Your teen has been in braces for three years, and it has truly been a labor of love to make sure they got to all their appointments on schedule. Your bank account likely reflects that the cost of raising a child is estimated at over $200,000 over a lifetime. Kids are expensive, and so is orthodontic treatment. Now, your child’s orthodontist has recommended that his wisdom teeth be removed this summer. Your teen’s wisdom teeth are not hurting him, so why the big rush to do surgery? This article is not meant to scare you or sensationalize the risks of avoiding wisdom teeth extraction.
Should some wisdom teeth be left alone? Absolutely! Should you ignore a recommendation for wisdom teeth surgery? Absolutely not! Here is why you should definitely have a consultation with an oral surgeon if your child’s orthodontist has recommended wisdom teeth removal.
Your Orthodontist Is Not Crazy, He’s Protecting Your Investment
I know, that title sounds like a pitch, but the fact is, there are numerous reasons that wisdom teeth might be recommended for extraction, even when there are no painful symptoms associated with them. Let’s take a minute to discuss some of the proactive indications for removal of wisdom teeth.
- Your orthodontist has a greater chance of success and ease of treatment moving the molar teeth when the wisdom teeth are not obstructing the path. When the wisdom teeth are impacted or partially erupted, they are often positioned right behind or under the second molars. These second molars cannot be moved easily or effectively with the wisdom teeth causing an obstruction.
- Once the braces are removed, the teeth are free to shift back into malposition. Removing the wisdom teeth helps prevent orthodontic relapse and dental crowding once the braces are removed. Incidentally, diligent use of the retainer all the way past age 25 is recommended for prevention of orthodontic relapse.
- Malpositioned wisdom teeth can cause damage to the adjacent teeth. Some of the damage that can be caused by malpositioned wisdom teeth includes tooth decay, gum disease and loss of bone around the second molars.
- Wisdom teeth can develop destructive pathology. Cysts, tumors and other pathology sometimes forms around an impacted wisdom tooth. Pathology such as this may be completely asymptomatic for a very long time. Once symptoms, pain, swelling develop, a cyst or tumor has usually already done damage to the jaw bone and/or teeth.
- Even erupted wisdom teeth are very hard to keep clean. Inadequate dental hygiene due to difficulty of access to the wisdom teeth can cause tooth decay and gum disease, putting other teeth at risk for damage and tooth loss.
What Happens If I Just Wait Until The Wisdom Teeth Cause Pain?
Your orthodontist is trained to identify the potential for future problems with the teeth as well as
diagnose and treat current problems. When your orthodontist recommends wisdom tooth extraction, it is typically for one of the reasons listed above. The only thing in it for the orthodontist is the satisfaction of a job well, done. He doesn’t earn any compensation for sending your child off to have their wisdom teeth removed, he honestly just wants to give you the best advice possible, and protect your investment of money, time and energy, which are all spent in straightening a teenager’s teeth. If you received a recommendation for wisdom teeth extraction, and decide to wait until symptoms develop, here are the risks you are taking:
- Wisdom teeth pain can be very uncomfortable. Your teen will probably develop the most severe symptoms in the middle of the night on a Saturday, if we buy into the whole “Murphy’s Law” philosophy. If this happens, you will either find yourself in the ER or frantically trying to get a last minute appointment first thing Monday morning.
- Dental crowding cannot be reversed by removing the wisdom teeth. If you wait for dental crowding or orthodontic relapse to occur, plan on starting the whole orthodontic treatment all over again- the teeth won’t shift back into position without braces.
- Tooth decay does not usually cause pain until the decay reaches the pulp of the tooth. Once this happens, repair of the tooth is usually extensive and costly, assuming the decay can be repaired in the first place. Second molars are important teeth- you definitely want your teen to keep them for a lifetime!
- Chronic infection is annoying, painful and can actually progress into a serious health concern. The same bacteria which cause gum disease cause chronic infection of the wisdom teeth. Some of these bacteria have been identified as a possible catalyst to systemic health conditions such as heart problems. At the least, chronic infection damages the gum tissue and results in loss of bone (which, by the way, holds the teeth in the jaw). In rare cases, chronic infection can settle in the bone itself, a condition called osteomyelitis, which can be very serious and require hospitalization.
- Cysts and tumors destroy precious jaw bone structure. If left untreated, benign cysts and tumors associated with impacted wisdom teeth will continue to grow and destroy any bone in its path. When there is extensive damage to the jaw bone, the jaw is at increased risk for pathological fracture. Teeth are often damaged and lost when a cyst or tumor is left untreated. Sometimes, pathology such as this becomes infected, further complicating the treatment required to resolve it.
This summer, if you received a referral from the orthodontist to have your teenager’s wisdom teeth extracted, don’t procrastinate. Find out how urgent the issue really is before you make a decision. Sometimes waiting is just fine- sometimes it is not. Go for a consultation with an oral surgeon, get facts and answers. Educate yourself on the pros and cons of wisdom teeth extraction, and make your decision based on what you learn. If this information is helpful to you, share it with a friend!