Wisdom Tooth Removal

When to Remove Wisdom Teeth

Wisdom teeth cause more problems than any other tooth in the mouth. They will either partially break the gum tissue and grow in crooked or remain underneath the gum. In nine out of ten people, at least one tooth remains underneath the gum - referred to as an impacted tooth, causing symptoms of future problems of varying degrees.

Wisdom teeth generally cause problems when they erupt partially through the gum. The most common reasons for removing them are:

  • 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.
  • 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 trismus (inability to open the 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.
  • 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.
  • 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 and this may compromise the orthodontic result.
  • 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.
  • 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. Rarely, tumors may develop within these cysts or the jaw may fracture spontaneously if the cyst grows very large.

 

When is the Best Time to Have my Wisdom Teeth Removed?

Surgery is technically easier and patients recover much more quickly when they are younger. What is a relatively minor operation at 20 can become quite difficult in patients over 40. Also the risk of complications increases with age, and the healing process is slower.