Removing Wisdom Teeth – Is It Wise?


Wisdom Teeth

When a dentist suggests removing someone’s wisdom teeth, many parents or young adults do not think twice and made appointments. For people in their 40s and 50s, removing the wisdom teeth was a milestone like getting a driver’s license and graduating high school. The assumption was that the wisdom teeth were going to cause problems, so get them before they can. But today, that assumption is being questioned.

For many, removing the wisdom teeth is still a right of passage – at least in the U.S. In other areas and some circles here, the latest thinking is that removing wisdom teeth may not be needed.

What are Wisdom Teeth and Reasons for Removing Them?

Wisdom teeth are the third molars. They usually come in when a person is in their late teens or supposedly once someone has matured and gained “wisdom.” Because not everyone’s jaw can accommodate 34 teeth, they sometimes come in at odd angles or do not descend below the gum line at all (i.e., are impacted).

According to a 2007 American Journal of Public Health report cited in the Wall Street Journal, 10 million wisdom teeth are extracted each year. Reasons given for the procedure range from the weak to the unlikely:

  • If the wisdom teeth are not removed at a young age, people are simply postponing the inevitable.
  • There is not always enough room in the mouth for wisdom teeth to grow properly. Whether they do break through or remain impacted, they many crowd the other teeth. Wisdom teeth can come in at an awkward angle or push straight teeth out of alignment (ruining all that orthodontia!)
  • In teens and those in their early 20s, the wisdom tooth’s roots are not fully developed and the jaw bone is not as dense, so it is easier to remove the tooth at that age. Consequently, the recovery should be the easier too.
  • Wisdom teeth are difficult to reach and clean so they may develop decay and gum disease.
  • If wisdom teeth only break partway through the gums, a flap of gum tissue typically grows over them. Food can get trapped under the flap, which then becomes a breeding ground for bacteria and causes gums to become swollen, and infected.
  • If a cyst forms around a wisdom tooth that is impacted, it could permanently damage nearby teeth and the jaw.
  • If someone has a medical condition that could get worse as they age, it makes sense to have the wisdom teeth removed before the condition precludes it. Wisdom tooth extraction like any surgery poses risks for complications.

Guidelines Evolving Today

The guidelines from the American Association of Oral and Maxillofacial Surgeons’ (the people who usually do wisdom teeth extractions) have changed in the last few years. In 2010, removal of wisdom teeth was still preferred if there was insufficient space for them. By 2012, the Association began to recommend regular monitoring of the teeth when the patient is a young adult to determine if they should be retained or removed. A panel of experts could not reach a decision whether they should be removed or not.

In England, the thinking has changed too. Removing wisdom teeth used to be one of the most common procedures, according to the National Health Service. But now, Britain’s National Health Service stopped paying for the procedure if there was no good reason for it.

So, what should an adolescent or parent do? If a dentist recommends removing wisdom teeth, ask why? What other options are there? After all, while it is rarely harmful to one’s health to have the wisdom teeth removed, it costs a lot (many dental plans only cover part of the cost) and there are health risks involved with any surgery.

By Dyanne Weiss

Web MD
New York Times
Wall Street Journal

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