Can you have too many teeth? You’d think that, by nature, we grow as many teeth as we need. However, some of us—about 25%—have a few more than others. And those “extra” teeth can be the very things coming between you and a beautiful smile.
What Makes Them Wise?
“We call them wisdom teeth because they usually come in at a more mature age than the rest of our adult teeth – between age 17 and 25, versus age 12 for the last of the other adult teeth,” says nationally-recognized oral health expert Dr. Charles Sutera, DMD, FAGD.
“And there’s nothing inherently wrong about having wisdom teeth. It’s believed that we have been evolving away from them, as our diets have gotten softer and easier to chew since our neanderthal days. If they grow in straight and don’t crowd your other teeth, they’re just another set of powerful molars.”
When to Nix the Wise Guys
It’s when they don’t grow in straight, says Dr. Sutera, overlapping with other teeth, squeezing up through the gums at awkward angles, or don’t fully erupt through the gums that we can run into problems with wisdom teeth.
And that’s pretty common because they come in so much later than the rest of your adult teeth and there’s often no room left for them.
The good thing about wisdom teeth is that it’s usually obvious if a wisdom tooth is going to cause a problem. Often your dentist can tell if wisdom teeth are going to be problematic even before they’ve fully erupted, just by looking at x-rays of your mouth.
Do You Really Need to Remove Them?
Because a wisdom tooth growing in a poor position or erupting in another tooth’s space will create more dental issues over time, dentists generally recommend that they be removed as soon as they can see that the path they’re on isn’t optimal.
Since studies show complications from a tooth extraction increase with age, dentists and oral surgeons in the United States recommend extraction early in life to reduce complications later in life.
Those complications can include:
- Impaction (this means they are wedged against another tooth or wedged against the bone)
- Infection of the gums
- Cysts forming around the wisdom teeth (the body’s version of socially distancing the wisdom teeth)
- Sinus issues
- Inflammation of the gums and jaw
- Cavities of the wisdom tooth or the tooth it is impacted against
- Lack of room, causing other teeth to shift, crowd, and overlap
Can’t We Wait and See?
Wisdom tooth surgery is no picnic, but the alternative can be worse. If the wisdom teeth stick around too long and cause the problems noted above, the situation becomes not only a matter of extracting the wisdom teeth, but also correcting whatever problems the wisdom teeth caused.
“We prefer to extract them rather than take a wait-and-see approach so we can avoid additional treatments you may need to address oral issues stemming from wisdom teeth,” says Dr. Sutera, noting some of the other treatments that may become necessary if wisdom teeth are not extracted early enough:
The primary reason why most wisdom teeth need to be removed is that there’s not enough room to fit them into proper alignment—think: Shaquille O’Neal trying to fold himself into a Mini Cooper. If wisdom teeth are erupting into insufficient space, they push the other teeth out of the way. Even if you had braces or Invisalign in the past, wisdom teeth can ruin all the hard work and expense of your braces. Wisdom teeth are one of the most common reasons why people have to have braces or clear aligners a second time in life.
TMJ Treatment (Temporomandibular Joint Disorder)
Wisdom teeth often erupt at unconventional angles—sideways, backward, and even into another tooth. Aside from the obvious issue of their awkward position, this can affect how your top and bottom jaws close together and the misaligned teeth can also place pressure on the joints of the jaw. TMJ pain and temporomandibular joint dysfunction can cause a clicking noise or sensation when chewing, headaches, muscle tension, facial pain, teeth grinding, and even ear pain. Treatment can include the use of orthotic devices, restorative dentistry, and botox.
Composite Fillings for Tooth Decay (aka Cavities)
When talking about wisdom teeth and cavities, the problem is two-fold. Wisdom teeth are far in the back of the mouth, which makes them difficult to brush. The position of wisdom teeth makes them the most likely teeth to develop a cavity, but it’s more than that. When a wisdom tooth is impacted or wedged against the tooth in front of it, it makes cleaning that area difficult as well—causing cavities on the adjacent teeth.
Why is it that things like serious tooth infections always seem to flare up at the most inconvenient times? It may not actually be the case, but an emergency visit is the last thing any of us want. Better to schedule wisdom tooth extraction on your own terms.
“As with every aspect of our health, it’s up to you to decide,” says Dr. Sutera. “But it’s best to make that decision with a good understanding of how things can snowball where wisdom teeth are concerned.”
About the Expert
Dr. Charles Sutera, DMD, FAGD, is a doctor of dental medicine, TMJ specialist, board-certified in moderate dental anesthesiology, and renowned for high profile cosmetic dental reconstructions. He is a Fellow of the Academy of General Dentistry and is the founder of his dental practice, Aesthetic Smile Reconstruction.