Wisdom Teeth – Reasons for Removal

Wisdom teeth, both impacted and erupted, can cause a variety of problems if they are not removed. This article reviews reasons to remove wisdom teeth and explores consequences if they are left in.

  • Maintaining good oral hygiene in the wisdom tooth area is very difficult for any patient. Furthermore, the gingival tissue in the wisdom tooth area does not have the ability to attach to the wisdom tooth as gingiva attaches elsewhere. Even patients with impeccable oral hygiene will not be able to keep the area clean and bacteria free. Consequently, the periodontitis affecting the wisdom tooth can extend to the adjacent 2nd molar. A recent study of 6,000 patients, ages 18-35, concluded that due to the presence of wisdom teeth the incidence of gingivitis and periodontitis doubles! Additionally, if gingivitis and periodontitis are detected only around the wisdom teeth, the odds of finding periodontitis in other teeth within a six year time period are five times greater!
  • Caries can also affect the wisdom tooth. Recent studies have shown that 40% of patients, ages 23-34, have experienced caries in their wisdom teeth. It also has been noted that when caries are present in the first and second molars the patient will have a very high probability of developing caries in the wisdom teeth within 3 years!
  • Over 90% of the population does not have adequate room for their wisdom teeth to erupt. This leads to a number of problems including:
  • pain
  • infection
  • damage to the adjacent second molar (usually irreparable)
  • cyst and tumor formation, which requires more complicated and extensive
  • procedures for removal and reconstruction
  • bone loss compromising the support for the second molar
  • Wisdom teeth are non functional teeth. The earlier that they are removed, the less likely the patient will experience any of the previously mentioned problems. Most patients experience very few, if any, symptoms even when the wisdom teeth are causing damage. Lack of pain does not mean lack of disease or bacteria.
  • With age, our jawbones become denser and the roots of the wisdom teeth grow longer. This makes them more difficult to remove and increases the likelihood of intra and post-operative complications. Patients older than 25 years of age are one and a half times more likely to encounter complications during wisdom tooth removal.

It is very important to encourage your patients to have their wisdom teeth evaluated for removal. A panorex is the best way to evaluate and identify wisdom teeth, as they may not be detectable in a full mouth series.

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