A family dentist recommends a teen patient visit an oral and maxillofacial surgeon (OMS) for removal of his wisdom teeth. But what if he’s not experiencing any problems with the teeth right now?

What oral and maxillofacial surgeons want every patient (and parent) to know is that pain-free doesn’t mean problem-free when it comes to wisdom teeth.

Third molar risks

Wisdom teeth, clinically called third molars, are those teeth in the back corners of the mouth that grow in the late teens or early 20s. Even wisdom teeth that are symptom-free pose an increased risk for chronic oral infections, periodontitis and tooth decay, according to results of a seven-year clinical trial conducted by researchers for the American Association of Oral and Maxillofacial Surgeons.

Wisdom teeth need to be extracted when they are unable to properly enter the mouth. They may grow sideways, emerge only partially or even remain trapped beneath the gum and bone. These “impacted” teeth can cause many health problems, even tumors or cysts around the roots that can destroy the jawbone and nearby healthy teeth. Partially erupted teeth may allow bacteria to grow, potentially leading to gum disease (gingivitis) that causes swelling, stiffness, pain and illness.

“While not all wisdom teeth need to be extracted, all of them need to be managed.”

Oral bacteria associated with periodontal disease have been linked to more serious health problems, including coronary artery disease, stroke, kidney disease and diabetes. The “Third Molar Clinical Trials” research added a new perspective to the possible risks for young women. Periodontitis affecting retained wisdom teeth can lead to inflammation throughout the body, increasing the risk of delivering a low birth-weight infant. 

Avoiding potential trouble

Third molars often push adjacent teeth out of alignment, thereby altering the bite and threatening jaw integrity. Many orthodontists refer their patients to an OMS for third molar extractions before beginning treatment to minimize the risk of gingivitis and other problems that could affect the success of the orthodontia.

In general, a young adult’s wisdom teeth have incomplete root development, making tooth removal relatively uncomplicated. As wisdom teeth continue to grow, however, the roots lengthen and may become tangled with the sensory nerves that run through the lower jaw or the sinus area.

While not all wisdom teeth need to be extracted, all of them need to be managed. Oral and maxillofacial surgeons provide their patients the best advice based on a thorough examination, appropriate imaging and tests and discussions with the patient and family. If a decision is made to keep the wisdom teeth, patients are advised to keep the areas meticulously clean and get an annual examination to assess any changes in the teeth or gum tissues.