Wisdom teeth, also known as third molars, are the last set of permanent teeth to emerge. They typically appear in the late teens or early twenties, between the ages of 17 and 25. Located at the very back of the mouth, behind the second molars, their late arrival can present unique challenges.
Understanding Wisdom Teeth Permanence
Wisdom teeth do not naturally fall out like baby teeth. Once they emerge, they are permanent adult teeth, intended to remain in the mouth unless compromised by underlying dental conditions. Any loosening is a sign of an oral health issue, such as severe decay or gum disease, not a natural shedding process.
How Wisdom Teeth Erupt and Impact
Wisdom teeth erupt by moving through the gums and ideally settling into a functional position. This process can take months or even years. However, many individuals lack sufficient jaw space for proper emergence, leading to impaction. An impacted wisdom tooth fails to fully erupt, remaining trapped partially or completely within the gums or jawbone.
Impaction can occur in several ways, depending on the tooth’s angle and depth.
- Mesial impaction: The tooth is angled forward toward the front of the mouth (most common).
- Distal impaction: The tooth is angled toward the back of the mouth (less common).
- Vertical impaction: The tooth is in a normal upright position but trapped beneath the gums.
- Horizontal impaction: The tooth lies completely sideways.
Impactions are also classified by coverage: soft tissue impaction means the tooth is covered by gum tissue, while bony impaction means it is fully encased within the jawbone.
Typical Problems with Wisdom Teeth
Impacted wisdom teeth can lead to various complications. One common issue 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 a gum flap, creating an environment for infection. Symptoms include pain, swelling, a bad taste, and difficulty opening the jaw.
Impacted wisdom teeth can also contribute to tooth decay in adjacent teeth. Their position often makes them difficult to clean, allowing food and bacteria to accumulate between the wisdom tooth and the neighboring second molar, increasing the risk of cavities. Additionally, the pressure from an erupting wisdom tooth can damage the roots of adjacent teeth or cause them to shift, affecting overall tooth alignment.
In some instances, fluid-filled sacs called dentigerous cysts can form around the crown of an impacted tooth. These cysts can grow, potentially damaging the jawbone and nearby teeth or nerves if left untreated.
When Professional Removal is Advised
Dental professionals often recommend wisdom tooth removal when they cause persistent problems or are likely to cause future issues. This includes recurrent infections, significant pain, swelling, or documented damage to adjacent teeth. Extraction is also advised if X-rays reveal potential impaction that could lead to problems, even without current symptoms.
A thorough dental evaluation, including X-rays, assesses the wisdom teeth’s position and identifies existing or potential complications. This assessment helps determine the most appropriate course of action. While the ideal age for removal is often between 17 and 25 due to easier extraction and faster healing, extractions can occur at any age if problems arise. The decision to remove wisdom teeth is based on individual circumstances and their potential impact on oral health.