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Why do I have to pull these teeth…for that matter why do I have them?

We will start with the second question first. Wisdom teeth are biologically designed for helping replace a tooth that was damaged by having a caveman’s diet of eating rocks (or close enough). Of course, cavemen lost these teeth at a MUCH younger age so your wisdom teeth will not do the job of a tooth that you lost through extraction in adulthood.  An implant or bridge will be needed to replace the gap caused by the extraction.

Okay that is why I have them but why do I have to pull them?

Wisdom teeth are just a problem waiting to happen. Most wisdom teeth have two stages of problems. Your first stage is as they are trying to come in. People always empathize with babies as they are teething but really wisdom teeth can be way worse. As they develop, wisdom teeth can not only give you the pain of erupting through the bone and gums but also the pain of pushing against the tooth in front. This eruption into the mouth gets stopped for almost everyone because people don’t have space (refer back to eating rocks). Since they don’t have space, the teeth get stuck (or impacted is the other word for it). As they are stuck, trouble develops in the partly erupted tooth.  Bacteria gets down between the gums and the partly erupted tooth and can cause infection between the teeth, (pericoronitis), or a cavity on either the wisdom tooth or more importantly the tooth in front of it. The cavity on the tooth in front can lead to losing a good tooth just because of a wisdom tooth.

Later on in life all of these earlier troubles can still happen but there are additional risks of getting a cyst around the wisdom tooth that can eat away the bone leading to a fractured jaw.

Well if my wisdom teeth may not cause me problems until later in life why don’t I wait until then to remove them?

The difficulty in removal is not the same at age 18 as it is at 60; especially for impacted wisdom teeth. An impacted wisdom tooth removed at 18 will make for a sore weekend of sitting on the couch. An impacted wisdom tooth removed at 60 can lead to a horrible couple of weeks or even a hospital stay.  Wisdom teeth removed at the right time, (talk to your dentist here), when they are not fully developed is ideal. As those roots develop, they can grow around the nerve of the jaw leading to a dramatically increased risk of permanent nerve numbness to the whole lower jaw.  And as mentioned earlier, waiting can cause a cavity on the tooth in front of the wisdom tooth leading to the patient losing a good tooth.

Fine, you convinced me. I know I need them out, who should pull them?

Talk to your dentist at Davidson Family Dentistry. Dr. Michael Davidson of our office does a number of wisdom teeth removals and generally recommends twilight sedation for the procedure.  Usually the patient has no memory of the surgery at all.

Well if they specialize in surgery why don’t I just go to an oral surgeon?

Specialists are great to have. Especially for situations where you have a cyst that has pushed your wisdom tooth up by your eye. Or a wisdom tooth that grew too long and grew around the nerve. God bless specialists. Many other times referral to a specialist is just overkill. For routine wisdom teeth, a general dentist can do it at a lesser cost in the same office that has made you comfortable.

My dentist told me to keep my wisdom teeth so I’m confused.

There are times, albeit rare, that wisdom teeth do not need removed. This is when the wisdom tooth is buried so far under the gums in a high risk area that the benefits do not outweigh the risks. It doesn’t mean the benefits of removing the wisdom teeth have gone away; it just is too risky. The other set of people who do not need to remove their wisdom teeth are people that have space.  By the time wisdom teeth start coming in, it will be obvious if you have space and your dentist will tell you if you are one of the lucky ones.

Of course with all of this if you have questions the best thing you can do is talk to your dentist.  And please remember that individual advice from your dentist for your unique situation trumps any article written to discuss the subject in general terms.

Making smiles happen,

Your Davidson Family Dentistry Team


Posted May 19th, 2016