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Wisdom teeth are usually the last teeth to erupt in the late teens or older (theoretically at the ‘age of wisdom’) and they are often referred to as third molars.
Not everybody has four wisdom teeth; some people have less and some have more than four (third as well as fourth molars). Unfortunately; as they are generally the last teeth to form and erupt at the back of the mouth, there is often not enough room for them to be accommodated in the dental arch.
If a tooth is partially or completely unerupted and wedged against another tooth, jaw bone or gum such that it has no hope of emerging into the mouth and into normal function, then it is referred to as impacted. Impacted wisdom teeth are common.
Wisdom teeth should be evaluated on a regular basis beginning in the mid-teen years. By age 16 or 17 jaw growth and the crowns of the wisdoms are essentially fully formed while the roots (which follow in development) are partially formed. The decision to remove them is based on a clinical judgement made by your dentist and if he is unsure then he will refer you to someone more experienced and qualified to make that decision.
Timing is important as there is general agreement that complications are less likely to occur and healing is more favourable if the wisdoms are removed when the roots are about two-thirds formed. Dentists should not post-pone the removal of wisdoms which will predictably only partially erupt as this ignores the potential for increased complications and unnecessary suffering. It is also a mistake to wait until the wisdoms are symptomatic with pain and swelling before deciding to remove them; i.e. “I’ll wait till they hurt!” With “prevention is the best medicine” philosophy, clearly healing and recovery will be better if the wisdoms can be removed before they become infected and inflamed.
Some dentists advocate the removal of the wisdoms as tooth buds at age 8 or 9 years as post-operative morbidity is significantly reduced. This is controversial and is generally not recommended in our practice unless requested by a Specialist Orthodontist.
Do all wisdom teeth always need to be removed?
The answer is no! If the tooth is healthy, can erupt normally into function with its apposing tooth and the gum around it is healthy then there is no indication for its removal. Whether the wisdoms pushing through the gum into the mouth or being impacted can cause crowding and ‘crookedness’ of the other teeth is controversial and probably unlikely. Your Orthodontist is best person to assess whether your wisdoms should be removed following a course of Orthodontic treatment.
Unfortunately wisdom teeth in general do tend to be problematic and most young people today have them removed. Symptoms include pain and swelling, often occurring during periods of stress (student exams etc) or when feeling ‘run-down’ and range from mild to serious and severe, even on occasion requiring hospitalisation! |
