Wisdom teeth, also called third molars, are the last of the teeth to come in, and usually, they’re the most troublesome. Almost everyone has problems of some kind with them. By the time they grow in — typically between the ages of 15 to 25 — the other teeth have taken all the available space in the jaws, leaving little room for four additional molars. When a wisdom tooth doesn’t have room to grow in properly, it becomes impacted. This means that it’s trapped against the adjacent teeth, surrounding bone, or soft tissue.

Left untreated, an impacted wisdom tooth can sometimes be trouble-free. However, if we determine that the third molars won’t grow in to an acceptable position, we’ll recommend their early removal to avoid a wide range of problems, which can include:

  • Tooth decay and periodontal disease
  • Infection
  • Damage to the adjacent molars
  • Cysts

Tooth Decay and Periodontal Disease

When wisdom teeth have not fully come in or when they are crowded against other teeth or tissues, bacteria get trapped on the teeth and under the gum tissue. Since impacted wisdom teeth can be difficult or impossible to keep clean, bacteria grow rapidly and plaque forms easily. The bacteria in plaque produce an acid that eats into the enamel layer of the wisdom tooth and any nearby teeth, causing cavities.

The plaque also hardens into tartar, which irritates the gum tissue, leading to the inflammation called gingivitis. Gingivitis leads to the more serious infection of the teeth, gums, and jawbone called periodontal disease. This occurs when the bacteria produces toxins, and these toxins, combined with the chemicals released by your immune system, cause increasingly swollen, inflamed, and receding gums and loss of jawbone. Left untreated, tooth decay and periodontal disease can lead to tooth loss and the spread of infection.

Infection

Pericoronitis is another infection that sometimes occurs with wisdom teeth. Pericoronitis is an inflammation of the gum tissues that cover the chewing surface of molars that have not fully come into the mouth. Before a molar comes in, gum tissue completely covers the area. As the molar begins coming in through the gum, the biting surface of the tooth remains covered by, but not attached to, a flap of gum tissue.

Because the surface of the tooth is not attached to the flap of gum tissue, it’s very easy for food and bacteria to get trapped under the gum. And because the tooth is covered by the gum, it’s almost impossible to keep the area free of bacteria. When this happens, infection, swelling, and pain can quickly develop. In addition, if the upper molar comes through fully before the lower one, the upper tooth may bite down on the lower gum flap, worsening the condition. If pericoronitis is left untreated, a much more serious infection can spread to the neck and cheeks.

Damage to Adjacent Molars

Because there is usually not enough room in the jaws for wisdom teeth to come in, they may grow sideways, into the roots of the adjacent teeth. They may also grow in at angle, so that the crown of the wisdom teeth tries to come in up under the adjacent tooth. In either case, the wisdom tooth can crowd or push the tooth next to it, causing the adjacent tooth to become crooked or even damaged.

Cysts

When a tooth begins to form, it is surrounded by a sac in the jawbone. This area is lined with cells, and as the tooth come in, these cells are supposed to transform into the lining of the crevice between the gum and tooth. Sometimes, though, especially when the tooth and its sac have been forced to stay in the bone too long, the cells produce fluid instead. This fluid expands the area in the bone around the tooth, causing a cyst. These cysts can become very large, distorting the bones and face. They can even lead to weakness in the jawbone, making it prone to fracture

Removing Wisdom Teeth

Because of the problems that wisdom teeth can cause, we’ll recommend taking them out if it looks like they won’t come in properly. Some people are lucky enough to have room in their jaws for wisdom teeth, but most of us don’t. If we do recommend the removing the wisdom teeth, we’ll explain the procedure and thoroughly discuss all the pros and cons, so that you can decide how to proceed. If you have any questions about wisdom teeth, we’ll be happy to talk with you about them. Dentart Implant & Aesthetic Dentistry, inter@dentart.com or call our office (+90 530 522 9179) in Istanbul Turkey

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