Wisdom teeth can cause so many problems it is a wonder that we often leave them in place and avoid treatment. Remember, earlier treatment is easier and less risky. One or more of these problem areas could apply to your case:
Silence: This can be one of the greatest concerns. Problems can be creeping in without your being aware of them. Wisdom tooth problems don’t always cause pain. Sometimes they are silent. So evaluate them and plan their removal as is appropriate.
Pain: Pain is the greatest motivator. We don’t want you to wait until your teeth are causing pain but it can be an indication of underlying problems.
Swelling: As the third molars try to come in they may just cause an expansion surrounding tissues. Biting on these may cause inflammation and pain. Pericornitis is a medical term used to describe inflammation of the tissues over an impacted tooth. Many of the other concerns listed below such as infection or tumors may also cause swelling.
Infection: It is common for wisdom tooth sites to become infected and this is often the symptom that brings the person in for care. When wisdom teeth are left in place, they may result in an area that is contaminated and difficult or impossible to keep clean. Germs and debris can settle in and cause infection, which can range from mild to severe cases requiring hospitalization. Remember that antibiotics do not cure these infections. They only treat the resultant tissue response. Removal of the offending tooth is the proper treatment.
Bacteria: This refers to the spread of infection through the body from an infected site. Even low-grade infections have an effect on the overall body and immune system. This is especially true for individuals who have other medical concerns. New research has shown that bacteria in the bloodstream put us at increased risk for other diseases including vascular and heart disease.
Positional Problems: Wisdom teeth often develop in abnormal angulations. Positive abnormal angulation can increase the likelihood that there will be difficulty with removal and increase the risks to surrounding structures, including other teeth. This can be diagnosed early on with
a simple x-ray.
Peridontitis and Bone Loss: Peridontitis refers to gum disease and bone loss. When wisdom teeth are impacted, they often act as spaces where debris and germs cause low-grade infections that result in bone loss on the adjacent teeth. Even when they are erupted, the wisdom teeth are often in unattached gum tissue that is less healthy and prone to inflammation and bone loss.
Cysts and Tumors: Wisdom teeth develop in a tissue sack when, left buried in the bone and tissues, can undergo a change and form into a cyst or tumor. This is one of the most serious complications with the retention of wisdom teeth. These growths can be very extensive and can even necessitate removal of whole parts of the jaw. These cases are “rare”; however, we regularly treat these in our practice. Cysts and Tumors are another one of the ‘silent’ problems with impacted teeth.
Migration of Wisdom Teeth: When left in place, impacted teeth can migrate in the jaws. Over time, they can shift into extreme positions. This is often brought on by their relationship to growths in the jaws. Early in development, they are often in the best position for removal.
Crowding/Shifting of teeth: When there are too many teeth in the dental arch, such as with wisdom teeth, they may shift to try to make room for all of the teeth.
Nerve Concerns: As the teeth develop in the lower jaw, the roots are often in close position to the sensory nerve bundles. They often overlap the nerve. We have even seen the roots develop completely around the bundle. When the wisdom teeth are removed, it will place the nerve at risk for injury. This further increases with age. Early removal helps to minimize this concern.
Sinus Concerns: Just as the nerves are at increased risks in the lower jaw, the sinuses are at risk in the upper jaw. The wisdom teeth develop at the back of the upper jaw below the sinuses. As the roots develop, they often extend into the sinuses putting them at risk. Again, early removal helps to reduce this risk.
Fused to Bone: In the teen years, the wisdom teeth are usually more mobile in the bone. As the teeth develop and age, they become more anchored in the bone. In some cases, a developmental change takes place where the teeth become “anklyosed” or fused in the bone. This increases difficulty with removal and therefore, increases risks. Early removal helps to reduce this concern.
