For many teens and their parents, it’s a debate on if or when their child should have their wisdom teeth removed. This is a fairly common question for some families when they are referred to my office for evaluation. Many people are glad to part with third molars, better known as wisdom teeth, when they are having pain related to these teeth. Others may not have symptoms but their referring dentist has recognized an abnormal eruption pattern on X-ray or has seen signs of developing associated dental problems. Wisdom teeth may be counted as part of the normal set of teeth but they are the most common teeth to have abnormal shape and eruption affecting neighboring dentition.

Wisdom teeth are the last set of molars to erupt, usually at about the age of 18. Not everyone has all four third molars, and not every wisdom tooth breaks through the gum. Some never erupt. Some erupt only halfway or come in crooked. When there’s not enough room for the wisdom teeth to break through the gum, they’re “impacted.” The wisdom teeth can tip or rotate in the jaw, push against other teeth or become lodged against the jaw bone. If wisdom teeth push only part of the way through the gum, they can become susceptible to decay and a gum infection called pericoronitis. No one seems to question extracting an extra tooth such as a mesiodens when it is causing crowding or risking damage to adjacent teeth. Similarly, dental X-rays can determine pathology or compromised eruption patterns of third molars. One can wait until pain or peripheral damage occurs but by waiting too long for removal of problematic third molars, the solution is usually more difficult and there tends to be more risk of complications over time.

I believe our team does a fantastic job to educate families and patients about wisdom teeth extraction surgery. We want everyone to feel 100% vested in their treatment and recovery process. I ask our patients to not believe all the “friend surgery stories”, crazy YouTube videos, and other social media presentations. Chances are, if the story ends up on social media, it is like “the fish that got away”…it gets bigger every time. We care for one patient at a time and prefer to not have social media stories to share.

Hopefully, this presents an overview of why we have consultations to discuss third molar removal and to ensure our families and patients are well informed.  Enjoy your summer!

Bart D. Williams, III, MD, DMD, FACS

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