During my last appointment, the dentist recommended a wisdom teeth extraction. She stressed the importance of preventative action: taking out your wisdom teeth at a younger age will lower your risk of getting infections in the future. In her opinion, removing the teeth before their roots fully mature would be a less invasive and less painful procedure (no bone drilling required!). Although she presented these reasons convincingly, I was suspicious about her vested interest in doing the extraction. I asked her about the fee for removing one wisdom tooth - a whopping $300! For three teeth, my dental insurance would not only max out, but over 2/3s of the funds would have to come from my pocket. Tooth be told, I needed to talk to other people and do my own research before making a final decision.
So far, I have shared my concerns with three of my colleagues at UofT dentistry. They have all provided me with some sound advice, despite the controversy surrounding wisdom teeth removal. One friend encouraged me to consider whether my teeth will induce pain and discomfort by putting pressure on adjacent ones. When I reviewed my X-ray images with the dentist, she pointed out that one of my teeth was growing in sideways. I admit that I was worried about this at the time and almost bought in to the procedure right away.
My other friend told me, in more detail, about how impacted wisdom teeth can cause many problems down the road. There are several ways. If they grow sideways, they can crowd the rest of your teeth and mess up your beautiful row of pearly whites. Although this may be true, tooth alignment does depend to some degree on the size of your jaw.
He also discussed the possibility of having the wisdom teeth erupt into the oral cavity, allowing bacteria to accumulate and cause decay on adjacent teeth. Although infrequent, these infections can spread to the head and neck regions, potentially damaging surrounding nerves. In a worst case scenario, the brain and heart can be infected through fascial spaces.
On the other hand, he mentioned about the cons of going forward with wisdom teeth extraction. With any medical procedure, risk is involved and mouth surgery is no different. For example, the lingual nerve, which is fairly close to the third molars, can be damaged if the surgeon is not careful. I wonder how often this happens as I have yet to look at studies that investigate dental errors.
My last friend talked about the risk of having caries on partially erupted and fully impacted wisdom teeth. This can potentially lead to damage to the surrounding bone structure if decay progresses toward the root of the tooth. When he mentioned this, I couldn't help but wonder whether good oral hygiene would save any of this from happening. He did say that brushing wisdom teeth is more difficult than brushing regular teeth. In addition, there is no accessibility to those that are impacted.
He did leave me with some positive considerations for keeping the "wise" ones. First, they can be used to treat damaged teeth - I guess in a similar way as grafting skin for burned areas on the body. Apparently, they can also prevent bone resorption of the jaw during old age. As to how this happens, I have no clue. I'm sure the dental literature holds the answer. All these considerations come with keeping immaculate oral hygiene.
At the moment, I am leaning towards having my wisdom teeth removed, but only when my dental insurance coverage gets renewed in the fall. I have three impacted wisdom teeth with one growing sideways into an adjacent tooth. Although none of them bother me at the moment, they are in a prime position for extraction because their roots are not fully grown. This means that the surgery will be less intense and post-operative recovery will be smoother if I do not delay.
I'm anxious to see what the literature has to say about my colleagues' advice.
WC
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