Professional Opinion

Professional opinion: The pros and cons of having wisdom teeth removed

Dr. Walter Fingar, a graduate of MUSC Dental School in Charleston, practices dentistry at We Care Family Dentistry located near the New River Auto Mall in Hardeeville. He sees patients of all ages, performs root canals and offers same-day CEREC crowns.

Question: My brother just had several of his wisdom teeth taken out. I was wondering, does everyone need to have their wisdom teeth taken out? And if so, why not? What causes some to have theirs out late in life like this?

Answer: Though research has shown that the removal of wisdom teeth later on in life (25 years or older) carries an increase in risks of post-op complications and recovery time, there are good reasons for the removal of wisdom teeth. Those reasons include gum disease and decay in the third molars. Wisdom teeth are referred to as “third molars.” The “second molars” are the teeth directly in front of the wisdom teeth. Perhaps your brother was having trouble keeping his second molars clean because of his wisdom teeth. For him, the possibility of periodontal disease or cavities can stand as wise reasons for the extractions. Simply reaching his back teeth to clean them properly may have been a challenge for him.

Research has shown that older adults have a higher risk of having periodontal defects behind the second molars when wisdom teeth are present. “Periodontal” is a term used in describing gum health. People with periodontal disease have a bacterial infection that destroys the attachment fibers and supporting bones that hold the teeth in the mouth. Left untreated, periodontal disease can lead to tooth loss. Perhaps your brother’s dentist detected the beginning of gum disease near his second molars and wanted to arrest the disease before worse complications began.

The possibility of cavities on wisdom teeth also increases with age. Tooth decay refers to the enamel wear that leads to cavities. A cavity is a hole in the tooth enamel - sometimes unseen - that can cause tooth sensitivity and pain. If left untreated, a cavity can lead to an abscess - a serious infection in the center of a tooth - or tooth loss.

With more sophisticated x-ray technology, dentists can get a three dimensional view of a patient’s mouth and possibly decrease post-operative complications. There are minute details that can be seen with cone-beam scans and important nerves such as the mandibular nerve can be evaluated and measured prior to surgery.

When planning the removal of wisdom teeth, the position of the mandibular nerve in relation to the roots of the wisdom teeth is an important consideration. This nerve often runs in very close proximity to the wisdom teeth, and injury to that nerve can cause temporary or permanent numbness of the chin or lower lip. I would like to believe that your brother’s dentist had use of such radiation technology and since his age may be contraindicated for wisdom teeth extraction, the risks were decreased because of the prior x-ray evaluations.

I like to look at each patient on a case by case basis. Every is unique and carries different risks and rewards in their dental hygiene needs. Though your brother is part of a small minority in having his wisdom teeth extracted at an older age, he may have decreased his risks for long term effects on his second molar and this was wise indeed.