Wisdom teeth, also known as third molars, emerge in the late teenage years or early twenties. Many individuals undergoing or considering orthodontic treatment wonder if these teeth can disrupt the alignment achieved by braces. This article explores how wisdom teeth relate to oral health and orthodontic outcomes.
The Common Belief Versus Scientific Evidence
It is commonly believed that erupting wisdom teeth exert pressure on existing teeth, causing them to shift and crowd, especially the lower front teeth. However, scientific evidence refutes this direct “pushing” mechanism as the primary cause of orthodontic relapse. Studies show no significant difference in crowding regardless of wisdom tooth status (impacted, erupted, extracted, or missing). Research indicates that wisdom teeth do not generate enough force to cause substantial tooth movement. Most tooth movement after braces is attributed to other factors, not a direct push from wisdom teeth.
How Wisdom Teeth Can Affect Oral Health and Orthodontic Outcomes
While wisdom teeth may not directly push other teeth out of alignment, their presence can affect oral health and complicate orthodontic outcomes indirectly. If there is insufficient space in the jaw for wisdom teeth to erupt properly, they can become impacted. Impaction occurs when a tooth is unable to fully break through the gum line or align correctly, leading to issues like pain, swelling, and infection. This lack of space and impaction can make it more challenging to achieve or maintain stable orthodontic results.
Impacted wisdom teeth can press against the roots of adjacent teeth, causing damage or cysts. Partially erupted wisdom teeth can create hard-to-clean areas at the back of the mouth, increasing the risk of cavities and gum disease. These problems can compromise overall health and impact orthodontic success and stability. An incorrect bite due to misaligned wisdom teeth can also lead to issues like teeth grinding or jaw discomfort.
Deciding on Wisdom Tooth Removal
The decision to remove wisdom teeth for orthodontic patients is a clinical assessment based on individual circumstances. Removal is recommended when there is evidence of impaction, pain, recurrent infection, or damage to adjacent teeth. If X-rays indicate that wisdom teeth are likely to become impacted or cause overcrowding, removal before or during orthodontic treatment may be advised to prevent issues.
Removal is also considered if their position complicates current or future orthodontic treatment, such as blocking tooth movement or hindering oral hygiene. Orthodontists and oral surgeons work together to determine the optimal timing for extraction, considering the tooth’s development stage and potential risks. The procedure is performed when the tooth roots are partially, but not fully, developed, usually between the ages of 14 and 20, to minimize issues.
Factors Contributing to Tooth Movement After Braces
Tooth movement after orthodontic treatment is a common occurrence, independent of wisdom teeth, and is primarily due to natural biological processes and habits. Teeth tend to return to their original positions, a phenomenon sometimes called “memory” of the surrounding bone and soft tissues. This is noticeable in the first 3-6 months after braces are removed, as gum fibers, stretched during treatment, pull teeth back.
Ongoing jaw growth and the natural aging process also contribute to changes in tooth alignment over time. Daily activities like chewing, swallowing, and speaking apply continuous pressure to the teeth, influencing their position. The most significant factor in preventing post-braces tooth movement is consistent retainer wear, as retainers help stabilize teeth in place while the surrounding bone remodels. Improper retainer use is a leading cause of orthodontic relapse. Other factors include habits like teeth grinding, tongue thrusting, and the presence of gum disease or tooth loss, which can alter tooth stability.