“18-year molars” is a common term for wisdom teeth, also known as third molars. These teeth are the last set of adult molars to emerge, positioned at the very back of the upper and lower jaws. Their name reflects the typical age range when they appear. While often associated with age 18, their eruption can vary and they do not always emerge without issues.
Understanding Their Appearance
The emergence of 18-year molars typically occurs between ages 17 and 25, though some individuals may experience eruption earlier or later. This late appearance leads to their common name, “wisdom teeth,” as they emerge during a period associated with increased maturity. Not everyone develops all four wisdom teeth, and some people may not have any.
Their biological development begins much earlier, often around 7-10 years old, with the tooth forming within the jawbone. Over several years, the root develops, and the tooth gradually moves towards the gum line. Their eventual eruption involves breaking through the gum tissue, which can sometimes be accompanied by discomfort.
Potential Complications
18-year molars frequently encounter complications due to insufficient space in the jaw. This often leads to impaction, where the tooth cannot fully erupt and remains partially or completely embedded within the gum or jawbone. Impaction can manifest in various ways, such as horizontal (lying sideways), angular (tilted), or vertical (upright but stuck below the gum line or against another molar).
A common issue with partially erupted wisdom teeth is pericoronitis, an infection of the gum tissue surrounding the crown. This condition results from bacteria and food particles becoming trapped, leading to inflammation, pain, and swelling. Impacted or misaligned wisdom teeth can also exert pressure on neighboring teeth, potentially causing damage, including decay or root erosion.
Furthermore, impacted wisdom teeth can sometimes lead to the formation of cysts or tumors around the tooth, which can damage the jawbone. These growths may require surgical intervention. Pressure from erupting or impacted wisdom teeth might also contribute to the crowding or misalignment of other teeth in the dental arch.
Deciding on Removal
Dentists and oral surgeons evaluate several factors when deciding to remove 18-year molars. Extraction is often recommended when these teeth cause recurring infections, such as pericoronitis, or significant pain and discomfort. Evidence of damage to neighboring teeth, including decay, gum disease, or root resorption, also indicates a need for removal.
The presence of cysts or tumors associated with wisdom teeth is another clear criterion for extraction. Significant impaction, especially when leading to persistent symptoms, typically warrants removal. Early removal can prevent more complex problems, as wisdom tooth roots become longer and more intricate with age, making later extractions more challenging.
However, not all 18-year molars require removal. If they are healthy, fully erupted, and properly aligned within the dental arch, they can function without problems. Teeth that are easily accessible for cleaning and do not contribute to crowding or other dental issues may be monitored rather than extracted. Regular dental check-ups, including X-rays, help determine if these teeth are developing without complications.
The Extraction and Recovery Process
If 18-year molars require removal, a dental or oral surgeon typically performs the procedure. It begins with administering local anesthesia or sedation options like nitrous oxide or intravenous sedation for patient comfort. For fully erupted teeth, extraction is similar to removing any other tooth.
For impacted teeth, a small incision in the gum tissue may be necessary to access the tooth, and sometimes a small amount of bone covering the tooth is removed. The tooth may be divided into smaller pieces for easier removal. After extraction, the site is cleaned, and sutures may be placed to aid healing.
Post-operative care is crucial for a smooth recovery. Managing pain and swelling is commonly achieved with prescribed or over-the-counter pain relievers and applying ice packs to the face. Patients are advised to maintain a soft diet for several days, gradually reintroducing solid foods as comfort allows.
Gentle oral hygiene, such as rinsing with warm salt water, helps keep the site clean and promotes healing, while avoiding vigorous brushing or spitting is important. Minor complications like dry socket, characterized by throbbing pain, can occur if the blood clot dislodges from the extraction site, but these are manageable with further dental care.