Wisdom teeth, also known as third molars, are the last set of adult teeth to emerge in the mouth. These teeth typically appear in late adolescence or early adulthood, generally between the ages of 17 and 25. While many individuals undergo extraction of these molars, it is not universally necessary for everyone to have them removed. The decision to keep or remove wisdom teeth depends on various factors, including their position, health, and whether they are causing any problems. Understanding the different scenarios associated with retaining wisdom teeth can help in making informed choices about oral health.
When Wisdom Teeth Are Not Removed
Wisdom teeth can be safely retained if they erupt fully and are properly aligned. This means they emerge without pushing against other teeth and have enough space to function without causing issues. When these teeth are healthy, fully grown, and positioned correctly to bite properly against opposing teeth, they may not require removal and can contribute to the chewing process without complications.
Another scenario where wisdom teeth may remain is if they are impacted but do not cause symptoms or pathology. An impacted tooth is one that is trapped beneath the gums or jawbone and cannot fully erupt. Some dental professionals may recommend a conservative approach for these asymptomatic teeth, particularly if there is insufficient evidence to suggest future problems. Adequate space in the jaw for eruption and proper cleaning is also an important factor in deciding whether to retain them.
Potential Issues from Retained Wisdom Teeth
If wisdom teeth are kept, especially when impacted or improperly aligned, various problems can arise. One common issue is impaction-related pain and pressure. An impacted wisdom tooth can grow at an odd angle, pushing against the adjacent second molar, which may cause pain, swelling, and discomfort. This pressure can sometimes lead to crowding of other teeth.
Infections, such as pericoronitis, frequently occur with partially erupted wisdom teeth. This condition involves inflammation and infection of the gum tissue surrounding the tooth. A flap of gum tissue, called an operculum, can form over a partially erupted tooth, trapping food particles and bacteria underneath, creating an environment for infection. Symptoms of pericoronitis can range from mild pain and swelling to severe cases involving pus, bad breath, and difficulty opening the mouth.
Retained wisdom teeth can also cause damage to neighboring teeth. If an impacted wisdom tooth pushes against the adjacent second molar, it can potentially damage the second molar’s roots or increase its risk of decay and infection. The difficulty in cleaning the area around a partially erupted or angled wisdom tooth can also make the second molar more susceptible to cavities and gum disease. This can lead to bone loss around the second molar, particularly in older individuals.
Though less common, fluid-filled sacs called cysts or even benign tumors can develop around an impacted wisdom tooth. These growths form within the sacs where wisdom teeth develop in the jawbone. If left untreated, these cysts can expand, potentially damaging the jawbone, nerves, and surrounding teeth. In rare instances, extensive growth might necessitate removal of tissue and bone.
Monitoring and Management of Retained Wisdom Teeth
For individuals who retain their wisdom teeth, ongoing monitoring by a dental professional is important. Regular dental check-ups, which include dental X-rays, are helpful for evaluating the wisdom teeth and the overall dental health. X-rays can reveal potential issues beneath the gum line or within the jawbone that are not visible during a routine oral examination. This allows dentists to track any changes or developing problems over time.
Maintaining thorough oral hygiene is important for retained wisdom teeth. Due to their location at the very back of the mouth, wisdom teeth can be challenging to clean effectively. Brushing along the gum line and flossing below the gum line around these teeth can help prevent plaque buildup and potential issues. Using an antibacterial mouth rinse can also assist in reducing bacteria in the mouth.
Even if initially asymptomatic, retained wisdom teeth may require removal later if problems develop or are anticipated. Conditions such as pain, recurrent infections, the formation of cysts or tumors, or damage to adjacent teeth can signal the need for extraction. A dental professional can assess the specific situation, considering the patient’s age and dental health, to determine the most appropriate course of action.