Third molars or wisdom teeth are one of the most common teeth that are removed today. These teeth erupt at around the age of 17-21 years. Why do so many people end up having their wisdom teeth removed? Well, to answer that question I have put together some facts and myths about wisdom teeth and will explain each statement as true or false after listing it, and finally, I will end with my own personal opinion about whether or not these teeth should be removed.
- Everyone has wisdom teeth. False. Not everyone has all 4 wisdom teeth. Wisdom tooth presence can vary a lot among individuals and even families. Some people have none and some can have 1, 2, or 3. Most individuals with wisdom teeth usually have all four.
- Wisdom teeth have to be removed. False. The only reason to remove wisdom teeth is if keeping them is certain to pose a risk of more serious dental problems in the future. Many people have impacted wisdom teeth. That means that they have not erupted into the oral cavity and this can be due to a number of reasons. Often there is not enough room in the arch of the jaw to allow the wisdom teeth to erupt. As long as the teeth remain under the gums and/or jaw bone, and there is no evidence of any pathology around the impacted tooth, and it is not causing any damage to the adjacent 2nd molar then extraction is not necessary.
- Wisdom teeth can cause the front teeth to crowd and shift. False. Erupting wisdom teeth are not the cause of crowding of the anterior teeth. This is physiologically impossible and the reason why many people have impacted wisdom teeth. If this is supposedly true then why do many people have crowding and no wisdom teeth?
- Keeping wisdom teeth can cause an increased risk of future dental problems. True. There are plenty of studies in the literature about wisdom teeth and increased risk of dental disease. The most common one is periodontal disease. This is mostly due to the fact that many people have a hard time brushing and flossing wisdom teeth because they are difficult to reach. This leads to the creation of a bacterial reservoir of periodontal pathogens around wisdom teeth. This is why regular dental care is important.
- One must be put to sleep to have their wisdom teeth removed. False. It is often recommended to be put under sedation if all 4 wisdom teeth are impacted and are being removed. In most cases it is not necessary, a local anesthetic will suffice. In general, it depends on the number of teeth being removed and what the situation is. Also, it depends on the patient and their level of anxiety about the procedure.
- Removing wisdom teeth is easy and has very little risk. Yes and No. Like I stated above, it depends on the situation. Root development, anatomic considerations, accessibility, the patient’s health all come into play. In a young and healthy person with 4 erupted wisdom teeth with short converging roots and no risk of other anatomic injury it can be very easy. On the other hand, if someone has 4 impacted wisdom teeth under the bone with full root development and the main nerve of the lower jaw is close to the roots on the lower and the roots of the upper extend into the sinus it may be much riskier to remove them. Deciding whether or not to do so should be a discussion to have with your dentist or oral surgeon.
In conclusion, the decision to remove wisdom teeth should be taken with as much information as possible regarding the risks vs. benefits. If one has all 4 wisdom teeth erupted, can brush and floss them properly, and are readily accessible by a dental professional there is no reason to remove them. If it can be concluded that keeping the wisdom teeth will increase the risk of future dental problems then extraction is not a bad option. One’s age can be an extenuating circumstance though, it is best to remove the wisdom teeth by the age of 35 if deciding to have them removed. Until next time, to your continued good oral health.