Do I Need to Have Wisdom Teeth Removed?
Wisdom teeth are the third set of molars that typically begin erupting around the late teens to mid twenties. Occasionally, wisdom teeth may never erupt (break through the gums) or may be missing altogether! Sometimes, it may be recommended to you to have your wisdom teeth removed. In this article, we’ll discuss why you may need to have wisdom teeth removed and the potential consequence of leaving them.
Does everyone need to have wisdom teeth removed?
No – not everyone needs to have wisdom teeth removed. If wisdom teeth are grown into position (fully erupted), positioned correctly, can be adequately cleaned and do not have decay, they can be maintained throughout your life. Some people do not develop wisdom teeth at all! This can be assessed on a full mouth x-ray called an orthopantogram (OPG). However, wisdom teeth frequently do not erupt fully or into a good position and this can cause significant problems. This may be why your dentist recommends for you to have your wisdom teeth removed.
What problems can wisdom teeth cause?
A common problem with wisdom teeth is when they do not have room to grow into the correct position completely, leading them to remain slightly covered with a gum flap. This means that food and bacteria can get trapped under the gum flap which can eventually cause a painful infection called pericoronitis.
If you cannot adequately clean your wisdom teeth because they are partially covered with a gum flap or in a poor malaligned position, this can lead to decay which may cause a painful toothache.
Furthermore, poorly positioned and angled wisdom teeth can make it more difficult to brush and floss the adjacent teeth, which can cause the adjacent well-positioned second molar teeth to develop decay. In severe circumstances, heavily decayed second molars cannot be saved and may also require extraction.
Rarely, dormant unerupted wisdom teeth can become cysts or tumours, which can rapidly cause a large amount of damage to the jaw bone.
I’ve never had any pain or problems from my wisdom teeth. Why do I need to have them removed?
While you may not have had any of the problems listed above, as part of your comprehensive dental examination, a dentist should assess how your wisdom teeth appear in your mouth as well as how they appear on an OPG x-ray. They may determine that based on the examination, you are at risk of developing severe pain or permanent damage to neighbouring teeth.
We often recommend for wisdom teeth extractions to be performed around the same time we might expect wisdom teeth to erupt (late teens to mid twenties). This is because we want to reduce the chances that you will experience pain from your wisdom teeth by removing them sooner. Also, at this age, most individuals are relatively healthy and can heal and recover quickly following the extraction. In some circumstances where wisdom teeth have been left alone, problems may start developing years down the track requiring urgent removal. It is often that older adults later in life have a more complex medical history, are at greater chance of developing complications after extraction and are likely to heal slower than a young fit person.
What if I just wait until it causes me pain?
Wisdom teeth can be among the most complex teeth to extract, and may require a surgical extraction if it is covered by gum and bone. If you attend a dental clinic as an emergency because of severe pain you are experiencing from your wisdom teeth, there may not be adequate time and you may not have the appropriate x-rays (which needs to be done at a radiology clinic) to remove the tooth at that appointment, which may mean you will need to wait for another appointment on a different day.
Sometimes, if your wisdom teeth are more complex to remove and at greater risk of complications, you may be recommended to see an oral surgeon who is a specialist at removing wisdom teeth. This may mean your wait to have your teeth removed may be even longer and your time in pain may be prolonged.
Finally, one of the symptoms of a wisdom tooth infection is limited mouth opening (trismus) which may make it impossible to reach and remove the infected tooth. You may need to take antibiotics to settle the infection before we can access the tooth to remove it.
If you do not follow the advice to have your wisdom teeth removed in a planned manner, you are at risk of a prolonged period of severe pain caused by your wisdom teeth.
What are the symptoms of a wisdom tooth infection?
Symptoms of a wisdom tooth infection include:
- Pain coming from the region of your last tooth
- Red swollen gums around the last tooth
- Inability to open jaw fully
- Swollen area near the cheek or neck
- Bad taste in the mouth
What can I do if I am in pain from my wisdom tooth?
If you are experiencing pain from your wisdom tooth, it is important to contact your dentist to arrange an appointment.
In the meantime, things you can do that may help to improve you pain include:
- Over-the-counter pain killers such as Panadol (paracetamol) or Nurofen (ibuprofen)
- Rinse with salt water
- Avoid hard foods that may be difficult to chew
- Suck on a ice chip or use a cold pack on your cheek
Wisdom teeth may exist silently for a long time but they can also suddenly cause severe discomfort and pain.