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B.U. Bridge is published by the Boston University Office of University Relations.
Wisdom teeth: removing them is a smart idea
My dentist recommends that I have my wisdom teeth removed. They haven't bothered me at all, so why do I need to have them taken out?
Contrary to their name, wisdom teeth do not make you smarter. Better
known to dentists and dental care professionals as third molars, wisdom
teeth are remnants of an age when humans had a larger skull with a longer
jaw that could accommodate more teeth.
According to John Guarente, D.M.D., assistant clinical professor at Boston
University's Goldman School of Dental Medicine, wisdom teeth do not serve
a purpose. "The third molars aren't necessary for proper dental function,"
he says. "They're an evolutionary leftover from a time when we needed
larger, grinding teeth to chew certain kinds of foods -- mostly things
we no longer eat."
In many cases, wisdom teeth do not cause any problems. However, Guarente
says, removing them can prevent a number of serious complications, including:
- impacted teeth (teeth that do not have enough room to grow)
- cysts around the tooth, which can lead to bone loss around the second molar or may transform into a more significant pathologic condition
- partially erupted teeth, which can allow bacteria to grow and infect the tooth and jaw.
While most dentists and oral surgeons recommend removing impacted wisdom
teeth, Guarente says that the benefits and risks involved need to be reassessed.
"There are cases where a watch-and-wait approach can be beneficial.
For example, if the third molars are erupted, and are not subject to any
kind of infection, it may be appropriate to leave them intact." Another
important consideration is age. Although we may not consider an individual
at the age of 30 to be old, this may very well be the case when evaluating
a patient for wisdom teeth removal.
However, if you and your dental care professional do agree that removing
the third molars is necessary, there are some important things to consider.
"This is a surgical procedure," says Guarente, "and patients
should be fully aware of what will take place, as well as the need for
postoperative care."
According to Guarente, it usually takes about one hour to remove all four
wisdom teeth. Each case is different, though, and he recommends that you
consult with your oral surgeon before the procedure to learn if you may
have a condition that might lengthen the surgery time. For example, a
tooth embedded in bone or one that is growing at a very unusual angle
may complicate surgery.
Guarente also suggests that you discuss pain medication and anesthesia
options with your oral surgeon before surgery. "Again, this will
vary from patient to patient. You can choose to have local anesthesia,
sedation with local anesthesia, or general anesthesia," he says.
Each anesthesia has different side effects, which should be discussed
at length with your oral surgeon. Some side effects of anesthesia can
include nausea, dizziness, and drowsiness for up to 24 hours after administration.
Guarente says that a patient can expect some discomfort, bleeding, and
swelling during the first two to three days after the procedure, and that
recovery usually takes seven to ten days. He also emphasizes that it's
very important to follow your postoperative instructions carefully. "Postoperative
oral hygiene and adequate nutrition are vital for a quick recovery and
for continued good oral health," he adds.
Although you can discuss your postoperative care plan with your oral surgeon
or dentist before and after surgery, Guarente advises that it is best
to do so beforehand, as "you probably won't be feeling up to asking
questions afterward."
"Health Matters" is written in cooperation with staff members of Boston Medical Center. For more information on alternative medicine or other health matters, call 617-638-6767.
05
October 2001
Boston University
Office of University Relations