Dental Care

Wisdom Teeth and Your Health

What are wisdom teeth and what common challenges can they present?

Most people have three sets of molars, which are the chewing teeth found at the back of the mouth. 

The third and farthest-back set of molars are informally referred to as the "teeth of wisdom".

Humans have both upper (maxillary) and lower (mandibular) teeth of wisdom, and most people have four of them - two in the upper jaw and two in the lower jaw. 

It's possible, however, to have more than four.  When this happens, the extra teeth are called supernumerary teeth.

Typical symptoms, as these teeth erupts through the gums is a sometimes painful process during the late teens or early twenties, often between the ages of 17 and 25 or so.  However, there are many exceptions to this timing, and a wisdom tooth can erupt through the gums in younger children and older adults.

As they develop and erupt through the gums, a wisdom tooth can affect the adjacent teeth, and sometimes they become impacted.  An impacted wisdom tooth is one which has failed to emerge fully into its expected position. 

A wisdom tooth that remains completely encased within the jaw bone is referred to as a bony impaction.  If a wisdom tooth has come out of the jawbone but has not erupted through the gum line, it's called a soft tissue impaction.

An impaction can be caused by several problems:  inadequate room in the mouth or jaw to accommodate the wisdom tooth completely; the wisdom tooth's path through and out of the gum being obstructed by the presence of other teeth; or an improper angle of eruption, either pitched too far forward, too far backward, or sideways.

Unless some medical issue could make extraction unsafe, many dental experts recommend the removal of impacted teeth, whether or not it is currently causing pain or other problems. 

Due to the increased likelihood of tissue damage as well as damage to adjacent teeth and bone, dentists don't normally recommend that an impacted tooth be left in place until it causes problems. 

Preventing future problems through judicious prophylactic treatment is at the heart of dentistry. 

This preventive approach means that unless more serious problems would be caused by their removal, impacted teeth will almost always be extracted before complications, such as teeth jaw pain, have the opportunity to arise.

A separate article will address impacted teeth in more detail, but for now, suffice it to say that like fully-erupted sideways teeth and impacted teeth are usually extracted.

Although patients often dread extraction, it's fairly common for people to need at least one wisdom tooth to be pulled out. 

While impactions are frequently the culprit behind wisdom tooth removal, several other dental problems can also make the procedure necessary. 

There are two basic reasons for removing these teeth:  they have already become impacted, or they could potentially cause problems if they are not removed.  

Even properly grown-in wisdom teeth can cause problems down the road.  For example, like any other tooth, a wisdom tooth can become infected and require extraction.  But, because of their position in the mouth, a wisdom tooth can present some particular challenges, including making good oral hygiene awkward at best.

Your wisdom teeth's position in the rear of your mouth makes brushing and flossing them difficult, and as a result it's common for food particles to become trapped and remain lodged behind them. 

Dental pain caused by sometimes medically dangerous infections are often the result, and although the practice is somewhat controversial, wisdom tooth extraction is sometimes performed prophylactically, to prevent a likely future infection. 

When a wisdom tooth is extracted in this type of preventive procedure it is often done during late adolescence or early adulthood.  Of course, extraction is also performed after the onset of an infection.

Other issues that might require wisdom teeth removal include misalignment issues which cause one or more of the teeth to painfully rub against the tongue or cheek, complications associated with tooth decay, gum disease, oral cysts or tumors, and the risk that they might damage adjacent teeth due to root resorption. 

In addition, some wisdom tooth extractions are performed for orthodontic purposes:  if there is insufficient room in the jaw or mouth, potential crowding or malocclusion of the nearby teeth can be prevented by removing the offending wisdom teeth.  This practice is by some dentists debated in the light of recent studies.

Once again, we'll go into wisdom teeth removal in more detail in a separate article.

By the way, if you've ever wondered why they're called wisdom teeth, there's a simple explanation:  they appear much later than all other teeth, at an age when people are theoretically "wiser" than when the other teeth appear during childhood.


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