Expert Advice: Wisdom Teeth, to Remove or to Keep?
Have you heard of the old joke about wisdom teeth? When we were younger, friends would say removing wisdom teeth is akin to throwing out those wisdom (in your brain!) accumulated over the years.
Cold joke aside, the appearance of wisdom teeth can pose a fair bit of edginess in the ‘lucky’ ones. Most stories often circle around intense pain, surgery and a dent in the pockets.
How much exactly do you know about wisdom teeth? Does everyone have them? And is it necessary to remove them?
What are wisdom teeth?
Our wisdom teeth generally appear in our mouths between 15 and 23 years of age. It is known as the “wisdom” teeth because it is the last set of molars which appears at the point where we cross over into adulthood.
What does it mean to have impacted or erupted wisdom teeth?
When there is insufficient space for the wisdom tooth to grow, it becomes buried within the gums, otherwise known as an “impacted” tooth.
In some situations, the gums around the wisdom tooth may become infected and you may experience gum soreness or swelling around the area. In severe cases, the infection can spread to the face, causing severe pain, fever and inability to open the mouth.
Is it always necessary to remove wisdom teeth?
Sometimes, wisdom teeth may be healthy and properly aligned, with no concerns at all. However, more often than not, our jaws lack the space to accommodate this extra set of teeth, resulting in crowding which may lead to food trap, infection and tooth decay.
When the tooth is partially “erupted”, or breaks through the gum, food can be trapped between the wisdom tooth and the adjacent tooth in front. In such situations, the food cannot be properly cleaned out and the wisdom tooth may become decayed. If it goes undetected, the adjacent tooth may also become decayed and may need to be removed as well.
Another common indication for wisdom tooth removal is the growth of cysts or tumours around the crown of the wisdom tooth. Although rare, there is usually no pain or signs until the cyst or tumour becomes very large. However, your dental practitioner can detect such lesions in the initial stages if a routine oral X-ray is done. They will then refer you to an oral surgeon for management.
Sometimes, wisdom teeth removals are indicated as part and parcel of orthodontic or braces treatment. The orthodontist treating you will advise accordingly.
It is typically easier to remove wisdom teeth in young people when the roots are not yet fully developed and bones are less dense. Healing and recovery time will take longer for older people.
How are wisdom teeth removed?
The removal of wisdom teeth is usually by a minor surgical procedure. The gum is pushed aside and the bone around the tooth is trimmed away. The tooth is then separated into smaller pieces and removed. There will usually be swelling around the gums and sometimes to the face for between three to five days. The sutures are usually removed in one week. In most cases, there will be a residual socket which will take a few months to completely close up. Your surgeon will advise you on the cleansing technique.
Today, besides the conventional method of having surgery under local anaesthesia only, there are other methods including intravenous sedation and general anaesthesia. The latter two methods are becoming more common as most patients do not want to feel the procedure as it is being carried out. For simple wisdom teeth removal, intravenous sedation will suffice. For multiple or deeply buried wisdom teeth, general anesthesia may be preferred. Speak to your Oral Surgeon regarding these methods.
Will everyone have wisdom teeth?
All of us have wisdom teeth. They sometimes give us issues and that is when the removal becomes urgent. Do not wait until that moment. Ask your dental practitioner about your wisdom teeth the next time you go for your dental checkup.
This article was contributed by Dr. Lim Kheng Ann, Specialist Oral & Maxillofacial Surgeon at Unity Denticare (Midpoint). Unity Denticare is part of the NTUC Health Co-operative Limited, an NTUC social enterprise.