The Smart Truth About Wisdom Teeth

Wisdom teeth are a 3rd set of molars that often arrive when we are in our late teenage years or early 20’s. Most people who have tried to answer the age-old question, “why are they called wisdom teeth?” have reached the conclusion that it is because they arrive much later than our other teeth. The other age-old question is “why do we have wisdom teeth at all?” It is a good question because, for many people, they are just a source of trouble.

HOW MANY PEOPLE HAVE WISDOM TEETH?

Sound statistics are not available, but decades-old Scandinavian studies are the main source in media reports that 85% of people have all four wisdom teeth, while up to 95% have at least one. There are other estimates that suggest that up to 35% of people from European ancestry may not have a 3rd set of molars and that even more decedents of Asians and Africans may lack the extra teeth. Whether or not these statistics are accurate, we do know that a large number of people do develop wisdom teeth and in the United States, a large number have them removed.

HEALTH PROBLEMS BLAMED ON WISDOM TEETH

Many health problems have been blamed on wisdom teeth. Pain, inflammation, headaches, TMJ, and bad breath are the most commonly linked problems. There are a fairly large number of people searching the Internet wondering if wisdom teeth can kill you.

WISDOM TOOTH PAIN AND SWELLING

Wisdom teeth can cause pain while they are erupting or if they become infected. Pain doesn’t always mean that the wisdom tooth needs to be removed immediately. Tooth pain can be caused by a variety of things, and it may be hard to separate minor issues that will go away from more serious problems. Swelling is another common complaint, which is often accompanied by pain.

HEADACHES FROM 3RD MOLARS

What is the actual cause of your headaches? The answer is most times a mystery to doctors and researchers. You can find plenty of sources that say impacted wisdom teeth can cause headaches. You can also find plenty of stories of patients who have worse headaches after having wisdom teeth removed.

Here at Smiles by Design, Dr. Schraw has treated numerous patients with dental-related headaches. She’s also treated patients for TMJ/TMD, jaw pain, and ear pain related to dental problems. Your wisdom teeth (impacted or not) could be having an impact on your headaches…or it could be other dental issues. Or not dental-related at all. The main nerve that runs in the back of your jaw up into your head can get activated for all types of reasons.

DEATH FROM DENTAL INFECTIONS

This is rare but serious. Published in the Journal of Endodontics is a study of tooth infection related hospitalizations from 2000-2008. An average of nearly 7,000 Americans were hospitalized each year and a total of 66 died as a result of tooth infections. So yes, an untreated infected wisdom tooth can kill you.

BAD BREATH FROM WISDOM TEETH

The wisdom tooth itself doesn’t cause bad breath. It is infection and bacteria caused by a poorly cleaned tooth that can cause this problem. Gum disease is known to cause bad breath and can happen with or without wisdom teeth. However, if your 3rd molars don’t fit well and only partially cut through your gums, it can be harder to clean them properly, leading to some embarrassingly bad breath. This can be treated without necessarily requiring the removal of the wisdom teeth, as long as the infection hasn’t gotten out of control.

WILL WISDOM TEETH SHIFT MY TEETH?

In short – no. You don’t have to worry about undoing all that time in braces because of your wisdom teeth. Researchers at the University of Iowa in the early 1990’s used pressure sensors to measure how the removal of wisdom teeth impact forces on the other teeth. It turns out that standing up causes more pressure on other teeth than impacted wisdom teeth do. So the researchers concluded that fear of crowding is not a legitimate reason to have your 3rd molars removed.

WHAT SHOULD I DO ABOUT WISDOM TEETH?

Not everyone has wisdom teeth, but dentists usually can’t determine if children have them while taking x-rays. The exact age at which the 3rd molars will become visible on x-ray depends on the child. In most cases, dentists will have a good indication of whether wisdom teeth are present before the latter teenage years when they normally begin to come in.

EXTRACTION NOT ALWAYS RECOMMENDED

For many years, regular removal of wisdom teeth was a much a milestone in growing up as getting a driver’s license or graduating high school. Not everyone did it, but the majority of people had those extra teeth removed. There has now been some adjustment to that, as evidence has shown that in some cases tooth extraction is not necessary.

In 2008, the American Public Health Association, an advocacy group, issued a policy statement against routine wisdom tooth removal. This came a full decade after Britain’s National Health Service stopped paying for routine extraction if there were no problems with the 3rd molars of patients. And with the 2014 publication of a treatment update in the Journal of the American Dental Association, it became clear that wisdom teeth that are not causing problems, likely don’t need removal.

WHEN DO WISDOM TEETH NEED TO BE EXTRACTED?

When your teeth are not bothering you, removal is probably unneeded. For most people this means:

Grown in completely
Positioned properly
Able to be cleaned easily
No signs of tooth decay or pain

But in many cases, wisdom teeth don’t meet the above criteria. Instead, they can only partially erupt and cause various problems in your mouth. A few things to be concerned about include:

molars that are hard to clean because the teeth erupt only partially
Impacted wisdom tooth
Repeated gum infections around the wisdom teeth
Crowding nearby teeth (usually because they are not positioned properly)
Serious problems – such as pain, infection, cysts and tumors