Info for patients

Wisdom Teeth


Most people will develop three sets of permanent molars in their lifetime. The first permanent molars are sometimes referred to as “six-year molars” because they often erupt (appear in the mouth) at approximately age 6. “Twelve-year molars” are the second set of molars to erupt and are located just behind the first molars. Most people (but not all) also develop a third set of molars that are commonly referred to as “wisdom teeth.” These third molars can erupt anytime in the late teen years or in early adulthood and are almost always the very last teeth of the dentition to erupt. Most people will develop four wisdom teeth (two top and two bottom). Some people never develop wisdom teeth and others may have only one or two or three. A special radiograph (x-ray) can be used in the early teen years to detect the presence (or absence) of wisdom teeth.

In many individuals, wisdom teeth develop within the jaws but never erupt. In this scenario, the wisdom teeth have become trapped and are referred to as “impacted” teeth. Various factors may contribute to impacted wisdom teeth, but there are two that are most common. It is not unusual to see impacted wisdom teeth that simply do not have sufficient space to erupt into the mouth. In simple terms, the tooth does not have a “parking space.” Also, the tooth may deviate from its ideal eruption path on its way into the mouth and become obstructed by an adjacent tooth. These two situations may coexist to result in an impacted tooth. Some impacted wisdom teeth can be fully impacted which means that they are permanently trapped within the gums or jaw bone and are not visible in the mouth. Wisdom teeth can also be partially impacted, meaning that part of the tooth has broken through the gums and is visible in the mouth but will not erupt to its full potential.

Impacted wisdom teeth have the potential to develop a variety of complications if left untreated. Fully impacted wisdom teeth can, on rare occasions, lead to the development of cysts within the jaw. They may also contribute to localized pain. Partially impacted wisdom teeth can lead to recurrent inflammation, infection, localized periodontal disease, and pain. Furthermore, partially impacted wisdom teeth can often be difficult to clean effectively and may be at risk for dental caries (cavities). On the other hand, impacted wisdom teeth that are left untreated do not always lead to a problem. For this reason, it is important that you discuss treatment options with a general dentist and/or specialist in oral and maxillofacial surgery (oral surgeon).

Impacted wisdom teeth can be surgically extracted (removed) as a preventive measure to eliminate the risk of the previously mentioned complications. The degree of impaction will dictate who can extract the teeth. Some general dentists are qualified to remove impacted wisdom teeth and will offer this service to their patients. Severe impactions are usually referred to the care of an oral surgeon. As with any surgical procedure, inherent risks of complications are associated with the extraction of these teeth. Generally speaking, the risk of complications from extracting wisdom teeth is lower when the procedure is done earlier in life rather than later. One reason for this is that it is often more advantageous to remove a wisdom tooth before the tooth root is completely developed. For this reason, preventive extraction of impacted wisdom teeth is often performed in the mid-teen years. Your dentist or oral surgeon can answer questions regarding the risks associated with removal of wisdom teeth.

There are many reasons why an individual may benefit from removal of wisdom teeth but orthodontic considerations are not usually among them. Generally speaking, WISDOM TEETH DO NOT CAUSE YOUR FRONT TEETH TO SHIFT. While there are certain situations when wisdom teeth must be removed to enable ideal orthodontic treatment, it is a popular misconception that the wisdom teeth push forward on all of the remaining teeth creating a “domino effect” that results in crowding of the front teeth. The fact is that shifting of teeth can be observed in most individuals throughout their lives regardless of the presence or absence of wisdom teeth. The most common area where this is seen is in the lower front teeth. There are numerous scientific studies that have demonstrated this phenomenon. Whether or not you have had braces, and whether or not you have had wisdom teeth, the only way to be sure that your teeth will not shift throughout life is by using an orthodontic retainer. A retainer is simple appliance that passively holds teeth in their current position.