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All about Wisdom Teeth -- Third
Molars
Wisdom of the Ages is Like Money in the Bank
Have you considered putting your wisdom teeth in a safety
deposit box? If you are like most people, then likely not.
However, it may be possible in the future for people to have
stem cells taken from their own wisdom teeth and saved. The
stem cells would be used to help regrow teeth, to restore nerve
cells, to correct a cleft palate or periodontal defects, to
regrow jawbone and to save teeth, according to Pamela Gehron
Robey, Chief of the Craniofacial and Skeletal Diseases Branch
for the National Institute of Dental and Craniofacial Research
at the National Institutes of Health. This type of stem cell
harvesting is non-controversial because the cells are removed
from a person’s healthy teeth, not from a fetus.
Robey advised attendees at a recent American Dental Association
conference that jawbone grown from bone marrow has already been
used to replace lost jawbone in a patient. She hopes that stem
cell technology can be used to regrow teeth for patients who
have been in car accidents or suffered some other trauma that
caused them to loose teeth and to help people whose nerves have
been damaged from Parkinson’s disease.
Some get them, some don’t; some are fine, some aren’t
When we are born we usually come into the world toothless, but
as we age, teeth appear in our mouths on a somewhat regular
schedule. For example, our first molars (large grinding teeth
at the back of the jaw) usually appear when we are 6 or 7 years
old, our second molars when we are 12 or 13, and our third
molars (wisdom teeth) when we are typically between 18-20 years
old*-when we are much “wiser.” Many people have four wisdom
teeth, one on each side of the upper and lower jaws, while
others have only 1-3 wisdom teeth.
Unfortunately, not all wisdom teeth erupt correctly (grow out
from under the soft tissue-gumline-covering the jawbone), if at
all. The tooth may lie sideways in the jaw, either pointing
inward toward the back of the mouth (distoangular
impaction-least common), outward toward the cheek (mesioangular
impaction-most common) or pointing directly at the second molar
(horizontal impaction). The wisdom tooth might only partially
break through the soft tissue, which is called vertical
impaction.
Unerupted Boney Impacted Wisdom Tooth
Angular Vertical Impacted Wisdom Tooth which has caused Decay
in the Second Molar in Front of it.
Horizontal Impaction
Erupted Third Molar
Various sources list the age range from as low as 15 years old
to as high as 25 years old.
Pericoronitis -- a Painfull Inflamation, Infection around the
Third Molars
Impaction is not a good thing
Impaction, simply stated, means that the wisdom tooth has
either not erupted at all or has not fully pushed up through
the gumline. An impacted wisdom tooth can cause serious-and
even deadly-health problems. For example, the person can
experience pain, get jaw and gum infection (pericoronitis), a
tooth abscess**, have crowded or crooked teeth, or the nearby
teeth and roots can be harmed. One of the more serious problems
is the development of a cyst. If not treated, the cyst can form
a tumor or cause jawbone destruction; it can move other good
teeth out of position or damage nearby teeth.
It is more difficult to reach, brush and floss a partially
erupted wisdom tooth. Bacteria can creep down into the soft
tissue surrounding the impacted tooth. The resulting infection
can produce pain, swelling, a stiff jaw (difficult to fully
open the mouth) and bad breath. The infection can spread to the
cheek and neck. Now for the really scary part: Older adults can
experience life-threatening problems when the infection causes
the other soft tissues in your mouth and throat to close off
the windpipe, you can develop heart disease, diabetes
complications, or the infection can travel to your brain!
In late 2005, a late 1990s study was made public that showed
that 60 percent of the pregnant women in their twenties who
participated in the study already had early gum disease around
their wisdom teeth. The study’s position is that pregnant women
who have their wisdom teeth are at a risk of having
complications with their pregnancy and other health issues. The
women who had the most serious gum disease were twice as likely
to have a premature baby, according to the American Association
of Oral and Maxillofacial Surgeons. The most significant aspect
of the study is that in the 1990s, it was thought that only
adults 35-40 years old suffered from complications caused by
gum disease, and now professionals know that age is not a
factor.
Sometimes, the person is unaware that any damage has occurred,
which presents an even more dangerous situation.
The good, the bad and the ugly
Here is the good and the bad about impacted wisdom teeth. If
treated early-early teen years-complications from impacted
wisdom teeth seldom arise. If not treated until later years,
after 20 years old, serious complications may occur. During the
teen years, the jawbone is not as dense and hard as it is when
the person ages, and the tooth root is comparatively short;
thus, extraction of a wisdom tooth is a relatively uneventful
procedure. A teen also heals more quickly than an older person.
Once the jawbone is hardened and the tooth’s roots have grown
longer, one might as well loop a 1-inch cable around the tooth
and hook the other end of the cable to the bumper of the family
sedan, figuratively speaking of course. Older adults can suffer
nerve damage from a difficult extraction. The American
Association of Oral and Maxillofacial Surgeons and the Oral and
Maxillofacial Surgery Foundation recommend that wisdom teeth be
removed while the patie nt is still a teenager, which brings up
an on-going controversy: The Ugly.
It has been a customary practice to routinely extract wisdom
teeth at an early age. However, there is a growing body of
research that shows that there is no substantial evidence to
either support wisdom teeth removal or to leave them in place
(Refer to link below to the Cochrane Collaboration.). Their
position is that 60 percent of wisdom tooth surgeries are
unnecessary.
From statistics the other side of the fence, however, show that
about 85 percent of wisdom teeth will need to be removed. These
contradicting ideas and statistics might indicate that there is
a substantial amount of subjectivity in deciding whether or not
to remove wisdom teeth.
So, what is a person supposed to do?
As usual, good oral health care is the Golden Rule. Dr. Trey
Petty, a spokesperson for the Academy of General Dentistry ,
advises people to take good care of their erupted wisdom teeth.
“…the key to preserving them (wisdom teeth) is maintaining good
oral health by brushing twice a day and going to see the
dentist twice a year,” states Dr. Petty.
If you are concerned about your wisdom teeth, talk to your
dentist. Your dentist will advise you about the risks,
complications and outcomes related to keeping or removing your
wisdom teeth.
Keep your teeth healthy; your future dental needs and your
health are depending on you. You can take that to the bank!
For more information, you may find the following Web sites
useful:
Academy of General Dentistry http://www.agd.org/
American Association of Oral and Maxillofacial Surgeons
http://www.aaoms.org/wisdom_teeth.php
Cochrane Collaboration http://www.cochrane.org/
National Institute of Dental and Craniofacial Research
http://www.nidcr.nih.gov
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