partially covered by bone and soft tissue. Once again, keeping the area clean is impossible and problems commonly develop.
- Complete Bony Impactions – There is no space for the tooth to erupt. The tooth is completely covered by bone, or if it is partially exposed through the bone, it requires complex removal techniques.
- Unusually Difficult Complete Bony Impactions – The impacted wisdom tooth is in an unusual and difficult position to remove.
If you do not have enough room in your mouth for your wisdom teeth to erupt into proper position they can cause a multitude of problems, such as:
- Infection – Without enough room for total eruption, the gum tissue around the wisdom tooth can become irritated and inflamed, resulting in recurrent pain, swelling and problems with chewing and swallowing.
- Damage to Adjacent Teeth – If there is inadequate room to clean around the wisdom tooth, the tooth directly in front of the wisdom tooth, the second molar, can be adversely affected resulting in gum disease (bone loss) or cavities (caries or decay).
- Disease – Non-infectious diseases also can arise in association with an impacted wisdom tooth. Cysts are fluid-filled “balloons” inside the jawbone which are associated with impacted wisdom teeth and slowly expand, destroying adjacent jawbone and occasionally adjacent teeth. Although rare, certain tumors can be associated with impacted teeth. Both of these conditions can be very difficult to treat.
- Crowding – Although controversial, many feel that impacted wisdom teeth directly contribute to crowding, or shifting, of your teeth. This crowding is usually most noticeable in the lower front teeth. This is most commonly seen after a patient has had braces. There are most likely a number of factors that cause our teeth to shift and impacted wisdom teeth may play a contributory role. Although wisdom tooth removal cannot be recommended solely to avoid crowding, it can be recommended in order to absolutely eliminate any possible role in future crowding and other bite changes.
So Do I Really Have To Have My Wisdom Teeth Removed?
There is no “magic rule book” in life that says you must have your wisdom teeth removed. In other words, removal of these teeth has nothing to do with you living to be 70 instead of 65. In almost all cases wisdom tooth removal is elective surgery. Very rarely could it be considered a critical, life-saving procedure. You don’t have to do anything until YOU choose to do so. Unless you have an active problem such as pain, swelling, infection, or soreness, the removal of your wisdom teeth is best viewed as a preventive measure, designed to keep you from having problems in the future. And although we cannot predict the future any more than you can, it is possible to identify potential future problems and make appropriate recommendations.
At your consultation visit we will examine your mouth and review your x-ray with you in great detail to determine IF you will benefit from having your wisdom teeth removed. Based on our findings, we will make certain recommendations and we will certainly answer all your questions. It is important to us that you are well informed and that you understand all your options.
What Is The Best Age To Have Your Wisdom Teeth Removed?
If you do not have enough room in your mouth for your wisdom teeth to erupt into proper position it is best to have them removed before the wisdom teeth are fully developed. For some patients this may be as early as 13 or 14, for others it may be as late as 17 or 18 years old. Without a doubt, younger patients (teenagers) heal faster, and in a more predictable fashion, and with fewer complications than older patients.
What If I Don’t Have Them Removed Now?
Many patients, especially in years past, were told to take a “wait and see” approach regarding their wisdom teeth. Many patients who did not have adequate room for their wisdom teeth developed problems previously mentioned. The problem with taking a “wait and see” approach is that if it becomes necessary to remove a wisdom tooth in your thirties or beyond, it is much more difficult for you as the patient. For patients older than thirty the post-operative course is usually more prolonged, and the potential complications are much greater.