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Should We Extract Wisdom Teeth?

Impacted wisdom tooth

Scenarios To Consider

The scan above shows an impacted wisdom tooth which is at an incorrect angle and digging into an alveolar nerve. Undesirable, probably painful and with only one practical solution.

Whether or not to extract a wisdom tooth is clear in the case above, although each situation will be unique, requiring specialist analysis.

If there is space in the mouth and the tooth grows normally, extraction may not be appropriate, even with temporary symptoms. We should still bear in mind that wisdom teeth are inessential and can cause problems in later life.

About 80% of wisdom teeth require extraction before people reach 70 years of age. Removing them at a time when our bone is more amenable and general health issues are likely to be lower holds advantages.

Your consultant will discuss and consider medical history at any age, which could enhance, or reduce reasons for extraction. They will also take scans, or x-rays and review your individual symptoms.

In some cases, a balanced decision will need to be made. In others, the right solution for you will become clear from additional factors.

Wisdom Tooth Diseases

A range of conditions can increase the rationale for extraction. The location of wisdom teeth makes them awkward to clean and the way they erupt can help to create common issues:

  • Pericoronitis is an infection of the gums around a wisdom tooth and a leading reason for extraction. You tend to encounter greater pain and swelling than normal growth would produce.
  • Wisdom teeth themselves, or others close by can be subject to general gum disease, called periodontitis. There may be no immediate symptoms but this is a pervasive condition.
  • Tooth decay in wisdom teeth, or their neighbours is quite prevalent. Looking to the future, restorative work to preserve, or rebuild a wisdom tooth might not be the best answer.
  • Conditions such as oral cysts, or spreading infections can evolve from wisdom teeth. Removing the tooth and therefore the source could be a sensible step.

There are clearly a number of cases where extraction is the best option, antibiotics, or improved oral hygiene would simply be palliative. We should still consider any points which may be against extraction.

Risks On Extraction

Our mouths are a key part of the sensory system, with the mouth and jaw holding a network of nerves. Dental treatment has the potential to cause damage, which can bring pain, or affect sensations you feel in your face.

As with any surgery, post operative infection can occur. Dry socket is another possibility, where a blood clot fails to develop correctly following extraction.

We should however note that issues are unusual. Research points to a rate below 5% for any type of downside and below 2% for nerve damage. In specialist hands with sound preparation, rates will be lower still.

If an issue does occur, this can normally be solved, although cases requiring significant intervention, such as surgical repair of nerve damage are quite rare.

The reality is that where required, wisdom tooth extraction is far more likely to prevent than cause oral disease. A procedure which can be pain free and cause relatively little inconvenience.