Wisdom teeth, or third molars, are the last teeth to emerge, typically making their appearance in the late teens or early twenties. It’s a common scenario: your dentist might suggest wisdom teeth removal, even if they aren’t currently causing you pain. This often leads to the question: “Why Do Wisdom Teeth Need To Be Removed if they aren’t bothering me?”. Understanding the reasons behind this recommendation is crucial for making informed decisions about your dental health.
When Keeping Wisdom Teeth Might Be Okay
In some fortunate cases, wisdom teeth can erupt and settle into the mouth without causing any issues. According to dental professionals, including experts at Mayo Clinic, wisdom teeth might not require removal if they meet certain criteria:
- Healthy: The teeth are free of decay and gum disease.
- Fully Grown In: They have completely emerged through the gum line.
- Properly Positioned and Biting Correctly: They are aligned correctly with the opposing teeth and don’t interfere with your bite.
- Maintainable Hygiene: You can effectively clean them daily with brushing and flossing as part of your regular oral hygiene routine.
If your wisdom teeth meet these conditions, your dentist may decide that monitoring them is sufficient. However, this ideal situation is not the most common.
Common Problems Associated with Wisdom Teeth
More frequently, wisdom teeth lack the space to erupt properly, leading to a range of potential dental problems. These complications are the primary reasons why dentists often recommend their removal. Here are some common issues:
Impacted Wisdom Teeth: Hidden Dangers Beneath the Gums
When wisdom teeth are impacted, it means they become trapped within the jawbone and gums, unable to fully emerge. This happens because there often isn’t enough space at the back of the jaw to accommodate them. Impacted wisdom teeth can present several risks:
- Infection: The trapped tooth can create a pocket where bacteria and food debris accumulate, leading to persistent infections.
- Cyst Formation: A fluid-filled sac, or cyst, can develop around the impacted wisdom tooth. Cysts can damage the roots of nearby healthy teeth and erode the supporting bone structure of the jaw.
Partially Erupted Wisdom Teeth: A Gateway for Bacteria
Wisdom teeth that only partially erupt through the gums create a particularly vulnerable area in the mouth. The gum tissue partially covering the tooth can form a flap, which is difficult to clean effectively. This creates an ideal environment for bacteria to thrive, leading to:
- Gum Disease (Pericoronitis): Bacteria trapped under the gum flap can cause inflammation and infection of the gum tissue surrounding the wisdom tooth, known as pericoronitis. This can result in pain, swelling, and difficulty opening your mouth.
- Tooth Decay (Cavities): Partially erupted wisdom teeth are challenging to clean, making them more susceptible to cavities. Due to their location at the very back of the mouth, treating these cavities with fillings can be difficult or impossible, often necessitating extraction.
Crowding and Damage to Adjacent Teeth
Even when wisdom teeth do erupt partially or fully, they can still pose problems if there isn’t sufficient space in the jaw. They can exert pressure on the adjacent molars, leading to:
- Crowding and Misalignment: Wisdom teeth pushing against other teeth can cause them to shift, resulting in crowding and misalignment of your bite. This can undo previous orthodontic work and affect the overall aesthetics and function of your teeth.
- Damage to Second Molars: The pressure from erupting wisdom teeth can damage the roots of the second molars, potentially weakening them or requiring root canal treatment in the future.
The Case for Early Wisdom Teeth Removal
Dentists often recommend proactive removal of wisdom teeth in young adulthood, typically between the ages of 15 and 22. This preventative approach is often considered safer and more beneficial for several reasons:
- Less Developed Roots: In younger individuals, the roots of wisdom teeth are not yet fully formed. This makes extraction surgically easier and less traumatic to surrounding tissues and nerves.
- Less Dense Jaw Bone: The jawbone in younger patients is less dense and more pliable, which also simplifies the removal process.
- Faster Recovery: Younger patients generally experience faster and smoother recovery from wisdom teeth removal surgery compared to older adults.
Removing wisdom teeth before they cause problems can prevent future pain, infections, and more complex dental issues down the line.
When is Wisdom Teeth Removal Necessary? Guidelines from the American Dental Association
The American Dental Association (ADA) outlines specific conditions where wisdom teeth removal is recommended. You may need to have your wisdom teeth extracted if you experience:
- Pain in or near your wisdom teeth.
- Repeated infection of soft tissue behind the lower last tooth.
- Fluid-filled sacs (cysts).
- Tumors.
- Damage to nearby teeth.
- Gum disease.
- Extensive tooth decay.
Making the Right Decision for Your Oral Health
Deciding whether or not to have your wisdom teeth removed is a personal decision that should be made in consultation with your dentist or an oral surgeon. They can assess your individual situation, evaluate the position and health of your wisdom teeth, and discuss the potential risks and benefits of extraction. Open communication with your dental professional is key to determining the best course of action for maintaining your long-term oral health and preventing potential problems associated with wisdom teeth.
References:
- Wisdom teeth. American Dental Association. http://www.mouthhealthy.org/en/az-topics/w/wisdom-teeth. Accessed Oct. 30, 2023.
- Wisdom teeth management. American Association of Oral and Maxillofacial Surgeons. https://www.aaoms.org/images/uploads/pdfs/Ebook_Wisdom_Teeth_R.pdf. Accessed Oct. 30, 2023.
- Management of third molar teeth. American Association of Oral and Maxillofacial Surgeons. https://www.aaoms.org/docs/govt_affairs/advocacy_white_papers/management_third_molar_white_paper.pdf. Accessed Oct. 30, 2023.
- Ghaeminia H, et al. Surgical removal versus retention for the management of asymptomatic disease‐free impacted wisdom teeth. Cochrane Database of Systematic Reviews. 2020; doi:10.1002/14651858.CD003879.pub5. Accessed Oct. 30, 2023.
- Should you have your wisdom teeth removed? National Library of Medicine. https://www.ncbi.nlm.nih.gov/books/NBK279590/. Accessed Oct. 30, 2023.
- Ettinger KS (expert opinion). Mayo Clinic. Nov. 17, 2023.
