Wisdom teeth are the last teeth to develop and erupt into the mouth. They are more accurately labelled as the third molar teeth according to dentists. Most of us however would probably know them better as wisdom teeth due to the timing of their eruption, which coincides with the coming of age. 

We have a total of four wisdom teeth, one located at each corner (end) of the dentition. Modern man have evolved to possess relatively smaller jaw bones due to his refined diet. This results in a lack of space for the wisdom teeth, causing them to become stuck or poorly positioned, gaining them notoriety for a myriad of problems. Treatment often involves its removal.

Common reasons for wisdom teeth removal include:

 

1. RECURRENT GUM INFECTION

 

Due to the lack of space, the wisdom tooth may only be able to erupt partially. This means that a significant part of the tooth is still covered by a flap of gum tissue. The space underneath the gum flap is hard to keep clean and easily accumulates food debris and bacteria, potentially resulting in an infection. Besides pain and swelling, severe episodes of infection may lead to jaw stiffness, fever, lethargy, bad breath, unpleasant taste and sore throat. If untreated, it can lead to a life threatening condition known as Ludwig’s Angina.      

 

2. DECAY

 

The wisdom tooth may also erupt into a tilted position against the tooth in front of it (the second molar tooth). This results in a narrow slit like opening that traps food particles, eventually leading to decay of both the wisdom tooth and the second molar tooth. In such a situation, treatment will involve the removal of the wisdom tooth as well as the restoration of the second molar tooth. Treatment of decay that lies on the back surface of the second molar tooth is very challenging for both patients and dentists alike. It may also escalate into more complicated procedures, such as root canal treatment or result in it’s loss if the decay is deep.  

 

3. CHRONIC GUM DISEASE

 

Chronic food trap between a stuck wisdom tooth and the second molar tooth may lead to chronic gum disease, resulting in bone loss. Loss of bony support around a tooth is detrimental to its longevity.        

   

4. PRESSURE ULCERS

 

Wisdom teeth that are erupting in the wrong direction can potentially cause pressure on its’ neighbours. Some authors have even suggested that they may play a role in the misalignment of teeth. Wisdom teeth that grow outwards toward the cheek has a tendency to rub against the inner side of the cheek, causing frequent ulceration and episodes of pain.

 

5. CYST FORMATION

 

Wisdom teeth that are unable to erupt due to a lack of space have a small chance of experiencing cystic changes over time. A cyst is a fluid-filled sac that gradually becomes larger over time, resulting in pressure resorption of bone and roots of teeth. A cyst of moderate size, may also cause displacement of nearby structures, such as teeth and nerves. Untreated cysts can grow very large in the longer term, resulting in facial disfigurement and increase the risk of jaw bone fracture.        

 

6. PREVENTIVE REASONS

 

Anecdotal evidence suggests that discomfort from a wisdom tooth tend to surface in the presence of stress (e.g. examinations) or increase daily activity (e.g. travelling, hectic work schedule). This could be due to a neglect in personal oral hygiene or a lowered immune status when a person is fatigue. The discomfort from an infected wisdom tooth on such occasions is of course distressing to the patient.

Fortunately, one can pre-empt this matter altogether by opting for the elective removal of wisdom teeth as a planned procedure.

Hormonal changes during pregnancy will increase the risk of gum infections, including the area surrounding the wisdom teeth. Women who are planning to start a family may benefit from the elective removal of wisdom teeth. In the event that you are pregnant and are experiencing wisdom teeth problems, the recommended time to remove the tooth is during the second trimester of pregnancy.

 

WHEN IS THE BEST TIME TO REMOVE YOUR WISDOM TEETH?

 

Most oral surgeons advocate the removal of wisdom teeth during late adolescence or  early adulthood. Younger patients often experience better healing and fewer complications during recovery. This is likely due to their physiologic state, relatively elastic bone and incomplete root development of the wisdom teeth. Wisdom teeth can be extracted or surgically removed depending on its orientation. Read more about the treatment options here and  here.