Wisdom teeth, or third molars, typically emerge between ages 17 and 25. While some individuals have no issues, they often cause problems due to limited jaw space, frequently requiring removal. A common question is whether it is acceptable to remove only one wisdom tooth.
Situations for Removing One Wisdom Tooth
Dental professionals may recommend the extraction of a single wisdom tooth in several scenarios. One common reason is a localized problem, such as pain, infection, or significant decay affecting only one of the third molars.
If this tooth causes symptoms while others are healthy, removing only the problematic one is suitable. Other reasons include a partially erupted tooth that is hard to clean, leading to infections or decay. A single wisdom tooth might also press against or damage an adjacent second molar, requiring removal to protect surrounding teeth. Removal can also facilitate orthodontic treatment or prevent future crowding if other wisdom teeth are not a concern. Some individuals naturally develop only one or two wisdom teeth, simplifying the decision to remove only the present, problematic tooth.
Considerations for Single Wisdom Tooth Removal
Removing only one wisdom tooth introduces several considerations for oral health and function. An important factor is the potential impact on occlusion, or how upper and lower teeth align when biting. While teeth generally do not drastically shift after wisdom tooth removal, minor bite alignment changes can occur, especially if the removed tooth was severely impacted.
A concern when removing a single wisdom tooth is supra-eruption, where the opposing tooth over-erupts into the newly created space. This occurs because the tooth loses its biting counterpart, continuing to erupt beyond the normal bite plane.
Supra-eruption can cause uneven bite pressure, discomfort, or interfere with chewing, potentially leading to cheek or gum biting. It also creates hygiene challenges, as the over-erupted tooth or space becomes harder to clean, increasing decay or gum disease risk.
While slight shifts of remaining teeth are possible, major misalignment is not expected, though the bite may feel different as the mouth adjusts.
Determining if One Wisdom Tooth Should Be Removed
The decision to remove a single wisdom tooth involves a comprehensive diagnostic process by dental professionals. This begins with a thorough visual examination of the patient’s mouth, including gums and existing teeth. Radiographic imaging, such as panoramic X-rays or 3D CT scans, is important for detailed assessment of impacted teeth and their proximity to nerves. These images help dentists evaluate the position, impaction status, root structure, and proximity to vital structures for all wisdom teeth.
This evaluation includes assessing the health and position of the opposing wisdom tooth. The dentist considers if this tooth is functional and healthy, or if its removal might prevent issues like supra-eruption.
The patient’s overall oral health, including decay or gum disease, is also considered. The dental professional also reviews the patient’s symptoms, such as pain or recurrent infections, and their dental history.
Finally, the dentist provides a long-term prognosis for all wisdom teeth and discusses the pros and cons of removing one versus multiple or all, enabling an informed decision.