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Don't let wisdom teeth crowd your perfect smile! Most people have me take their wisdom teeth out due to their fear of crowding their front teeth. But, this is only one reason for taking out wisdom teeth. As a dentist, I have other reasons for taking them out. Wisdom teeth, or 3rd molars, commonly cause problems that jeopardize the health of the 2nd molars. The 2nd molars, or 12 year molars, are teeth you want to keep for life!
The most common problem that endangers the 2nd molars is periodontal (gum) disease. Because it is so difficult to clean around wisdom teeth, they commonly get gum pockets that can't be cleaned. These pockets lead to bone loss and with the bone loss they become more difficult to clean. The bone loss that occurs between the 2nd molar and 3rd molar may cause the loss of both teeth. Although it is a slow process, most people don't want to start losing their 2nd molars in their 40s and 50s if they can help it. Removing the wisdom teeth allows you to easily clean the back side of the 2nd molars and help prevent this unfortunate situation.
Some impacted wisdom teeth come into the mouth sideways and push into the back side of the 2nd molars. I have seen two bad consequences of this scenario. One consequence is this creates a pocket where food can collect. Resultedly, a cavity develops on the deep backside of the 2nd molar. Even if we catch this cavity early, it often leads to a root canal and crown due to the location of the cavity. Worse yet, the cavity sometimes goes down the root of the 2nd molar and the only solution is extraction of the 2nd molar. The second scenario involves the wisdom tooth causing pressure resorbtion on the back side of the 2nd molar. This is not a cavity but the results are similar to the first scenario; it leads to a root canal or extraction.
Most people have wisdom teeth removed because of the fear of them crowding their teeth. The theory here is that as the roots grow in one direction they push the crown of the tooth in the other direction. This force might lend to crowding your teeth. I like people to know that teeth can crowd even without wisdom teeth. The natural forces of chewing are forward so teeth can still crowd. This is important because if you stop wearing a retainer after braces your teeth may still crowd.
Even if your jaw is big enough to accomodate your wisdom teeth, problems often develop when you are older. Most people have to gag themselves when brushing their wisdom teeth to keep them clean. As a result they don't get clean and eventually develop cavities. I can't tell you how many 40 to 50 year old adults who have told me they haven't had a cavity in 20 years but have developed a huge cavity on their wisdom teeth. Unfortunately, due to lack of room, I often can't fill these teeth. Now, an extraction that would be easy as a teenager is much more difficult as an adult.
Have you had your wisdom teeth evaluated? I can give you a fast evalaution and tell you if there are any negative consequences to keeping your own wisdom teeth.
Thanks for reading,
David Gryzick
When should you remove your wisdom teeth? Wisdom teeth should begin to be evaluated when people are about 14 or 15 years of age. The average age for wisdom teeth removal is 17 years old (in my own practice). Not everyone needs their wisdom teeth out but it is very common.
Why is there commonly not enough room for wisdom teeth? Let me share the theory that makes the most sense to me. If you look at the human diet, it has drastically changed in the last 100 years. Just imagine eating meat 100 years ago. It was tough! You had to really chew to eat. Our modern diet I refer to as the McDonalds diet. Our food is very easy to eat. Now think about a fast food hamburger. You can almost eat it without teeth. So what difference does it make? Our jaw muscles are not nearly as developed as they were just 100 years ago. And here is the key...Bones develop in response to muscles. (Not vica versa). So, jaws are developing smaller and there is a lack of room for your teeth which are the same size.
Why not wait til they bother you? I like to pick on teenagers for several reasons. First, the healing curve for a teenager is awesome. They seem to heal much faster than someone who is even 25 years old. My theory here is that their bone may be less dense and have a better blood supply. Second, wisdom teeth come out less traumatically when the roots are not fully formed. The last 10 to 20% of the root formation is where they often form nasty curves. These curved roots anchor the tooth in the bone and cause the dentist to be much more aggressive to remove them. And, more aggressiveness or bone trauma means more pain and healing time. Curved roots can also cause other complications such as nerve numbness or a hole into your sinus cavity (when they are removed). 17 year old patients on average have roots which are about 75% formed and perfect for removing. Thirdly, teenagers have the time to have their teeth removed. I had to have one of my wisdom teeth removed 6 years ago and it was tough! When you have a family, it is nearly impossible to schedule a week off. Finally, teenagers are usually on their parents insurance. I see a lot of 20 and 30 year olds who suddenly have wisdom teeth aches but have no insurance. They regret not having it done when they were covered.
The other end of the spectrum is removing wisdom teeth too early. I don't like to remove wisdom teeth when they are "full boney impactions". What this means is that the teeth are fully covered by bone. To remove teeth this early means they have to be uncovered first and in my experience this leads to more swelling and pain. 14 and 15 year olds quite often have wisdom teeth in this stage. I also have to make larger incisions in the gums and stretch the patient's cheek more in this stage. I prefer to wait until the teeth can be removed easier and thus when they should heal easier.
Although 17 years old is the most common age for wisdom teeth removal, they should be evaluated earlier. I have had quite a few 15 year old patients that have developed early. Their roots would probably be fully formed by 17 and then more difficult to remove.
If you are in the office, don't be afraid to ask for my opinion or evaluation!
Thanks for reading,
David Gryzick
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