September 19, 2005
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Pennsylvania Dental Association Offers Tips on Wisdom Teeth Extraction
What to do about third molars, commonly known as wisdom teeth, is a quandary that most people face during the course of their dental treatment. The Pennsylvania Dental Association (PDA) offers the following advice to help patients understand when and why it is necessary to remove wisdom teeth.
There has been some debate about whether wisdom teeth can remain healthy and unobtrusive in the mouth long-term. A recent seven-year, landmark clinical trial funded by the National Institutes of Health (NIH) and the American Association of Oral and Maxillofacial Surgeons (AAOMS) will, in large part, settle the debate.
This study strongly suggests that wisdom teeth should be evaluated no later than a patient's early 20s to prevent future problems. Early stages of periodontitis may present first in the third molar region, even in young adults.
The cause of many problems occurring with wisdom teeth is that they are difficult to clean. The inability to maintain proper oral hygiene of wisdom teeth is the leading factor causing subsequent complications, such as periodontal disease, decay, pain, infection and swelling.
When the jaw isn't large enough to accommodate wisdom teeth, they may grow sideways, emerge only part way from the gum or remain trapped beneath the gum and bone (impacted).
It is important for patients to ask their dentist about the health and positioning of their wisdom teeth. The dentist may make a recommendation for removal or send the patient to an oral and maxillofacial surgeon for further evaluation.
"In approximately 90 percent of the population, wisdom teeth create the potential for infection, decay and periodontal bone loss in the molar region," said Dr. Greg Kewitt, an oral and maxillofacial surgeon in State College. "It's important that people have them evaluated in their teenage years. If they do need to be removed, patients should be encouraged to do so prior to the development of complications."
Extraction of wisdom teeth is generally recommended when:
- Wisdom teeth are impacted or mal-positioned.This condition often allows bacteria to enter around the tooth and cause an infection.Pain, swelling, jaw stiffness and general illness can result.
- Decay or periodontal disease is present.
- Maintaining good hygiene in the area of the molar teeth is difficult.
- A cyst (fluid-filled sac) or rare instance of a tumor forms, destroying surrounding structures such as bone or tooth roots.
In most cases, a patient benefits from removal of wisdom teeth in their teenage years.
"The recovery time is shorter and potential for complications is lower when you have wisdom teeth removed on an elective basis rather than an urgent, pain-driven basis," Dr. Kewitt said.
There is a small percentage of the population that can maintain excellent oral health without having their wisdom teeth removed.
"If wisdom teeth are erupted and in good functional position where the patient is able to keep them clean, then removal is not necessary," Dr. Kewitt said. "But that is by far the exception rather than the rule. And, in fact, new data challenges this long-held belief."
A surprising finding of the NIH/AAOMS Third Molar Clinical Trial is that wisdom teeth that have erupted into the mouth in a normal, upright position are as likely to exhibit disease as wisdom teeth that remain impacted.
Remember to visit your PDA member dentist regularly to keep your smile lasting a lifetime.
About the Pennsylvania Dental
Founded in 1868, the Pennsylvania Dental Association (PDA) is comprised of approximately 6,000 member dentists. It is a constituency of the American Dental Association (ADA), the largest and oldest national dental society in the world. PDA’s mission is to improve the public health, promote the art and science of dentistry and represent the interests of its member dentists and their patients. PDA is the voice of dentistry in Pennsylvania. Learn more about PDA.