Discover the signs indicating the need for wisdom teeth removal, alongside the pros and cons of the procedure.
Wisdom teeth, also known as third molars, are the last set of teeth to develop and typically emerge in late adolescence or early adulthood. While some individuals retain their wisdom teeth without complications throughout their lives, many people face significant oral health challenges related to these teeth. The question of should you remove wisdom teeth is one that millions of people grapple with annually, and the answer depends largely on individual circumstances, the position and health of the teeth, and risk factors for future complications.
The significance of this decision cannot be overstated, as wisdom teeth extraction represents one of the most common surgical procedures performed today. Understanding the advantages, disadvantages, and long-term implications of removal versus retention is essential for making an informed decision about your oral health.
Several indicators suggest that wisdom teeth removal may be necessary. Pain or pressure in the back of your mouth is often the first noticeable symptom. You may also experience difficulty removing food and plaque around your molars, which can lead to secondary issues.
Additional warning signs include:
Wisdom teeth removal offers substantial benefits for oral health and long-term dental outcomes.
Prevention of Crowding and Misalignment
Wisdom teeth don't always fit properly behind your second set of molars, as research shows they grow at an angle approximately 44% of the time. When this occurs, they can crowd adjacent teeth or even grow roots into them. By removing wisdom teeth proactively, you can prevent the need for orthodontic treatment and avoid the costs and time commitment associated with braces.
Reduced Risk of Impaction
Impacted wisdom teeth—those that break only partway through the gum—can be extremely painful and cause jaw stiffness. Removing wisdom teeth early prevents these issues and the associated discomfort. Research indicates that among patients with pain-free and disease-free wisdom teeth who chose to keep them, at least one-third developed disease requiring removal within 4 years.
Improved Oral Hygiene
Wisdom teeth are difficult to reach with a toothbrush and dental floss due to their position at the back of the mouth. Over time, they accumulate bacteria, acids, and food debris, leading to bad breath, cavities, and gum infections. Removing them eliminates this challenge and reduces decay risk. Removal of wisdom teeth results in a threefold reduction in gum and bone health problems for adjacent teeth.
Infection Prevention
Impacted wisdom teeth can cause inflammation leading to bad breath and infection. In 40% of patients with visible wisdom teeth and gum disease with bone loss present, the bone loss is expected to involve other molar teeth within 2 years. Removal prevents these cascading complications.
Long-term Cost Savings
While extraction involves upfront costs, avoiding wisdom teeth can lead to complications such as crowding, impacted teeth, cysts, gum disease, nerve damage, and infections. Regular dental x-rays are required to monitor their progress, and if issues arise, removal may still be necessary later. Early removal avoids the additional costs and time associated with ongoing monitoring and future corrective procedures.
Protection of Adjacent Teeth
Unchecked impacted wisdom teeth can potentially damage adjacent teeth, particularly their roots, leading to severe discomfort and additional dental treatments.
While removal offers significant benefits, the procedure does carry certain drawbacks and risks.
Anesthesia Requirements and Complications
The extraction process requires numbing medication, and any history of allergies or negative reactions to anesthesia should be discussed with your dentist beforehand. For individuals with complications from anesthesia in the past, this represents a legitimate concern.
Surgical Risks
As with any surgery, wisdom tooth removal involves potential complications. These include nerve damage, infection, dry socket (when the blood clot protecting the wound dissolves prematurely), and damage to nearby teeth. Up to 1 out of 100 people may experience permanent problems such as numbness or damage to nearby teeth as a result of the procedure.
Pain and Recovery Time
The extraction process can cause pain, swelling, bruising, and general discomfort in the mouth and jaw that may last several days. It generally takes about a week to recover from wisdom tooth extraction, during which patients may experience pain, swelling, and difficulty eating. Returning to a regular diet can take additional time.
Age-Related Complications
Increasing age (particularly greater than 24 years), level of impaction of the wisdom tooth, and the need to remove bone are all associated with delayed patient recovery and delayed clinical healing. Not surprisingly, delayed clinical healing increases the risk for delayed recovery of lifestyle activities, oral function, and prolongs bad breath and discomfort in the mouth. There is a greater risk of surgical complications associated with wisdom tooth removal after age 25.
Wisdom teeth removal is a common practice among oral surgeons and is seen as an essential procedure to prevent future dental issues.
Understanding the procedure, recovery, and the implications of retaining wisdom teeth can empower individuals to make the best decisions for their oral health.