Other factors that affect the decision to remove the wisdom tooth include the possibility of recurrent infection and the future usefulness of the tooth.
Conditions when your wisdom tooth can be left alone:
- The wisdom tooth is not visible in the mouth at all, i.e. it is completely buried in the jawbone. Then chances are the tooth can be left alone. It is wise to monitor the tooth by taking X-rays periodically to make sure that problems like cysts do not occur around the buried tooth.
- The wisdom tooth has grown completely into the mouth and is in good alignment with the other teeth and can be easily cleaned with your toothbrush and floss
Conditions when your wisdom tooth needs to be removed:
- The wisdom tooth has partially grown into the mouth and then gets stuck (impacted) because of lack of space in the jaws.
- The gums around the wisdom tooth gets infected (pericoronitis)
- The wisdom tooth has decay
- The wisdom tooth affects adjacent teeth e.g. accumulation of food debris between the impacted wisdom tooth and the tooth in front of it leads to tooth decay. The decay can often go undetected as in the early stages there may be no pain. (Please see diagrams below)
Figure 1: X-ray of an impacted (jammed) wisdom tooth. Food debris can collect in the groove between the two teeth. It is often impossible to clean‚ this groove.
Figure 2: Decay can develop in hidden areas between the teeth. In the early stages, such decay is often undetected as there is no pain. Left alone, the decay can grow and grow.
Figure 3: X-ray of an actual case in which the decay destroyed much of the wisdom tooth as well as the tooth in front. Eventually both teeth had to be removed.
- Plaque accumulation around the wisdom tooth causes gum disease and bone loss.
- The tooth has no function i.e. it is not used for chewing because the wisdom tooth in the opposing jaw has been lost.
- The wisdom tooth interferes with other treatment e.g. treatment with braces to straighten the teeth or, construction of dentures & implants
- The tooth is associated with conditions like cysts or tumours