Options Regarding Wisdom Teeth:

* You should consider many options with regards to wisdom teeth removal.

*Some of your options include:

  1. Do nothing option.
  2. See an oral surgeon for a second opinion
    (or if you desire expert level care with/without general anesthesia)
  3. Have 1 (or all) of the wisdom teeth removed by our general dentists with local anesthesia in our office.

*The oral surgery specialist office that we send our referrals to, is a company called “Fairfax OMFS” in Reston VA. Please reach out to them for a second opinion about your wisdom teeth.

*Reasons to have your wisdom teeth removed as early as possible:

  1. Before the age of 16yo the root tips are still soft follicle material, as opposed to hard calcified root tips that   can injure the main nerve. Thus, the root tips are not fully formed yet at age 16 making it much easier and safer to remove the wisdom teeth.
  2. Before the age of 40, the surrounding bone is not as hard yet, thus it is easier to successfully remove the entire tooth without broken root tips. The bone (and all tissues in the body) continually calcify as we age.
  3. It is obvious that doing surgery young is better because, patients are more healthy and they heal faster when they are younger.
  4. The sooner you remove the wisdom teeth directly correlates with the amount of flexibility the dentist will have with regards to coronectomy vs complete removal of the tooth.

*If you come with pulpal caries on the tooth, then the dentist is forced to go after broken root tips, increasing risk of nerve injury and jaw fracture.

*However, if you come with no caries (or minimal superficial caries) on the tooth, then the dentist can ignore a broken root tip and simply do “coronectomy”. This is one of the main benefits for removal of wisdom teeth while they are still healthy. The dentist can elect to do coronectomy instead of full extraction which is often a very useful and effective option.

  1. Removal of wisdom teeth in advanced age is much more dangerous (and complicated) then during adult years with increase in incidence of jaw fracture, post op infection and abnormal bleeding problems.
  2. Elderly patients are much more prone to complications associated with wisdom tooth removal.

*In elderly patients, the palatal shelf of alveolar bone thins to be replaced by a fat pad. This also makes wisdom tooth removal much more complicated and risky. Thus, our dentists often recommend that people remove their wisdom teeth while they are still young and healthy.

* General reasons to remove your wisdom teeth:

  1. Wisdom teeth almost always cause some problems for the patient throughout life, and often times these problems are severe, painful and/or dangerous. Sometimes these dangerous wisdom teeth infections happen during pregnancy and/or other un-favorable periods during  a person’s life
  2. Common problems with wisdom teeth:
  • Wisdom teeth get more caries then other teeth due to heavy usage and inadequate hygiene which leads  to a large problem with occlusal and interproximal caries (aka dental infection).
  • Wisdom teeth get more gum disease then other teeth due to heavy usage and inadequate hygiene which leads to significant periodontal bone loss, which effects the wisdom tooth and the adjacent 2nd molar with bone loss around the roots.
  • Furthermore, periodontal disease is known to be a factor in cardiovascular disease and possibly diabetes, etc.
  1. Humans have evolved to have shorter jaws  that no longer have space for the wisdom teeth to erupt properly. Thus , the wisdom teeth are typically impacted causing pain and infections due to food traps that form  around them.
  2. Wisdom teeth are thought to continually push forward (mesial drift phenomenon) during a patients entire life. Thus, the bone remodeling that happens behind the wisdom teeth actually pushes the molars forward in a mesial direction (mesial drift) causing crowding of the front incisors. Many orthodontists agree that removal of wisdom teeth can  avoid unwanted anterior crowding.
  3. Even if your wisdom teeth have not started hurting yet, Dr. Ali still recommends having all of them removed preventatively to avoid further problems that could happen later in life. However, if you have already felt (i.) pain, (ii.) swelling, (iii.) infection, (iv.) the taste of infection/pus or (v.) the pressure associated with impacted wisdom teeth then those are all important symptoms that reinforce the importance of having the wisdom teeth removed.

*Most common complications from wisdom tooth removal:

*Broken root tips or ankylosed  root system.

*Coronectomy: Extraction procedure that results in leaving a root tip in place (or leaving the entire root system in place) and simply removing the crown of the tooth in hopes it heals well and gets entombed under healthy bone.

* Infection at the site of the surgery

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