What are wisdom teeth?
Wisdom teeth are otherwise known as ‘third permanent molars’. They are the last teeth to develop, usually erupting between the ages of 17 – 25 years old. Most people have four wisdom teeth, at the back of both sides of the upper or lower jaws, but it is possible to have less than four or even none at all.
As wisdom teeth are the last teeth to develop, there is often not enough space in the mouth to accommodate them. This can lead to them emerging at strange angles and becoming impacted on the surrounding gum and bone, or the tooth in front (the second permanent molar).
Why do we have wisdom teeth?
Molars serve as grinding teeth. One theory explaining the existence of wisdom teeth suggests that they helped our ancestors to grind their coarse, plant-based diet in order to extract sufficient nutrients for survival. It is even believed our ancestors had larger jaws and possibly even more teeth in order to efficiently digest plant tissue. The theory hypothesis that as our diets have changed, human jaws have evolved to become smaller, but wisdom teeth or ‘third molars’ have remained; as a result there is often not enough space for them to erupt properly in the mouth, particularly in the lower jaw, and thus they become impacted.
Why do impacted wisdom teeth cause problems?
There are a number of reasons why impacted wisdom teeth may cause problems.
- Impacted wisdom teeth erupt only part-way into the mouth and often at strange angles; they therefore can serve as food-traps and are almost impossible to clean effectively. Subsequently they can easily become decayed and give rise to dental infections.
- Some impacted wisdom teeth, usually lowers, emerge in such a way that they have an overlying ‘flap’ of gum. In this situation, food debris can become caught in the space between the tooth and gum, and bacteria can accumulate here. This leads to a relatively common condition known as ‘pericoronitis’; where the gum tissue surrounding wisdom teeth becomes swollen, painful and infected. Pericoronitis can be treated with antibiotics alongside a deep clean from your dentist, however, whilst the wisdom tooth remains, it constantly serves as a potential source of infection.
- Persistent food trapping around an impacted third molar also risks damage to the tooth in front (most commonly the lower second molar). As patients are often unable to clean the space between the two teeth, bacteria will accumulate easily. The outcome can be a difficult-to-treat combination of decay and gum disease effecting the adjacent tooth. So, if left untreated, impacted third molars frequently result in the early loss of second molars.
- Finally, it is possible for fluid-filled cysts and tumours to form around impacted wisdom teeth, causing damage to the surrounding jawbone, nerves and teeth.
Should I have my wisdom teeth removed?
For a surgical procedure to be undertaken, the benefit must always outweigh the risk. Therefore, if your wisdom teeth are well-aligned and are not the source of any pain or problems, there is no need for them to be removed.
However, if your wisdom teeth are causing you pain or you suspect they are impacted, it is important to speak to your dentist in order to prevent any of the above listed problems.
A simple clinical examination with radiographs will reveal exactly how your wisdom teeth are aligned, as well as the risks and benefits of having them removed. You and your dentist will then be able to construct the best treatment plan for you. Wisdom tooth extraction is classed as minor oral surgery and can be performed under local anaesthesia alone; you can also elect for sedation and general anaesthetic in combination with the local anaesthetic should you prefer.
Dr. Natalie Miller
Dental Surgeon at MALO CLINIC Nuffield Dental
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