Wisdom Teeth - Why and When to Remove Them

Wisdom Teeth Part II: Why Remove Wisdom Teeth?
By Dion Krame

Wisdom teeth generally cause problems when they erupt partially through the gum.
Below are the most common reasons for removing wisdom teeth.

1. Tooth decay
Saliva, bacteria and food particles can collect around an impacted wisdom tooth, causing it, or the next tooth to decay. It is very difficult to remove such decay. Pain and infection will usually follow.

2. Gum infection
When a wisdom tooth is partially erupted, food and bacteria collect under the gum causing a local infection. This may result in bad breath, pain, swelling and the inability to open your mouth fully. The infection can spread to involve the cheek and neck. Once the initial episode occurs, each subsequent attack becomes more frequent and more severe.

3. Pressure pain
Pain may also come from the pressure of the erupting wisdom tooth against other teeth. In some cases this pressure may cause the erosion of these teeth.

4. Orthodontic reasons
Many younger patients have had prolonged orthodontic treatment to straighten teeth. Wisdom teeth may cause movement of teeth particularly the front teeth when they try to erupt. This will compromise the orthodontic result.

5. Prosthetic reasons
Patients who are to have dentures constructed should have any wisdom tooth removed. If a wisdom tooth erupts beneath a denture it will cause severe irritation and if removed, the patient will need to have a new denture constructed as the shape of the gum will have changed.

6. Cyst formation
A cyst (fluid filled sac) can develop from the soft tissue around an impacted wisdom tooth. Cysts cause bone destruction, jaw expansion and displacement or damage to nearby teeth. The removal of the tooth and cyst is necessary to prevent further bone loss. Tumors may develop within these cysts or the jaw may fracture spontaneously if the cyst grows very large.

Why remove an impacted wisdom tooth if it hasn’t caused any trouble?

Impacted wisdom teeth are almost certain to cause problems if left in place. This is particularly true of the lower wisdom teeth. Such problems may occur suddenly and often at the most inconvenient times.

When is the best time to have my wisdom teeth removed?

It is now recommended by dentists that impacted wisdom teeth be removed between the ages of 14 and 22 years whether they are causing problems or not. Surgery is technically easier and patients recover much more quickly when they are younger. What is a relatively minor operation at 20 can become quiet difficult in patients over 40. Also the risk of complications increases with age and the healing process is slower.

Traveling to foreign places
It may be advisable to have them removed before traveling if you are going to an area where specialist dental services are not readily available and your wisdom teeth are impacted.

Should a wisdom tooth be removed when an acute infection is present?
Generally, no. Surgery in the presence of infection can cause infection to spread and become more serious. Firstly, the infection must be controlled by local oral hygiene, antibiotics and sometimes the extraction of the opposing wisdom tooth.

Wisdom Teeth Part III looks at the "Pros & Cons" of wisdom tooth removal.
By Dion Kramer

Dion Kramer is co-founder and managing director of NobleHealth. NobleHealth is a dental plan for the people of Brisbane, Australia. Dion Kramer collaborates with a NobleHealth Brisbane dentist so that his writings are topical and up-to-date. You can visit the website to learn more about NobleHealth and each NobleHealth Brisbane dentist http://www.noblehealth.com.au

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