Wisdom teeth, or third molars, are the last set of molars to emerge, typically between ages 17 and 25. Many individuals considering orthodontic treatment wonder about their presence, as their relationship with straightening teeth is a common concern. This article explores how wisdom teeth factor into orthodontic care and the considerations involved.
Understanding Wisdom Teeth and Orthodontics
It is often possible to receive braces even if wisdom teeth are present. The decision to proceed with orthodontic treatment while wisdom teeth are still in place often depends on individual circumstances and the specific position of these molars.
If there is sufficient space in the jaw for the wisdom teeth to erupt properly and they are not causing any immediate issues, an orthodontist may choose to monitor their development rather than recommend immediate removal. Braces can even be applied to third molars if they are fully erupted and positioned correctly.
Impact of Wisdom Teeth on Braces Treatment
Even if not immediately extracted, wisdom teeth can introduce various complexities to orthodontic treatment. Their eruption can lead to new crowding or a relapse of straightened teeth, especially if there is limited jaw space. Emerging wisdom teeth can exert pressure, shifting teeth from their ideal positions.
The eruption process can cause discomfort, pain, or swelling around the gums, which can be exacerbated by orthodontic appliances. Impacted wisdom teeth, unable to fully emerge, may press against adjacent second molars, potentially causing damage or root resorption. Partially erupted or misaligned wisdom teeth are difficult to clean, increasing the risk of food trapping, bacterial buildup, cavities, or gum disease. These issues can complicate and prolong orthodontic treatment.
When Wisdom Teeth Extraction is Considered
Extraction of wisdom teeth in conjunction with orthodontic treatment is considered under specific circumstances. A primary reason is impaction, where the tooth is trapped within the jawbone or gums and cannot erupt.
Insufficient space in the jaw is a frequent cause for recommending removal, as there may not be enough room for the wisdom teeth to emerge without crowding or shifting other teeth. If the presence or eruption path of wisdom teeth actively interferes with the planned movement of other teeth during braces treatment, extraction may be advised. Pathology associated with the wisdom teeth, such as cysts, tumors, or significant, unrestorable decay, also warrants removal. Additionally, recurring pain, swelling, or infection around the wisdom teeth can be a compelling reason for extraction.
The Consultation and Decision-Making Process
Determining the best course of action for wisdom teeth during orthodontic treatment involves a thorough professional assessment. An orthodontist will conduct an initial evaluation, including X-rays, to visualize the position and development of the wisdom teeth. These images help predict potential issues or confirm adequate space.
If extraction is deemed necessary, the orthodontist will typically refer the patient to an oral surgeon for a more detailed assessment and the surgical procedure. The decision is influenced by several factors, including the patient’s age, the specific position and angulation of the wisdom teeth, their overall oral health, and the long-term goals of the orthodontic treatment. Ultimately, the final decision regarding wisdom teeth and braces is a collaborative one, involving careful discussion between the patient, the orthodontist, and the oral surgeon.