impacted wisdom teeth / wisdom tooth extractions

This second grouping of reasons for having one's wisdom teeth removed adopt a philosophy that if a wisdom tooth does not or cannot erupt into proper position then the tooth has few benefits to offer and instead will be a potential source of problems. Listed below are some of the types of problems that can develop in association with impacted wisdom teeth.

Cysts and tumors.

While it is not a common occurrence, cysts and tumors can develop in the tissues surrounding impacted wisdom teeth. (If a decision is made to not remove an impacted wisdom tooth, a dentist will often recommend that an x-ray should be taken of the tooth periodically. This allows the dentist to evaluate the tooth and its surrounding tissues for changes that might suggest that a cyst or tumor is forming.)

Tooth crowding.

There is a theory that suggests that impacted wisdom teeth, as part of their effort to come fully into place, can put pressure on a person's other teeth and cause them to become misaligned (crowded or shifted). Changes in the alignment of a person's lower front teeth, especially, are frequently blamed on pressure created by a person's wisdom teeth.

This theory has never been proven by scientific studies and is certainly not universally accepted by the dental profession as a whole. This is not to say that people don't have teeth which do shift but rather that this type of tooth shifting cannot be conclusively demonstrated by research to be caused by a person's wisdom teeth coming in and is most likely simply coincidental. Part of the proof for this stance is that studies have found that people who lack wisdom teeth (have congenitally missing wisdom teeth) experience this same crowding phenomenon.

Damage to neighboring teeth.

While uncommon, the attempted eruption of a misdirected impacted wisdom tooth can cause damage to a person's 2nd molar (the next tooth forward of the wisdom tooth).

This event is somewhat similar to what happens to baby teeth. Baby teeth, when they fall out, look as though they have no root portion. The tooth did have a root at one time but the action of the permanent tooth erupting underneath has caused its root to resorb, hence the baby tooth looks rootless.

Similarly, when misdirected wisdom teeth attempt to erupt they can cause resorption of the root of the 2nd molar. The worst case scenario in this instance is that both the offending wisdom tooth and the damaged 2nd molar will have to be extracted.

Especially in those situations where their wisdom teeth are in the early stages of formation, a dentist may not be able to come to a conclusion about the potential risks that a person's wisdom teeth pose. In other cases, even after being informed about the potential problems associated with their impacted wisdom teeth, some patients will simply prefer to not have these teeth extracted. In these instances a dentist will usually recommend that the teeth be observed and re-evaluated periodically. These examinations will almost certainly need to include the use of dental x-rays.

Do all impacted wisdom teeth need to be extracted?

This is a question that can only be addressed by your dentist and only after they have had an opportunity to perform a thorough dental examination that includes x-rays. It is a fact that the wisdom teeth that have the greatest potential for becoming problematic are those that are "partially erupted" (meaning only part way through the gums) as opposed to those impacted wisdom teeth that lie fully below the gum line (and have no communication with the oral cavity). If a decision is made not to remove impacted wisdom teeth they should be evaluated regularly (including the use of dental x-rays) so to ensure that no pathological conditions are developing.