Unfortunately our jaws are not large enough for our wisdom teeth (also known as 3rd molars). According to some studies up to 90% of us do not have large enough jaw bones to have our wisdom teeth to erupt properly into functioning occlusion.
At Medical Lake Family Dental, we evaluate wisdom teeth using panoramic x-rays. We evaluate proper eruption, space, anatomy, and any pathology developing by the use of these x rays. On the image below, the white arrows point to the lower wisdom teeth. Generally, all wisdom teeth are removed at the same time. This ensures the need for one surgery and only one time to recover.
During recovery, often one tooth site will have lingering pain so if you take out all four at the same time you can ensure only one tooth causing you discomfort.
Dr. Ryan Bushman does not believe everyone needs their wisdom teeth out. Actually Dr. Davis still has all his wisdom teeth. Some patients have enough room and removing their wisdom teeth is not indicated. A quick exam and panoramic x-ray will allow us to evaluate if proper eruption is possible and if space is sufficient.
Below are some possible complications if wisdom teeth are left without removing them.
As many of you know when your wisdom teeth come in you can feel the pressure and sometimes discomfort. This pressure can cause other teeth to crowd or shift and cause an uneven bite. Proper cleaning also becomes difficult and we often see cavities or decay begin on the tooth in front of the wisdom tooth.
Impacted wisdom teeth can cause damage to the bone supporting the tooth in front of them. Often expensive and uncomfortable repairs are needed to fix the complication of having impacted wisdom teeth. Bone grafts and gum grafts are often needed to repair the damage.
A small balloon-like cyst can fill with fluid surrounding the impacted wisdom tooth. If the cyst is left untreated it can expand and cause damage to the nerve or bone, which would require surgery and bone grafting.
When the wisdom tooth is impacted and crowded behind teeth it becomes difficult to clean and maintain. Bacteria are able to live off the food and debris that is trapped and could lead to a serious and life threatening condition if the infection spreads to the face and neck. Oral infections have also been linked to other major health conditions such as heart disease.
There are different classifications of impacted wisdom teeth, there are “complete,” “partial,” and “soft tissue.” Regardless of the classification impacted teeth do not have enough room to properly erupt into the mouth and become cleansable and fully functional.
IMPACTED (BEFORE ROOTS FORM)
The best time to have your wisdom teeth removed are when they are approximately one-third to one-half formed. There is often insufficient anatomical space to accommodate normal third molar eruption. The optimal time to extract is when the roots are approximately one-third to one-half formed. At this time, the mouth is mature but the roots of the third molars do not yet encroach upon the inferior alveolar nerve canal, which can mean fewer complications.