Controversies About Wisdom Teeth

Forty years ago, the controversy was whether or not to remove everyone’s tonsils, now it is about wisdom teeth.  Over one million wisdom teeth are extracted each year in the United States – even if they don’t cause any problems. Oral surgeons perform 90 % of these procedures.  Keeping one's wisdom teeth has risks, including cyst formation (a sac filled with infected fluid around the crown of the tooth like a water balloon), gum irritation and infection in most cases with pain and swelling.  They can certainly damage the other teeth adjacent to them.  On the other hand, taking out the wisdom teeth may also cause some unwanted side effects such as infection, bleeding and even in rare cases nerve damage.  There are multi-center studies, sponsored by The American Association of Oral and Maxillofacial Surgeons, to come up with new strategies and recommendations as to who is the best candidate to have their wisdom teeth removed. What makes that such a hard case is that oral surgeons don't have predicting factors that let them know who's going to be at high risk of developing problems with wisdom teeth and who's not.

Third molar problems are probably an evolutionary leftover from prehistoric humans, who had larger jaws and didn’t have to worry about impacted teeth. Today, many people's jaws are too small to comfortably accommodate a third set of molars. The result is that a developing wisdom tooth's path is often blocked by bone, gum or another tooth - in which case the tooth is considered to be impacted. Some teeth are fully impacted, failing to break through the jawbone at all, while others are partially impacted, with part of the tooth poking out through the gums. Sometimes an impacted tooth lies in the jaw at an angle instead of sitting straight up. A wisdom tooth coming in at an angle can generate enough pressure to erode the bone that supports and protects the back of the adjacent second molar.

###