Wisdom teeth, also known as third molars, are the last set of molars to erupt in the mouth typically between the ages of 17 and 25. Many people experience issues related to wisdom teeth due to lack of space in the jaw, improper eruption, or impaction. While some wisdom teeth emerge properly and cause no problems, most people will face some disadvantages from having their third molars. Understanding the potential drawbacks can help you decide if and when to remove your wisdom teeth.
Pain and Discomfort
One of the most common problems associated with wisdom teeth is pain and discomfort in the back of the mouth. As wisdom teeth push through the gums and jawbone, it can put pressure on nerves, soft tissues, and other teeth. This often leads to symptoms like:
– Throbbing, aching pain that may be mild to severe
– Tenderness and swelling in the gums around the erupting tooth
– Jaw and tooth pain that radiates to the temple, ear, and neck
– Headaches
– Difficulty opening the mouth fully
– Stiffness and pain when chewing or biting down
For many people, the pain and discomfort from erupting wisdom teeth can significantly disrupt daily life for days or even weeks. Even after wisdom teeth fully emerge, the additional crowding they cause can lead to ongoing pain and irritation.
Infection
Because wisdom teeth attempt to erupt through thin gum tissue, they create an opening for bacteria to enter around the tooth and infect the gums and bone. This leads to pericoronitis, a common problem occurring in partially erupted wisdom teeth. The infection causes swelling, severe pain, bad taste/breath, and difficulty opening the jaw.
Without treatment, the infection can quickly spread deeper into tissues and other teeth, potentially becoming a very serious condition. Extraction is often needed when wisdom teeth become infected.
Damage to Nearby Teeth
There is limited space available in the jaw, so wisdom teeth often emerge at an odd angle or only partially erupt. Partially erupted teeth near a second molar can encourage decay in hard-to-clean areas. The pressure of emerging wisdom teeth can also displace adjacent teeth, leading to misalignment or bite problems.
Wisdom teeth may fuse to or become embedded in the bone over second molars. This can destroy tissue, damage nerves, and make the second molar prone to infection. Extraction of the wisdom tooth is required to prevent damage to other teeth.
Cysts and Tumors
When wisdom teeth become impacted or fail to fully erupt, the gum tissue around them may be unable to shed dead cells properly. This can lead to the formation of cysts or even, in rare cases, benign or cancerous tumors. Cysts cause damage as they expand in the jawbone surrounding the wisdom teeth. Any tumors or abnormal growths require surgical removal.
Tooth Decay and Gum Disease
Partially erupted wisdom teeth encourage cavities by trapping plaque deep in hard-to-clean areas. The position of wisdom teeth also makes them difficult to brush and floss adequately, increasing the likelihood of tooth decay and periodontal disease.Impacted wisdom teeth are even harder to access and keep clean.
Without proper oral hygiene, wisdom teeth contribute to faster development of gum disease, which destroys tissues holding the teeth in place. Tooth decay around wisdom teeth that goes untreated can lead to more complex problems like infection spreading to the jawbone or other teeth.
Overcrowding
| Age | Jaw Size | Impact of Wisdom Teeth |
|---|---|---|
| Teenage years | Still growing | May have enough space to accommodate wisdom teeth |
| Early 20s | Fully developed | Often not enough space for wisdom teeth to erupt properly |
The majority of jaw growth occurs during childhood and adolescence. For most people, the jaws are fully developed and unable to expand further by their early 20s. However, wisdom teeth begin erupting at this age before completing growth by the mid-20s.
The result is wisdom teeth crowding against already erupted teeth, causing misalignment problems. Excessive crowding increases risk for decay, gum disease, bite issues, and damage to nearby teeth. Orthodontic work to straighten teeth can be ruined by emerging wisdom teeth pushing other teeth out of place.
Impaction
Impaction is very common with wisdom teeth, occurring when a tooth becomes stuck against the jawbone or another tooth. Partial impaction leaves part of the tooth above the gumline. Full impaction, where the tooth remains trapped below the gums, has a frequency of up to 73% for lower wisdom teeth.
Impaction causes complications like:
– Infection or cysts – More common with partial impaction
– Damage to adjacent teeth and roots – Impacted tooth may move against neighboring tooth
– Crowding – Tooth pushes on other teeth due to lack of space
– Tooth decay – Impaction makes area hard to clean
– Gum disease – Increased risk from inability to clean impacted teeth
– Bone loss – Pressure from impacted wisdom tooth damages jawbone
– Tissue or nerve damage – Most concerning if impacted wisdom tooth pushes on nerves
If left unaddressed, many issues caused by impaction will worsen over time, so extraction is typically recommended.
Difficult Extraction
Due to their position at the back of the mouth and tendency for impaction, wisdom teeth are often very challenging to remove. Extraction may require incisions, bone removal, tooth sectioning, and stitches. Surgery to extract impacted wisdom teeth also poses higher risks like:
– Nerve damage – Inferior alveolar nerves are often near impacted lower wisdom teeth
– Dry socket – Slow healing after removing impacted mandibular wisdom teeth
– Infection – Greater risk associated with surgical extractions
– Sinus issues – Upper wisdom teeth roots may extend near the maxillary sinus
– Tissue damage – Complex removal may traumatize surrounding gums and bone
Difficult wisdom tooth extraction, especially lower ones, may also have a prolonged recovery period with increased pain, swelling, and other complications compared to simpler extractions.
Higher Costs
Given the high likelihood of problems arising from wisdom teeth, the costs over a lifetime may be substantially greater versus timely removal. According to the American Dental Association, removing asymptomatic wisdom teeth can lead to long-term savings.
Potential costs from retaining wisdom teeth include:
– Emergency care for infections or complications – Often costs more than preventive extraction
– Restorative treatment for decay or damage to other teeth
– Gum disease treatment
– Extensive periodontal surgery to treat advanced gum disease made worse by wisdom teeth
– Orthodontic treatment to realign teeth shifted by emerging wisdom teeth – May require braces again if already had them
– Complex wisdom tooth extraction if impaction or other issues develop – More invasive surgery with higher risks
The cost of simple wisdom tooth removal in adolescence or early adulthood is typically much less than future costs of complications that develop. For example, a standard extraction may cost $100-$200 per tooth, while later surgical removal can cost $600 or more per tooth.
Higher Risk of Serious Infection
When wisdom teeth crowd the jaw, partially erupt, or become impacted, the risk of serious infection from pericoronitis greatly increases. Lingering impacted wisdom teeth triple the risk of developing osteonecrosis of the jaws from tooth infections, a rare but potentially disfiguring condition.
Osteonecrosis, also called osteomyelitis, is a severe bone infection that destroys jawbone tissue. It develops from untreated dental infections that spread to the bone, often many years after a wisdom tooth extraction. The condition can be difficult to treat with antibiotics and often requires surgery to remove dead bone tissue.
Conclusion
Wisdom teeth frequently present more problems than benefits. The most advantageous time for removal is before full root development during the mid-teens to early 20s. Removal at a younger age carries lower risks and healing is quicker. It also prevents future problems from wisdom teeth crowding or impaction once the jaws are fully grown. For people with properly aligned and erupted wisdom teeth, regular exams are key to watch for developing problems.
While extraction has risks, retaining wisdom teeth often leads to preventable complications that become more severe over time. Addressing issues early through wisdom tooth removal provides significant long-term health and financial benefits for a majority of patients. Individuals should weigh the advantages and disadvantages of wisdom teeth removal with their dentist. For many people, the potential drawbacks of keeping asymptomatic wisdom teeth eventually outweigh the benefits.