In this month’s Teeth Talk article, Senior Dentist Dr. Jeffrey Field explains what you need to know about wisdom teeth, including the risks and considerations regarding wisdom teeth removal.
Why should I get my wisdom teeth removed?
There are a number of valid reasons to remove wisdom teeth:
1) They are not functional. Studies have shown that most of chewing is done on the second bicuspid and first molar. That is we do not use our second molars let alone our wisdom teeth (third molars) to chew.
2) There is not enough room in the dental arch to allow them to completely erupt (fully emerge). As they remain partially submerged(partially impacted) they are very prone to recurrent infections. With each subsequent infection more and more jaw bone is destroyed, which in turn leads to a greater potential for re-infection and the cycle of infection after infection continues.
3) They are so far back in your mouth that you can’t properly clean them, leading to both dental decay(cavities) and periodontal diseases(gum infections)
4) They are growing close to nerves in the lower jaw and your sinus in the upper jaw. All teenagers should be assessed for wisdom teeth between the ages of 14-16 years old. Assessment at this age allows the dentist to see if wisdom teeth are present, their position, and likelihood of normal eruption. If any problems are noted, then this is the best time to remove them. The reason is, at this age the wisdom teeth will not have developed much of their roots and you can greatly decrease the chance of either nerve damage or damage to the sinus during their removal. If you wait till the person is 18 years old or older, the roots will be fully developed are therefore increase the risk of nerve or sinus damage.
What are the risks of having wisdom teeth removed?
For lower wisdom teeth there is a nerve that exits your brain in front of your ear and behind the jaw bone. This nerve provides feeling but no motor function to structures it innervates. The nerve splits into 2 pieces. One ends up supplying feeling to your lower lip and chin, but does not make your lower lip and chin move. So if this nerve is damaged your lip won’t droop in fact you will look no different, but you can have numbness to the lower lip and chin. This occurs in one patient out of every 5000 treated. The second branch of this nerves innervates the tongue supplying feeling and taste sensation to the side of the tongue. Numbness and loss of taste sensation can occur in one patient out of 15000 or 3 times less likely to occur than damage to the nerve to the lower lip and chin.
For upper wisdom teeth there are no nerves in the area, however upper wisdom teeth are close to the maxillary sinus (the air space under your eye that gets stuffed up when you have a cold. The risk is that extraction of upper wisdom can lead to an opening into the sinus. This is not a big issue and can be closed at the time of extraction. The only downside is that if this occurs you should not blow your nose for one month, just squeeze and wipe.
Where should I have my wisdom teeth removed?
Wisdom teeth can be removed either in a hospital operating room or in the dental office. In hospital you will have a general anesthetic and in the office you can either sedation plus local anesthetic (numbing) or just local anesthetic. However, except for the simplest of extractions we do recommend sedation for your comfort. Please see the information on general anesthesia versus sedation.
If you have questions about your wisdom teeth or that of your children, please book a no obligation consult with Dr. Field or Dr. Antonoff to discuss your options.