Wisdom Teeth Removal Often Unnecessary
Study: Taking Out Symptom-Free Wisdom Teeth Neither Helps nor Hurts Health
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Wisdom Tooth Removal: Surgery, Not a Rite of Passage continued...
"If the jawbone is straight, the tooth wants to come in straight," Curtis tells WebMD. "But most people run out of bone. Your jawbone starts its curve upward, and the wisdom teeth on the lower jaw get caught in that curve and tip forward."
Impacted wisdom teeth may lie fully horizontal. If that's the case, trouble almost certainly lies ahead. It's a harder call when a wisdom tooth fully emerges but is only slightly tipped toward the molar next to it. Some worry that, over time, this will cause crowding of the front teeth. The Mettes review, however, suggests this is not the case.
"If a wisdom tooth is completely horizontal, I almost universally recommend taking that out," Curtis says. "The chances of bone disease are so high that I can predict with pretty good probability that 10 or 20 years down the road that person will have gum problems that will pose a risk to other teeth as well."
Also risky, Curtis says, is a wisdom tooth that emerges from the underlying bone but comes only part way through the skin. That leaves a person open to high risk of decay and infection.
When a dentist deems wisdom tooth removal necessary, he or she should talk to the patient about possible risks of surgery.
"It is surgery, so there is risk of infection, there is some risk of jaw fracture, and risk of numbness that lingers on because a nerve is damaged in pulling the tooth," Curtis says. "And that is a really uncomfortable thing to have your lip numb for the rest of your life or even for a couple of years. You have to think of risks."
What Good Are Wisdom Teeth, Anyway?
We get three sets of molars -- and get them at different times of life -- because the diet we ate as we evolved into humans was tough on the teeth. A third set of molars -- the wisdom teeth -- kept us chewing on as our first set of molars wore out.
The modern diet isn't so tough, so we aren't as likely to wear out our first two sets of molars.
"Wisdom teeth simply aren't necessary. I don't know anyone who can't get along without them," Curtis says. "And a wisdom tooth is very difficult to clean. Even when it comes in well, it is far back against the upward curve of the jawbone. Sometimes you can't get a toothbrush behind it -- sometimes not even to it. So if it takes a root canal or crown to fix a decayed wisdom tooth, that is not an unsubstantial cost. So is it worth it to do that?"
Bassiouny says it's still a good idea to have an extra set of molars.
He points out that the wisdom teeth can take up the slack should other teeth fall out or need to be pulled -- as commonly happens as we age. And when a person needs a dental bridge, Bassiouny says, wisdom teeth provide an important anchor.