Wisdom teeth, also known as the third permanent molars, are the final teeth to appear and typically emerge in late adolescence or early 20s. Positioned at the very back of the mouth, most adults have up to four wisdom teeth, with two on the top and two on the bottom. While some people have their wisdom teeth come in without any problems, most others face complications like impaction, where the teeth fail to erupt properly, causing infections,decay and overcrowding. These issues often lead to a common question: Is it always necessary to remove wisdom teeth?
This debate continues as some dentists suggest extraction to prevent future dental problems, while others advocate for a more conservative approach, depending on the specific circumstances of each individual.
Could keeping your wisdom teeth be a risk to your oral health?
Understanding Wisdom Teeth
But first, what exactly are wisdom teeth, and why do they appear?
As mentioned above, wisdom teeth are typically the last teeth to emerge. They are referred to as “wisdom” teeth because they appear at a more mature age when people are presumably wiser.
However, due to limited space in the jaw, wisdom teeth often present issues. For instance, they may become impacted, which means they cannot fully erupt through the gums due to blockages from other teeth or the jawbone itself. This can lead to various problems, including crowding or damaging adjacent teeth, impaction into the jawbone, or only partially breaking through the gum. These situations can contribute to discomfort, swelling, and sometimes more serious complications like decay and gum disease due to the difficulty in cleaning these areas. Whether partially or fully impacted, these molars need careful monitoring through dental X-rays or CT scans to decide the appropriate action.
Why Must Wisdom Teeth be Removed: Reasons for Removal
Several factors influence the decision to extract wisdom teeth, including whether they are causing discomfort or have the potential to cause problems in the future. Often, these issues arise when wisdom teeth become impacted.
Impacted wisdom teeth frequently cause complications because they trap food, making them difficult to clean and leading to persistent bad breath and decay. Unfortunately, the decay often does not happen on the wisdom teeth itself, but on the tooth in front.
Furthermore, the impaction can lead to significant discomfort in the gums and potentially severe infections, sometimes resulting in dangerous swelling of the face or throat, a condition known as Ludwig’s angina. In the days before the discovery of antibiotics, the most common cause of death in people in their early 20’s was a wisdom tooth infection. Other common issues include cheek biting, ulcer formation, resorption of neighbouring teeth, and cyst development.
These complications collectively underscore the importance of removing impacted wisdom teeth to maintain overall oral health and prevent future problems. Some common issues associated with the need for wisdom teeth extraction include:
1. Health Concerns
Wisdom teeth that remain fully or partially beneath the gums pose significant risks. Often, these impacted teeth become trapped in the jaw, leading to potential infections or the formation of cysts that can damage adjacent teeth roots or even the jawbone itself. Beyond that, their awkward position at the back of the mouth complicates cleaning efforts. Moreover, crowded wisdom teeth that do not have enough room to develop properly can pressure and damage nearby teeth.
Plus, when wisdom teeth only partially emerge, they create a perfect environment for bacteria to invade the gums, causing gum disease and further infections. As a matter of fact, a study done in Singapore back in 2003 revealed that nearly 70% of adults between 20 and 40 years old had at least one impacted wisdom tooth, escalating the risk of dental caries and gum disease.
2. Preventative/Elective Care
Tucked away in the furthest corners of your mouth, wisdom teeth are particularly difficult to maintain. Even with diligent brushing and flossing, reaching these areas effectively can be nearly impossible. What happens if you do not remove your wisdom teeth in such cases?
This difficulty in maintaining proper hygiene can lead to the build-up of bacteria, resulting in tooth decay and inflammation of the surrounding gums. By electing to remove wisdom teeth before these issues manifest, individuals can avoid the complications associated with decay and gum disease, ensuring better overall oral health and reducing the need for more complex dental procedures in the future.
When Removal Isn’t Necessary
So, is it always necessary to remove wisdom teeth? Not quite.
Wisdom teeth that fully erupt and align properly do not always need to be extracted. When these molars fit well within the jaw without disturbing neighbouring teeth and cause no discomfort, they can be effectively maintained as part of your overall dental health.
Simply put, the key factors in deciding whether to keep wisdom teeth include:
- Their proper alignment in the jaw
- Lack of pain
- The ability to keep them clean
For those lucky enough to meet these conditions, regular dental care is sufficient to preserve the natural integrity of the mouth without undergoing unnecessary surgical procedures.
Considerations Before Removal
Now, how do you determine if wisdom tooth removal is necessary for you?
Firstly, a comprehensive dental evaluation is crucial. This typically includes a detailed examination of your mouth and X-rays to assess the position and health of your wisdom teeth as well as the condition of adjacent teeth and bones. This preliminary assessment helps dentists understand the risks and decide whether prophylactic removal is advisable.
Timing is another important factor to consider. This is because younger patients generally experience fewer complications and quicker recovery after extraction. Research indicates that those over 25 may face more challenges, such as denser bone tissue under the gums and an increased risk of conditions like dry sockets. Additionally, health conditions such as diabetes or cardiovascular issues can complicate recovery, necessitating careful medical management around the procedure.
Surgical Considerations
Wisdom tooth removal varies from straightforward extractions to more complex surgical procedures depending on the tooth’s position and development stage.
If your wisdom tooth has completely emerged from the gums and is easily accessible, a simple extraction is typically sufficient. This process involves numbing the area with local anaesthesia, loosening the tooth with dental tools, and then removing it with forceps.
However, if a wisdom tooth is impacted—meaning it is trapped below the gum line or against another tooth—surgical extraction often becomes necessary. To access the impacted tooth, the dentist carefully creates an opening in the gum to expose the tooth and bone. Parts of the bone might be removed, or the tooth may be divided into segments to facilitate easier and safer removal. The surgical site is then cleaned and closed with sutures to facilitate healing and minimise scarring.
Recovery post-surgery typically involves some swelling and limited ability to open the mouth, and discomfort is generally manageable with prescribed medications. Following the dentist’s aftercare instructions is also crucial for a smooth recovery, minimising the risk of complications.
Evaluating the Need for Wisdom Teeth Removal
From the above, it is clear that deciding when to remove wisdom teeth often hinges on individual circumstances and professional advice. Not everyone requires wisdom teeth removal, but for many, it is a crucial step to prevent future dental issues.
If unsure, consulting with a dentist skilled in wisdom teeth removal can provide guidance based on your specific needs. And if you experience discomfort or complications, seek immediate attention from an emergency dentist in Singapore. Ultimately, whether it’s a must to remove your wisdom teeth depends on factors like alignment, discomfort, and potential risks, ensuring each decision towards dental health is informed.