Wisdom Teeth Extractions
What are wisdom teeth? Why do we even develop wisdom teeth at all? Can I wait and see if I will have room for them? They don’t bother me, can I just leave them alone? When is the best time to have my wisdom teeth removed? These are just some of the questions that I regularly receive about wisdom teeth. In this post, we will answer all these questions and hopefully give you some peace of mind if you are considering having your wisdom teeth removed.
Wisdom teeth are also known as third molars. They are the 3rd row of molars that typically erupt around 21 years of age (hence ‘wisdom teeth’, because by 21 we are all so wise!!). Just looking at your molars (the big teeth in the back), from front to back you have your 6-year molars, 12-year molars, then your wisdom teeth. One in each corner of the mouth, so four wisdom teeth are typical. I often see people who never develop wisdom teeth at all, and I regularly see people who have an extra wisdom tooth or two (I have seen as many as 8 wisdom teeth on a patient).
Hundreds of years ago, wisdom teeth were seldom problematic. The human diet was much coarser, with no refined foods and minimal sugar. By the time a person reached their early twenties, their other teeth would have been worn down significantly thus allowing more room for the wisdom teeth to erupt in a normal position. Believe it or not, wisdom teeth were actually useful once upon a time! In modernity, however, few people have room for wisdom teeth to fully erupt, and even those that do have just enough room often develop decay or gum disease around these teeth as they are difficult to maintain so far back in the mouth.
Patients who have wisdom teeth that are just starting to erupt, or those who didn’t have enough room for the tooth to fully erupt, can have recurrent painful infections around that tooth. The term for this is pericoronitis, or ‘inflammation around the crown of a tooth.’ Food and bacteria get trapped under a flap of gums covering part of the tooth, the patient can’t floss or brush it out, it becomes infected and painful, swells, and causes the patient to bite on it thus hurting every time they chew or fully close their teeth. This infection typically resolves itself in a week or two, but often recurs cyclically, each time more painful than the last.
I often hear the “if it doesn’t hurt, don’t mess with it” attitude from patients who are reluctant to treat their wisdom teeth. They believe that it’s better to adopt a ‘wait and see’ approach, electing to extract wisdom teeth if and when they become a problem. My biggest concern with this approach is that by the time wisdom teeth are symptomatic to the patient, they are often much more difficult to extract, have a higher risk of complications with the sinuses or nerves, and can potentially damage adjacent teeth or restorations. When a patient is young, the bone is softer (it can flex slightly), the wisdom teeth are not fully formed (no hooks on the end of long roots to deal with), and they are typically as healthy as they’ll ever be in life. All these things lead to a faster, easier surgery and a quick recovery. Contrast that to someone who waited until their 30s or 40s when a wisdom tooth started to hurt. Fully formed roots, denser bone, greater risk of trauma to the adjacent teeth/restorations all make for a more difficult surgery and recovery.
For all of the above reasons, here at My Sherman Dentist, I recommend evaluating wisdom teeth on every patient by the time they are 13-14 years old. Sometimes we will recommend extraction that early and other times we will recommend waiting, depending on the particular patient’s tooth development and other factors. Ask us about IV sedation and PRP/PRF treatment to go along with your wisdom teeth extractions! Every treatment plan is tailored to fit the patient’s needs.
What about those who have their wisdom teeth already fully erupted? Again, I recommend a comprehensive evaluation to take into account gum health, any missing teeth, oral hygiene habits, teeth alignment, patient age, etc. But in general, under the age of 25, I typically recommend removal of wisdom teeth even when asymptomatic. Over the age of 25 and assuming healthy teeth, the roots are already fully formed so I typically recommend not extracting but instead giving special attention to proper hygiene in these areas.
As always, if you have any questions about wisdom teeth removal or other dental topics, please email me and I’ll do my best to answer back quickly!