The wisdom teeth, or third molars, are the final teeth to develop, typically emerging at the very back of the mouth. Orthodontic treatment, such as braces, corrects misaligned teeth and bite issues by applying gentle force to reposition the teeth. Many patients worry that the late emergence of these third molars could destabilize their newly straightened smile. This concern stems from the belief that erupting wisdom teeth exert enough pressure to push other teeth out of alignment, potentially undoing orthodontic work.
Dispelling the Myth: Do Wisdom Teeth Cause Teeth Shifting?
Wisdom Teeth and Force
The belief that wisdom teeth cause crowding by pushing other teeth forward is not supported by current scientific evidence. Orthodontic research has shown that third molars do not exert enough force to cause significant shifting in the front teeth. Crowding often occurs even in individuals who were born without wisdom teeth or who had them removed years earlier. The actual causes of late-stage tooth movement relate more to natural biological processes.
Natural Causes of Shifting
Teeth naturally drift throughout a person’s lifetime due to constant forces from chewing, the tongue, and the lips. Late mandibular growth, a slight forward and upward growth of the lower jaw, is a more probable factor in minor crowding of the lower front teeth. Therefore, the shifting seen years after braces is typically a natural physiological change associated with age, not directly caused by the third molars.
When Wisdom Teeth Emerge During Orthodontic Treatment
Monitoring Development
Wisdom teeth generally emerge between the ages of 17 and 25, a timeline that frequently overlaps with the end of orthodontic treatment. Orthodontists carefully monitor their development throughout the treatment process and afterward. Monitoring is primarily done using panoramic X-rays, which provide a complete view of all the teeth, including the developing wisdom teeth within the jawbone.
Eruption Trajectory
These X-rays track the angle of growth and the overall trajectory of the third molars. If the teeth are growing in a healthy, vertical path with sufficient space to fully erupt, they may be left in place. The main concern during this period is not the risk of shifting, but rather the potential for localized problems like pain or infection as the tooth breaks through the gum tissue.
Factors Leading to Wisdom Tooth Extraction
The decision to remove wisdom teeth is based on pathological reasons or the potential for future oral health complications, separate from preventing alignment changes. One common reason is impaction, which occurs when the tooth is trapped within the jawbone or gum tissue and cannot fully erupt. An impacted tooth can grow at an awkward angle, sometimes horizontally.
Impaction and partial eruption can lead to several serious issues requiring extraction:
- Formation of cysts or tumors around the tooth, potentially damaging surrounding bone and the roots of adjacent teeth.
- Chronic infection called pericoronitis, which results when partially erupted teeth create a gum flap where bacteria accumulate.
- Repeated infection, pain, and swelling, which are clear indicators for removal.
- Damage to the adjacent second molars, such as decay or root resorption caused by the third molar’s pressure.
Post-Braces Stability and Wisdom Teeth
The Role of Retainers
Maintaining the alignment achieved with braces depends on the consistent use of retention devices, regardless of whether wisdom teeth are present or removed. The bone and ligaments supporting the teeth require time to stabilize in their new positions after braces are removed. Retainers hold the teeth in their final placement during this period of healing and stability. Ultimately, wearing a retainer as prescribed is the most significant factor in preventing the natural tendency of teeth to shift back toward their original positions.
Extraction and Stability
If a wisdom tooth is healthy, fully erupted, and cleansable, its presence does not necessitate removal to maintain a straight smile. Conversely, if a wisdom tooth is causing pathology, its removal is integrated into the overall retention plan.