Wisdom Tooth Removal - To Pull or Not to Pull?

A look at wisdom teeth and the continuing debate on whether or not to pull them out.

It happens to all of us sooner or later. We are chopping along with our lunches or dinners, when we suddenly feel something

in the back of our mouth - something that wasn’t there before. On a closer look we see two little white towers protruding through the gum line. There is really no need to press the panic button. What is likely happening is that your wisdom teeth are coming through.

Wisdom teeth are the far back molars in the mouth. They generally come through around ages 17 and 18. However, some children as young as 12 have had them come through while others are well into adult hood.

The first reaction of dentists in decades past regarding wisdom teeth was to pull them out. It was feared that decay, space and pain would all become issues if the teeth were left in. However today, the attitude toward wisdom teeth has softened. They are being removed less and less and only in cases where it is deemed necessary.

Wisdom teeth can present with some problems. They can really cause damage if they are impacted. This means that only a portion of the tooth has come up through the gum line. In these cases they are almost always removed. Impacted wisdomteeth are more vulnerable to decay than the other teeth. A portion of the tooth remains below the gum line. This creates a sort of pocket between the gum and the exposed portion of the tooth. When this happen, food and bacteria can become trapped in this area. This leaves the tooth highly vulnerable to decay and further infection.

Wisdom teeth can also cause pain due to their position in the mouth. They start to form along the arch of the gum line. This means they quite often grow in at an angle. As the teeth start to develop the can slide up against other teeth causing some intense pressure pain. They can also cause teeth to move and shift if they grow to their full potential. In these cases again, the wisdom teeth are most often removed.

Wisdom teeth can actually cause cysts to form. This is a fluid filled sack that can start formation around the area of the impacted wisdom tooth. These cysts can lead to further infection and damage the soft tissue as well as the jaw bone. In rare cases teeth can be lost and the jaw fractured if this is not taken care of.

The debate continues on whether or not to remove wisdom teeth if they are not causing any problem. Some dentists will argue it is pointless to undergo an operation for something that is causing so pain or damage. Others argue that the teeth will eventually start to cause a problem and it is best to have the problem taken care of early. In fact the best time to remove wisdom teeth is when one is young. Once they have fully formed dentists say they should be removed. What is a simple operation for a teenager can become more serious for n adult.

Those against removing wisdom teeth will likely cite the following reasons. One is that everyone is different. Some have what is called a simple extraction. The result is some slight post operative pain, bleeding and swelling. However, others have to have a more complex extraction. They post operative symptoms can range from severe pain, swelling and bleeding. Those with sensitive skin can experience severe bruising as well. Another problem is a condition known as dry socket. This is where the blood clot that forms in the space of the teeth comes out. This exposes the jaw bone and becomes very painful. It does heal up in a few days however. Finally, adults really need to consider this option. As one ages the bone around the teeth becomes denser. This makes the teeth harder to remove and more evasive procedures may be needed. Consult an oral surgeon to see if it is worth it and get a second opinion.

Those that do take the plunge and have the wisdom teeth removed will have to follow some post operative care instructions. Smoking and drinking through straws are usually prohibited for the first 48 hours. This can lead to infection and dislodge the blood clot. One should also eat soft foods for the first few days. Hard foods could be painful and disturb the wound.

When it comes to the removal of wisdom teeth, the debate continues on. The camps are evenly divided as to whether removal should be automatic or only done when needed. The decision lies with the patient. If your unsure if this is the right course of action you should express your concerns and get a second opinion.