Update on wisdom teeth surgery

diagram picture of girl jaws showing arrangement of teeth along with impacted wisdom teeth behind premolar and molar teeth

Why operate on wisdom teeth?

In order for wisdom teeth to erupt normally, there must be sufficient growth in the back of the jaws. In most people, this rarely happens, and wisdom teeth cannot fully emerge. In fact, these remain either “impacted”, if they are completely submerged under the gum, or “semi-impacted”, if they only partially pierce the gum.

It is recommended to extract these molars when they are symptomatic or cause problems such as recurrent pain, infections, damage to other teeth. What to do when these teeth are causing absolutely no symptoms? We often hear that they cause tooth displacement by exerting pressure on other teeth to find their place. This would disrupt the alignment of the teeth, and promote dental overlap. In fact, studies have shown that they have only a minor role in this phenomenon. Other more important factors, such as residual growth, must be considered. So even when wisdom teeth are removed, dental displacement can occur afterwards. Several dental associations have ruled that it is not appropriate to extract them just for this reason.

However, other reasons may justify an intervention:

The wisdom tooth can sometimes be difficult to access while brushing, causing cavities. When she is "semi-impacted", her chances are high of knowing this fate in the medium term. However, their position means that traditional care is not enough to treat them. Better to take the lead and extract it when it is still healthy.

When the second molar is decayed and the wisdom tooth is too close to it, it is often difficult to treat it properly. It is then necessary to extract the unnecessary tooth in order to be able to treat the diseased tooth.

It is also advisable to extract a wisdom tooth when it does not have an antagonist on the opposite arch. If a tooth has no more support, it will tend to continue its eruption until it finds a new point of support to stop it (the gum for example) and it will disturb the stability of the dentition . So even if there is only one wisdom tooth causing the problem, it is better to remove the corresponding tooth as well.

A person may therefore very well have their two wisdom teeth extracted at an advanced age, when only one of them becomes decayed. (1) Semi-impacted tooth and (2) impacted tooth

However, it is possible to keep your wisdom teeth "impacted" if they are not showing any symptoms, but they should be monitored regularly. Every 3-4 years, it is recommended to take x-rays, in order to detect the appearance of potential problems. Indeed, it is impossible to predict the movement of wisdom teeth in the long term.

Den Tim

Practicing dentistry for 20 years