Impacted wisdom teeth

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    Alan Carr, D.M.D.

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Question

Wisdom teeth removal: When is it necessary?

My dentist suggested I have my wisdom teeth removed, but they’re not causing problems. Is wisdom teeth removal necessary?

Answer

from Alan Carr, D.M.D.

CLICK TO ENLARGE

Illustration showing an erupting wisdom tooth
Impacted wisdom teeth

Wisdom teeth removal may not be necessary if the teeth are:

  • Healthy
  • Fully erupted — grown in completely
  • Positioned correctly and biting properly with the opposite tooth
  • Able to be cleaned as part of daily hygiene practices

Many times, however, wisdom teeth — the third molars in the very back of your mouth — don't have room to grow properly and cause problems. Erupting wisdom teeth can grow at various angles in the jaw, sometimes even horizontally. Some wisdom teeth only partially emerge through the gums. Other times, they remain completely hidden. Wisdom teeth that aren't able to emerge normally become impacted, or trapped, within your jaw.

To prevent an impacted tooth, dentists often recommend removing the wisdom teeth before they emerge or grow too large. Many dentists believe it's better to remove the teeth when someone is younger and more likely to recover faster from surgery. This is why many teenagers or young adults have their wisdom teeth extracted before the teeth cause problems and become more firmly rooted in the jaw.

Wisdom teeth removal may be necessary — according to the American Dental Association — if:

  • Wisdom teeth partially emerge through the gums. This increases the chance of a bacterial infection called pericoronitis.
  • Unerupted wisdom teeth are expected to grow crooked and damage other teeth.
  • A fluid-filled sac (cyst) develops around an unerupted wisdom tooth, which can damage surrounding tissue or bone.

The decision to remove wisdom teeth isn't always clear. Talk to your dentist or an oral surgeon about the position and health of your wisdom teeth and what's best for your situation.

Next question
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References
  1. Wisdom teeth. American Dental Association. http://www.ada.org/2988.aspx?currentTab=1. Accessed Dec. 16, 2010.
  2. Gonsalves W. Oral health. In: South-Paul JE, et al. Current Diagnosis and Treatment in Family Medicine. 2nd ed. New York, N.Y.: The McGraw-Hill Companies; 2008. http://accessmedicine.com/content.aspx?aID=3036778. Accessed Dec. 17, 2010.
  3. Wisdom teeth. American Association of Oral and Maxillofacial Surgeons. http://www.aaoms.org/wisdom_teeth.php. Accessed Dec. 16, 2010.
  4. Carr AB (expert opinion). Mayo Clinic, Rochester, Minn. Dec. 17, 2010.
  5. Jauch EC, et al. Mouth. In: Knoop KJ, et al. The Atlas of Emergency Medicine. 3rd ed. New York, N.Y.: The McGraw-Hill Companies; 2010. http://accessmedicine.com/content.aspx?aID=6001473. Accessed Dec. 16, 2010.
AN01961 Feb. 19, 2011

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