Wisdom teeth typically start developing under the gums around age 10, far sooner than they typically are managed or even a consideration on a parent’s radar screen. However, they typically start to attempt eruption around 17, which tends to coincide with the end of high school (that’s how they got their name). Teens and parents probably use some of the wisdom from these teeth in making the great decision to have them monitored by your pediatric dentist or orthodontist and managed by an oral surgeon under the age of 25.
Some teens get their wisdom teeth without any fanfare except for the usual gum soreness of teeth cutting through. In some cases, this in itself can be the source of problems, however. The very back of the mouth is hard to reach, hard to clean, with lower quality gum tissue less resistant to allowing food particles and plaque under the gumline. If plaque and bacteria are allowed to happily burrow in the grooves between the wisdom tooth and gum, this can cause tooth decay even before the tooth gets through the tissues. Infection or abscesses can also occur.
Wisdom teeth often need to be removed because of this reason, in addition to the following equally painful situations:
- The tooth is decayed or broken
- Not enough room in the mouth, so the wisdom tooth is disturbing the natural tooth alignment or orthodontic treatment or even blocking a perfectly good 2nd molar from erupting into the mouth
- The tooth is growing in or has grown in at the wrong angle, potentially damaging or shifting adjacent teeth
- The tooth is trapped, and only the tip has pushed through the gum causing a highway for bacteria to get under the gum line
- A fluid-filled sac, called a cyst, has formed around the tooth
Wisdom tooth problems can lead to damage to neighboring molars, tooth decay, inflammation (and then infection) in the gums and other tissues, and in rare cases, jawbone damage.
Wisdom teeth would show up in most but not all x-rays. It is important for children and adults with wisdom teeth under the surface to have visual monitoring, typically via panoramic radiograph to see the entire tooth and if there is/are cysts around them. Without monitoring, a very large cyst could develop without any knowledge of it occurring by the patient. It is important to catch these problems early before they become large and require a difficult surgery.
Mesial wisdom teeth– the most common type of impacted wisdom tooth– are angled horizontally instead of vertically, and should be removed before they emerge to avoid the painful complications above. The surgery involves removing a small portion of the covering bone to extract the tooth. The surgeon will often “section” the wisdom tooth so that each section can be removed through the small opening in the bone.
Each case is unique so healing time varies, depending on the extraction.
But normal wisdom teeth still help in chewing and should be allowed to grow in if there is space in the rear of the mouth and adequate quality tissue surrounding the erupted tooth. Just because it erupts, does not mean it can stay. Your pediatric dentist or orthodontist can assess later whether your teen’s wisdom teeth are earning their keep, or are better off taken away. All of our orthodontic patients are followed after treatment until wisdom teeth are properly managed as a courtesy service that is included at NO additional cost in our orthodontic treatment plan and fee – peace of mind for that investment!
Dental sealants can also help a lot in keeping these third and hard-to-reach molars cavity-free when they are kept. Also, your teen should use tapered toothbrushes that can reach and clean the back teeth.
About Pediatric Dentistry and Orthodontic Specialists of Michigan, the offices of Drs. Delaney, Plunkett, Ralstrom, Makowski, Thanasas, Ker, and Associates
Pediatric Dentistry and Orthodontic Specialists of Michigan have specialized in pediatric dentistry and orthodontics since 1968. Our family-friendly and newly renovated office gives patients and families a more comfortable and consistent experience with dentistry from the very beginning. Our pediatric dentists treat children from newborn to 18 years of age while our orthodontists provide care for both children and adults and are proud to be Premier Providers of Invisalign and Invisalign Teen services. The ability to treat all patients with compassion and individuality, including those that may have special needs reaches beyond our facility, which has treatment rooms available for children who require additional privacy and customized care options. We pioneered valued hospital affiliations to allow dental services to be performed at DMC Children’s Hospital and St. John Macomb Hospital, when appropriate or necessary, and our specialists are also proud to be on staff at Henry Ford and Beaumont hospitals.