Wisdom teeth are the last set of adult teeth to emerge in the mouth. They appear in late adolescence or early adulthood, between the ages of 17 and 25. While some wisdom teeth erupt without issue, their emergence often presents challenges that can impact oral health.
How Wisdom Teeth Grow
The eruption of wisdom teeth follows a biological process similar to other teeth. They develop within the jawbone and then push through the gums. This process can take months or even years for a tooth to fully emerge. For some, these teeth grow into proper alignment with sufficient jaw space, integrating seamlessly with existing dentition.
However, the modern human jaw often lacks adequate space for these additional molars, leading to problematic growth. When a wisdom tooth cannot fully erupt or emerges at an improper angle, it is impacted. Impaction occurs if the tooth is trapped partially or completely beneath gum tissue or bone, growing sideways, angled towards other teeth, or horizontally. This lack of space and alignment can lead to various dental complications.
Potential Issues with Wisdom Teeth
Leaving wisdom teeth to grow without monitoring can lead to several oral health problems. Pain and discomfort are common indicators, often manifesting as a dull ache in the back of the jaw or radiating pain. This discomfort can be persistent and may intensify as issues progress.
A frequent complication is pericoronitis, an inflammation and infection of the gum tissue surrounding a partially erupted wisdom tooth. This occurs when food particles, plaque, and bacteria become trapped under the gum flap, creating an environment conducive to infection. If untreated, pericoronitis can lead to more severe infections, causing swelling, pus discharge, and difficulty opening the mouth.
Impacted wisdom teeth can also damage neighboring teeth. Pressure from an impacted wisdom tooth pushing against the adjacent second molar can lead to structural damage, such as root resorption (where the root structure of the neighboring tooth is dissolved) or decay. This pressure can also cause adjacent teeth to shift or become misaligned. While patients often worry wisdom teeth cause general crowding, research indicates they are not the primary cause of overall dental crowding; however, they can impact the alignment of immediate neighboring teeth.
Fluid-filled sacs called cysts can form around an impacted wisdom tooth within the jawbone. These cysts can expand, damaging the jawbone, adjacent teeth, and nerves. Although rare, impacted wisdom teeth can also be associated with benign tumors.
The position of wisdom teeth makes them challenging to clean effectively. This difficulty in maintaining oral hygiene increases the risk of tooth decay (cavities) on the wisdom tooth itself and the adjacent molar. It also contributes to gum disease, including gingivitis and more severe forms like periodontitis.
Navigating Wisdom Tooth Concerns
Given potential complications, seeking professional dental evaluation for wisdom teeth is important. A dentist or oral surgeon can assess their position and determine if intervention is necessary. This evaluation involves a thorough clinical examination and dental X-rays, such as panoramic or periapical images, which provide a clear view of the teeth, jawbone, and surrounding structures, identifying impacted teeth not visible through the gums.
Based on the assessment, the dental professional will discuss the appropriate course of action. If wisdom teeth are fully erupted, properly aligned, and not causing issues, observation may be an option. However, extraction is frequently recommended when problems arise or to prevent future complications. Removing wisdom teeth in younger adults (17-25 years old) is considered safer and leads to quicker recovery because roots are not fully formed and the jawbone is less dense, simplifying the procedure.