Wisdom Teeth Removal: To Keep or Not to Keep?

Everyone always dreads the recommendation wisdom teeth removal. But why? Well let’s face it, no one likes to have surgery or be put under. The only part of that the general public enjoys is watching videos of people coming out of their anesthesia. The real question is: why do some people get to keep their wisdom teeth, and others don’t? What happens if my dentist tells me to get them out and I don’t? Believe it or not, we recommend things for a reason. We are all about PREVENTATIVE dental care which means prevent something wrong before it happens. Here’s the scoop on those “extra teeth” we don’t really need.

What happens if I don’t get them out?

If your dentist is recommending the wisdom teeth come out, you really should get them out. We typically address the wisdom teeth around junior/senior year of high school, or age 17-18. This is when we have a good idea of whether or not a person has room for them or not. We take a panoramic x-ray that circles around your head and shows us all your teeth, including the roots and surrounding bone. This shows us how many wisdom teeth there are and if the roots are developed enough to have them extracted and if the patient does, in fact, have enough room to keep them. Some patients only have one wisdom tooth or none (lucky!!). We have seen some with 8. That’s right, and they grew two sets.

What Age Should You Remove Your Wisdom Teeth

The younger the wisdom teeth come out, the better. The bone is more flexible, and the healing time is faster. Delaying having them out can cause cysts to develop around the teeth, leading to infections and more invasive surgeries. We have seen it: 25-year-old male presents with pain on the lower left. We had recommended the wisdom teeth come out at age 18 due to shortage of space.

A Patient Who Didn’t Get Their Wisdom Teeth Removed

All four teeth were impacted (under the gums). The patient developed a cyst on the lower left wisdom tooth and was referred to the oral surgeon immediately. The bone had to be scraped out under the tooth and sent in for a biopsy. The extra scraping or debriding, along with the biopsy bill, led to the patient having a much longer recovery and more out of pocket costs. Thankfully the cyst was benign, and no further action had to be taken. Thank goodness this was caught early because if left untreated, could have caused a hold in the jaw. The risks of surgery highly outweigh, keeping them, and not being able to predict what the future holds. If they do happen to come in the mouth, we typically see gum problems and cavities develop due to hard to access areas.

Why do some people have a room and get to keep them?

Like we said earlier, every single patient is different. Some people have large mouths, and the gum tissue is healthy around the wisdom teeth, and they can keep them super clean. We also see a lot of cases where a patient had 4 teeth out for braces due to crowding, but later grew and had room for the wisdom teeth to come in and stay. Trust us when we say this: If we truly believe you have room to keep the teeth and keep them healthy and predict they will not cause issues down the road; we will absolutely recommend keeping them. The thing is, the average person, unfortunately, does not have room and needs to get them out.

At Dental Reflections Dublin, we typically refer all of our wisdom teeth extractions to an oral surgeon, who specializes in removing these types of teeth. Wisdom teeth can be unpredictable and come in different sizes and shapes, so we feel most comfortable with our patients in the hands of a surgeon, who extract teeth all day long. Recovery is the same whether having one or four removed at the same time, so we recommend all 4 to keep it to one procedure. An oral surgeon can address any questions or concerns you may have about recovery, sedation options, and the procedure itself.

Wisdom Teeth Crowding

Many times, we may start to notice our bottom front teeth crowding as those wisdom teeth start to come in. You may start to wonder – could that be what is crowding my teeth and “pushing them forward”? At Dental Reflections Dublin, we see the crowding all the time, and we often hear it from patients even later in life. They will tell us their bottom front teeth were always straight whether they had braces, but once those wisdom teeth started coming in, they started crowding. The average age for wisdom teeth to come in is 17-22 but it can most definitely be earlier or later. That leaves us with the burning question…

Do Wisdom Teeth Crowd Your Other Teeth?

Long story short, the answer is no. I know the timing can correlate together, however, the wisdom teeth do not push all the other teeth forward as they are making their way in. Either they have room to come in or they don’t. A study was done and published in The Scientific World Journal that included patients with impacted (teeth under the gums), erupted (teeth in the mouth), extracted, or congenitally missing wisdom teeth. These studies included cross-sectional and longitudinal, and there was no difference between the two groups. What this means is whether someone ever had wisdom teeth form, they still noticed crowding and that these teeth are not the cause.

What Causes the Crowding?

As we age, our mandible continues to grow. Have you ever noticed an older person with larger ears and nose? This is because they also continue to grow as our jaw does. Have you also noticed how older people have a pointier chin and crowded teeth in the front? I know, I know, no you are thinking ages 17-22 is not old. That is correct. Our jaw goes through growth spurts just like the rest of our body. Ages 17-22 is one of those times. Therefore, more people will notice the teeth beginning to crowd at that age. For some it’s later, everyone is different. Another study was done following patients for 12 years after their braces came off. The study found that after just 10 years of removal of all retention (permanent or removable retainers no longer being used), more than 70% were classified as showing moderate to severe crowding.

How Can This Crowding Be Prevented?

The ultimate way to prevent teeth from crowding is a retainer. This is recommended whether a patient has had braces or not. Permanent retainers are most common for post ortho patients, while removable retainers are great for those who have never had retainers. Crowding is not just a cosmetic concern but also puts a patient at risk for gum disease. Crowding makes it much harder to keep the teeth clean, therefore infecting the gums as well. Orthodontics, or braces, are the only way to correct the crowding and are a great option to consider. If you are concerned about your teeth shifting, contact us today for a consultation on retainers, Invisalign or options for orthodontics.