Wisdom Teeth – Retention vs. Extraction
Wisdom Teeth (3rd molar) Extraction on Lima, Peru
Most of us will develop a third molar in each quadrant of our mouths. The last molars in the line are called 3rd molars or more popularly ‘wisdom teeth’. These teeth usually erupt through the gum tissue after the age of 17. Some will only partially erupt and others will stay completely buried under the tissue and bone. Many patients never develop 3rd molars although a few patients will get 4th molars. Fortunately, these are rare.
When to Retain Wisdom Teeth
- If the tooth is in normal function, has a vital pulp, a healthy periodontium and is accessible for cleaning.
- If complete eruption will likely occur and local inflammation about the erupting crown can be controlled until full eruption occurs.
- If the surgery may cause more harm to adjacent teeth or tissues than the risk of leaving the tooth in its existing state.
When to Extract Wisdom Teeth
- If the third molar has inadequate room in the dental arch to erupt fully into useful function.
- If the third molar is of no functional use.
- If a periodontal pocket is developing between the second and third molars.
- If the patient cannot keep the wisdom tooth area clean because of difficult toothbrush access.
- If repeated pericoronitis in the tissue about the third molar is inevitable.
- If damage is being caused to an otherwise healthy second molar or as resorption of the second molar root from pressure of the third occurs.
- If there is caries in the third molar and the tooth is unlikely to be usefully restored, or when there are cavities in the adjacent second molar tooth which cannot satisfactorily be treated without the removal of the third molar.
- In patients with predisposing risk factors whose occupation or lifestyle precludes ready access to dental care.
- In cases of dentigerous cyst formation or other related oral pathology.
Damage is being caused to an otherwise healthy second molar (resorption) due to 3rd molar impaction
Pressure from impacted 3rd molar causes teeth along the arch to become crowded.