Wisdom Teeth: Pain-Free Doesn’t Mean Problem-Free

Every summer, countless teens and young adults make the pilgrimage to oral surgery offices across the land to have their wisdom teeth looked at. Usually, they’re sent by their general dentist for reasons they can’t remember, and when asked why they’ve come in, they say the almost-universal phrase “my dentist says I need them out”. But what if they’re not experiencing any problems with the teeth right now? Do they still need them out? Of course every case is different, but what every patient (and parent) should know is that pain-free doesn’t mean problem-free when it comes to wisdom teeth.

Wisdom teeth, or third molars, are the teeth in the back corners of the mouth that grow in the late teens or early twenties. Wisdom teeth may need to be removed when they cannot properly enter the mouth. They can grow sideways, erupt only half-way or even remain trapped underneath the gum and bone. These ‘impacted’ teeth can cause many problems including cavities, oral infections or even cysts or tumours that can destroy the jawbone and nearby healthy teeth. Partially-erupted teeth may allow bacteria to grow and proliferate potentially leading to gum disease that can cause swelling, stiffness and pain.

Even wisdom teeth that are symptom-free may pose an increased risk for oral infections, gum disease and cavities. Painless third molars can also push neighbouring teeth out of alignment thereby changing the bite. Many orthodontists refer their patients to an oral surgeon for third molar removal before beginning treatment to minimize the risk of gum disease and other problems that could affect the success of the orthodontic treatment.

While not all wisdom teeth need to be removed, all of them need to be managed. Oral surgeons provide sound advice based on a comprehensive examination, appropriate x-ray imaging and discussions with the patient (and family). If the decision is made to keep the wisdom teeth, patients are advised to keep the areas clean and get an annual examination to assess any changes in the teeth or gums.