If my wisdom teeth are in my mouth do they still need to be checked by my dentist?

Question

Wisdom teeth are the last teeth to erupt into the mouth. Normally they come up and appear in the back of the mouth. They are called "wisdom" teeth due to the fact that they emerge in ones late teens and early twenties. Their location that they are in puts them at high risk for impaction. This means that the tooth may never erupt or appear into the mouth due to their location in the bone of the mandible and maxilla, the lower and upper jaws respectively. Sometimes they partially appear into the mouth, and a portion of the tooth is present. In a case like this it is considered partially impacted/erupted and described as such. Teeth that are only partially visible, usable and maintainable are at risk for pathology, disease and symptoms.

Answer 1

Teeth that do not meet all the requisites should be considered for treatment.

A partially erupted/impacted tooth, which is partially covered by tissue, is at risk for serious infection. Bacteria and food accumulates and can't be cleansed. A major issue is that these teeth flank the airway and swelling of these tissues can affect the airways patency. In a young 25 year old patient, in the presence of less than ideal conditions for healthy wisdom teeth and gum tissue, consider the laws of probability for recurrent infection over their lifetime, they're likely, and no one knows how severe the infection will become on next go around. Therefore, it's best to consider definitive treatment, because at this age the risks of recurrence are greater than the potential risks associated with tooth extraction. All procedures carry some form of risk, having a conversation with the patient about the specific risks of treatment for infected impacted teeth should be weighted against the benefits and the alternatives of treatment.

The patient having this knowledge can make an informed decision on their options for treatment. In many cases, removal of the tooth is an option since this is the reason for the problem in the first place. As we age our healing potential diminishes with an increase in the incidence of chronic illnesses, resulting in increasing the post-operative risks. Therefore, knowing that there's the likelihood of serious problems occurring, it would be best to have the tooth/teeth extracted as early as they're diagnosed. I'm not suggesting to extract every impacted tooth at any age because that isn't the standard of care.

Elderly patients in their 70's and older presenting with infected impacted teeth pose a serious risk for post-operative complications like a fractured mandible. Often times these kind of impacted teeth present with thin atrophic jaws that are at risk for fracture with or without treatment.

Dr SHARON P.