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Margaret Shaw, DDS
Bethany Sharpe, DDS
105 Ovilla Creek Court #200
Ovilla, TX 75154
Wisdom Teeth
9/1/2016 Margaret Shaw, DDS, PA

Wisdom is Overrated At Least When It Comes to Teeth
Here’s a word to the wise: get your wisdom teeth out early. The third molars, or wisdom teeth, develop much more slowly than our other teeth, and despite their fashionably late appearance serve little purpose. The fact is we simply don’t need them. Many of us don’t have room for them, and leaving them in place often leads to a variety of complications, including gum infection, decay, pain, swelling and possibly even crowding.

The perfect time for removal of wisdom teeth is between the ages of 15 and 17, before the roots have formed. If this time frame is missed and the roots have begun to take hold, extractions become much more complicated and there is an increased risk of nerve and sinus damage. In fact, studies show that starting around age 18, for every period of five years a person waits, the possible complications as well as post-operative pain and recovery time grow exponentially. Simply put, the younger you are when you have this procedure done, the easier it will be on you.

"But, they don’t hurt!” That is the common objection from patients who don’t want to deal with their wisdom teeth. To which a dentist should reply, "Precisely! That’s why now is the perfect time to take them out!” Dentists don’t wait until a tooth is causing pain to perform a filling. If we did, many of those fillings would become root canals, and no one would like that! The same principle applies to wisdom teeth—it is much easier to prevent dental pain than to suffer through it once it has begun.

Then there is the age-old question: "If I don’t get them out, will my front teeth become crowded?” Local orthodontist and Associate Clinical Professor at the University of Texas Dental Branch Houston, Dr. Claude Stephens, shared this: "The question of the relationship between wisdom teeth and orthodontic crowding following the removal of braces is one that is still debated even within the profession. What is known is that wisdom teeth often begin to erupt in the late teens or early 20s, which is typically the time youngsters have lost their retainers and the teeth are free to move with or without the influence of wisdom teeth. Since crowding or relapse of the front teeth coincides with the eruption of wisdom teeth, it is natural to assume a cause and effect relationship. A review of the literature would seem to suggest that there are almost an equal number of published studies claiming that wisdom teeth do result in crowding of the anterior teeth as there are studies to say that is not the case." Dr. Stephens went on to state that unless there is clearly adequate room for the wisdom teeth to erupt fully, he routinely recommends their removal following orthodontic treatment.
Removing the wisdom teeth is relatively simple. An oral surgeon or a general dentist providing oral surgery services performs the procedure, usually with IV sedation. IV sedation is generally recommended because the drugs used produce an amnesia effect, which renders the patient unable to recall the noises and unpleasantries of the operation. In addition, IV sedation is actually the safest option since an intravenous line is already in place, making it possible to administer additional drugs or medication quickly in the unlikely event there is an adverse reaction to the procedure. Other forms of sedation—nitrous oxide, oral sedation and local anesthetic—do not allow that, but because medical needs vary with each individual, a thorough discussion with the surgeon is critical to determine the best course of action.

After the patient has been sedated and the mouth has been numbed, incisions are made behind the back molars to release the gum tissue and a drill is used to remove some of the bone from around the impacted tooth. At this point, if the patient is young and the roots have not formed, the doctor is able to simply roll the small marble-like tooth out of the socket. Stitches may or may not be required.

Antibiotics, analgesics, and a rinse are usually prescribed to help prevent infection. One week later, the patient returns for a post-operative appointment and further instructions on how to care for the sockets until they are completely healed. The downtime for this procedure is usually two days—the day of surgery and the following day. Of course, that number increases as the age of the patient increases!

So what is the wisest choice when it comes to wisdom teeth? Get them out at an early age because prevention really is the best medicine!

Margaret Shaw, DDS, PA is a family dentist in Ovilla. Contact her office at 972.223.0313.

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Ovilla Family Dentistry
105 Ovilla Creek Court • Ovilla, TX 75154
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