J. Bruce Burley, D.D.S.

Wisdom teeth

Wisdom teeth, also called 3^rd molars, usually begin to erupt through the gums around age 18-20, bringing the total number of teeth in a person’s mouth from 28 to 32.  Not everyone will develop wisdom teeth; however, on average, 85% of people will develop all four wisdom teeth and 95% of people have at least one wisdom tooth.

Scientists point to the fact that the human jaw is smaller than it was long ago, and for this reason, many people do not have enough room to accommodate their wisdom teeth.  As a result, the wisdom teeth cannot erupt normally and are said to be “impacted.”

Impacted wisdom teeth can lead to a number of potential problems.  These include:

• Predisposing the 2^nd molar tooth (tooth in front of the wisdom tooth) to periodontal disease and dental decay.  Depending on positioning, periodontal pocketing and bone loss can occur behind the 2^nd molar tooth.  This pocket can trap bacteria and be difficult to clean.
• Infection of the soft tissue overlying an impacted tooth.  Sometimes the wisdom tooth may only partially erupt out of the gums.  When this happens, the flap of gum tissue overlying the back of the tooth is easily inflamed or infected.
• Cysts may develop around impacted teeth.
• Impacted wisdom teeth may cause jaw pain.
• Impacted wisdom teeth may render the jaws more susceptible to fracture, since the tooth is taking up space that should be occupied by bone.
• It may be suggested to remove wisdom teeth before orthodontic treatment or before fabrication of a removable prosthesis.

Removal of impacted wisdom teeth does not come without risks. Potential risks include:

• Advanced age and/or compromised medical status:  As patients age, the bone becomes more calcified and less flexible and likely to bend.  Additionally, older patients do not heal as quickly as younger patients.  A general rule of thumb is to lean more toward monitoring an impacted wisdom tooth (rather than remove it) in a person over 35 years old as long as there are no signs of disease or any of the above listed problems associated with it.
• Probable damage to adjacent structures during removal.  If the tooth is in a position in which removing the tooth may seriously jeopardize adjacent nerves, teeth, or dental prostheses, the tooth may be left in place and monitored for disease.

As with any important decision, it is important to weigh the risks vs. benefits in deciding whether or not to remove wisdom teeth.