General Dental Information
and Education Page
Generally a tooth is extracted when it is too badly
damaged to be repaired. This can be the result of an accident, abuse
or neglect. Teeth should not be used to open bottles, tear open
packages or crack nuts. This type of abuse will eventually crack the
teeth. Poor dental hygiene will result in periodontal disease, which
can cause enough bone loss that teeth need to be extracted.
The exception is wisdom teeth. Your wisdom teeth,
or third molars, are the last teeth to emerge from your gums during
your late teens, or "age of wisdom", which gives them
their name. But wisdom teeth are not really so wise. They often
become impacted or trapped in the jaw bone and gums and fail to
erupt as straight and fully functioning teeth. Impacted wisdom teeth
nearly always have to be removed. Example of impacted wisdom teeth
can be seen in the following graphics
Why do we have wisdom teeth at all if they have to
be removed so often? Human beings once had tougher diets. As our
diets became softer and more refined, we no longer needed jaws for
strenuous chewing. The jaws failed to develop, leaving little room
for third molars. In addition, due to mixing of gene pools, some
adults never develop wisdom teeth at all and some end up with more
teeth than jaw. Perhaps in the distant future, we won't have to
worry about them at all. Today, most people experience at least
one impacted wisdom tooth.
Why Remove Wisdom Teeth? Wisdom teeth that are not painful seem
harmless enough. But if they are not removed early, they often cause
problems such as:
- INFECTION (PERIOCORONTIS): The mouth is full of bacteria that
normally do not get past the protective layer of gums. But when
an impacted tooth breaks through the gum surface, bacteria can
get in causing an infection in the gums around the crown of the
tooth. This infection can cause severe pain, swelling, jaw stiffness,
and even general illness.
- DESTRUCTION OF THE NEXT TOOTH: An impacted tooth may still
try to grow where it has no room, eroding the tooth next to it.
This is called RESORBTION. Eventually, this could lead to the
loss of both teeth.
- PAIN: Infection in a decayed wisdom tooth or in the gum around
an impacted tooth can cause pain. If a decayed wisdom tooth is
not situated in a healthy position, or if it is not restorable,
we may recommend its removal. An impacted tooth can also cause
pain if it presses against a nerve or the next tooth.
- CROWDING: An impacted tooth can crowd nearby molars out of alignment.
If you are undergoing orthodontic care, we may recommend that
your impacted wisdom teeth be removed.
- CYSTS: When a tooth is impacted, the sac of tissue around the
crown remains in the bone. Occasionally, the sac fills with fluid
forming a cyst that can readily destroy or enlarge the bone and
endanger surrounding structures.
Why Early Removal? Before you reach adulthood, the roots of your
teeth are not totally formed and the surrounding bone is softer.
Therefore, there is less chance of damaging nerves and other nearby
structures during surgery. The operation itself may be more difficult
as you get older. The risks are greater and the healing is slower.
If you wait until your wisdom teeth cause you trouble, you may have
to be treated for complications such as infection, before they can
be removed. In short, early removal of your wisdom teeth is likely
to prevent problems later on. In addition, we may recommend that
opposing healthy wisdom teeth be removed at the same time if they
are impending on the opposing jaw. A recently completed clinical
study of more than 9,500 patients revels that the optimal time for
extraction is between the ages of 12 and 24 years. In general, difficulties
increase with age.