Wisdom Teeth

There has been discussion in recent years about third molars.  A good portion of the population get at least one.  However,  the number  of third molars can vary.   Many of us have them extracted in our late teens or early twenties.  It is just something that you do.  What is the rationale behind extracting wisdom teeth?  Should you get them out or leave them in?

Personally, I had all four mine extracted in my early twenties.  I was referred to the oral surgeon by a family dentist to have them taken out because I have developed cavities in both mandibular (lower) third molars.  The experience was overall good.  The procedure was performed under IV sedation.  All I remember before the procedure is the dental assistant counting down from ten.  By the count of four I was completely out.  Then I remember being woken up after the procedure was completed.  It felt like I was asleep for a few seconds.  I did have a minor complication which was due to my own fault.  The oral surgeon recommended that I take some antibiotics.  I figured that I did not need them and I didn’t take them.  I ended up with an infection.   After a course of antibiotics I was back to normal.  Let’s explore in more detail indications for extracting of wisdom teeth.

When  should wisdom teeth be removed and when can they be left in?  It is a matter of opinion.   Some of the common  reasons  for extraction of wisdom teeth are  cavities (especially deep decay), limited room in the jaw, inability to clean around them, or any other condition that might adversely affect any other tooth.

Extraction of wisdom teeth due to decay is justified because the tooth is not being cleaned properly.  This can be because of a small mouth, or inability of the patient to get to the tooth.  Hypothetically, if we do fill the cavity we will probably end up with another one in the near future.

In some cases wisdom teeth will not erupt fully and there may be  a lot of gum tissue around or on top of them.  This condition is know in medical terms as pericoronitis.  This prevents good access to the area and  eventually the tooth will end up with decay, localized periodontal disease (gum disease) or a soft tissue infection.  Sometimes the tissue can be removed and the tooth can be  left in place.  However, in most cases the optimal long term solution is tooth extraction.

There are some situations when wisdom teeth can be left in place.  If the tooth fully erupts, there is plenty of room in the jaw, good oral hygiene (brushing and flossing),  and there is no indication of potential immediate or long term issues.  Every case is different and each should be discussed with your dentist on an individual basis.


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