Do I need my wisdom teeth pulled?

 

Do I need my wisdom teeth pulled?

Do I need my wisdom teeth pulled?

We see a lot of adolescents and young adults in the office, and I am frequently asked that question. The removal of third molars (“wisdom teeth”) for prevention of future problems is a subject of much discussion in dentistry. There is no clear consensus in the dental literature. This makes the question difficult to answer.

I think that it is important to look at risks vs. benefits when making a decision about any dental procedure. If the risks outweigh the benefits, then I would not recommend the procedure. The biggest risks of wisdom tooth removal are:

1) Nerve damage. This is an issue with lower wisdom teeth. The roots of a lower wisdom tooth can be located very close to the nerve that innervates the lower jaw. If the nerve is traumatized or, in rare cases, severed, there will be prolonged or permanent numbness to the lips and cheek. The nerve than runs to the tongue can also be involved during extraction of a deeply impacted lower molar.
2) Sinus exposure. This is a problem associated with removal of upper wisdom teeth. The roots of these teeth can be very close to the maxillary sinus. The removal of a tooth in that position can result in an opening into the sinus.
These risks become more of problem as we get older and the roots of these teeth become more fully developed.

There are also risks involved with not removing wisdom teeth.
1) Pericornitis. This a very painful condition where a partially erupted tooth becomes infected. It is not uncommon.
2) Decay . Widsom teeth are difficult to keep clean and are much more prone to tooth decay. Even more of a problem is decay on the second molar associated with a partially erupted wisdom tooth. The partially erupted wisdom tooth creates a major trap for food and bacteria that is impossible to clean.
3) Periodontal disease. Because third molars are difficult to clean, they are also more prone to development of calculus (tartar) and thus bone loss.
4) Crowding. This is another subject that dentists debate, but some literature shows that the presence of wisdom teeth can lead to crowding of the incisors.

So, after thinking about the risks and benefits involved with removing wisdom teeth, I can make some recommendations. If the risk of sinus or nerve involvement is minimal, root development is incomplete and patient is under 25 years of age, I would almost always suggest that the third molars are removed. These teeth will only cause problems later in life.

I would not recommend removing wisdom teeth if they ARE close to the nerve or sinus and asymptomatic.
Ultimately, the decision to remove a tooth (or any dental procedure for that matter) is up to the patients. It is my job to give you enough information to make an informed decision. If you are considering having wisdom teeth removed, please contact the office and we can refer you to one of several exceptional oral surgeons in our area.