Dear Doctor: What happens if I ignore my wisdom teeth? | TahoeDailyTribune.com

Dear Doctor: What happens if I ignore my wisdom teeth?

Dan Martin & Rachel Appelblatt

Well, the unfortunate news is that 9 out of 10 people will have at least one impacted wisdom tooth requiring removal. With that in mind, let's take a closer look at wisdom teeth — what are they exactly and what happens if you leave them untreated.

Wisdom Teeth 101

Wisdom teeth, also known as third molars, are the very last teeth in the jaw to develop, and are located in the back most part of your mouth. These teeth often appear during what has been called the "Age of Wisdom"; that time of life between the ages of 17 and 25 years old.

Looking back in our human history, wisdom teeth didn't give us the hassles they do today. Our hunter-gatherer ancestors primarily ate a diet of raw vegetables and meat which required large, strong jaws to chew — their third row of molars were helpful! Then, with the emergence of agricultural farming practices, our diets changed significantly. Early farmers had a much softer diet of cooked foods that didn't demand as much chewing strength.

Our skull and jaw sizes responded to these dietary changes by getting smaller. But while our jaws got smaller, our teeth size and number did not similarly decrease. So now most of us are left with the unfortunate situation of having relatively small jaws that just don't have the room needed to best accommodate our wisdom teeth.

When can I keep my Wisdom Teeth?

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We're not all built the same, and truthfully some jaws can still accommodate wisdom teeth just fine. In these relatively few cases, wisdom teeth can "erupt" (that is, come completely through the gum) without any pain, disease, or other dental problems. In these cases, your oral surgeons may not recommend immediate extraction, but rather will recommend strongly that you stick to regular check-ups and cleanings with your dentist, that you maintain excellent oral hygiene practices at home, and receive periodic x-rays to evaluate the ongoing health of your wisdom teeth.

When do my Wisdom Teeth need to be extracted?

When a wisdom tooth doesn't fully erupt through the gums, it is called an "impacted" tooth. An impacted tooth is one that is unable to fully enter into the mouth through the gums because there just isn't enough room. An impacted tooth can cause a whole host of problems, including:

Difficulty maintaining adequate brushing, which can lead to tooth decay and infection.

Damage to neighboring teeth.

Pain from pressure of the tooth overcrowding.

Systematic infections and illnesses that can affect the heart, kidneys and other organs when oral bacteria travels from the mouth into the bloodstream.

Fluid-filled cysts or tumors can form that can lead to hollowing of the jaw and damage to surrounding nerves.

Wisdom tooth extractions are recommended if any of the problems listed above are present or likely to develop.

Okay, I need my Wisdom Teeth out — what happens during surgery?

If your dentist recommends that your wisdom teeth be removed, you will be given a referral to be evaluated by an oral and maxillofacial surgeon. During your consultation visit, your oral surgeon will:

Review any existing health conditions and medications that you are currently taking;

Assess the placement and health of your wisdom teeth;

Review steps of the extraction procedure;

Discuss the best anesthesia options for your case;

Go over post-operative care;

Answer any questions or concerns that you have.

On the day of your procedure, your oral and maxillofacial surgeon will work with the plan outlined during the consultation, including administering your preferred anesthesia option. Once you are comfortable, the oral surgeon will skillfully remove the wisdom teeth.

When is the best time to have my Wisdom Tooth extracted?

It is best to schedule your procedure when life stress is low, when health is good, and when you have the help of someone to take care of you. If you are a student, the optimal time for your procedure would be during a school holiday, either our upcoming spring break or at the start of summer break. If you are no longer in school, the best time would be when you can take a few days off work, and can arrange to have a friend or family member drive you to and from your appointment and assist in your recovery.

The Healing Process

Everyone's healing process varies depending on the condition and position of your wisdom teeth, health prior to surgery, nutrition habits and dental hygiene, as well as how closely the surgeon's post-operative instructions are followed. These instructions are so important to your recovery! When instructions are followed, patients typically heal within a week, often even less time is needed for cases that are straightforward and without complications. During a healthy healing process patients may see:

Sutures dissolving within one week of surgery.

Swelling and/or discomfort may peak 36-48 hours after surgery, subsiding more and more each day following.

New tissue developing gradually over the next month.

If recovery recommendations are not followed, pain, swelling, infection, dry socket, and other problems can arise. If symptoms of any of these complications arise, it's important to consult your oral surgeon right away. With that being said, oral and maxillofacial surgeons perform tooth extractions every single day, generally with very few complications.

The truth of life is that most of us will need to have our wisdom teeth extracted. We encourage you to be proactive in the health of your teeth and mouth — if you can, schedule an evaluation of your wisdom teeth earlier in life (ie 16-20 years old), when recovery from wisdom teeth is easier and quicker, complications from extractions are less likely, and when life schedules are more flexible.

But that doesn't mean you should postpone treatment if you're older! It is important to take your dental health seriously, especially the health of your wisdom teeth. Be wise about your wisdom teeth! Visit your dentist for regular check-ups, follow dental recommendations, and adopt a healthy oral care routine.

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About the Authors

Drs. Dan Martin and Rachel Appelblatt at Tahoe Oral Surgery and Implant Center are your local dental implant and oral surgery specialists. They are experienced and board certified oral surgeons who specialize in customer care using state-of-the art equipment and techniques. If you have any questions or concerns about oral surgery or dental implants, please don’t hesitate to contact them at TahoeOralSurgery.com.