Surgical removal of wisdom teeth in orthodontic treatment
Wisdom teeth are the set of last four teeth which erupts into our oral cavity at around 18-25 years of age. Lower jaw growth size varies from individual to individual. Depending on the availability of space and the jaw size, wisdom teeth either erupt into the cavity or remain impacted inside.
Orthodontic treatment is usually started at 12-13 years and correction is accomplished by the age of 15-16 years. Since there is some amount of growth expected in the lower jaw in adolescent stage, it’s normal to wait and see for eruption of the wisdom teeth. Irrespective of whether the wisdom teeth are present or absent, due to lower jaw growth some up-righting of teeth happens naturally giving space for their self-alignment. Hence the possibility of crowding because of the wisdom teeth eruption doesn’t need to necessarily happen all the time.
On observation and follow up, orthodontic treatment may require the removal of wisdom teeth to create space for recurrent crowding, or if they have moved into an un-favourable position and are interfering with function.
But in general at most instances the wisdom teeth, do not erupt into space upright and they remain impacted. In such cases when they are partially erupted they cause severe gum infections due to food impaction. They may have cavities that are untreatable and many at times cause damage to the neighbouring tooth. Such cases will definitely require surgical removal of the lower wisdom teeth. Upper wisdom teeth do not create much problems most of the time, unless they are turned towards the cheek or partially erupted.
Rarely in cases when the second molars are heavily treated or badly decayed, there are two options open to patients to avoid recurrence of crowding. One is that, remove the second molars and go for implants. Second is that, the partially erupted wisdom teeth (if they are upright) can be moved orthodontically to achieve a functional occlusion. This is much easier to achieve in adolescent age groups, because the roots of the wisdom tooth are yet to form and they naturally move and erupt into the lost second molar space. Up-righting and functionality can be obtained orthodontically. Since the wisdom teeth size is not always the same with the other teeth, some compromises need to be done to achieve the best possible functional relationship.
So to summarize unless there is a general requirement as stated above or a specified orthodontic need for wisdom teeth extraction, they need not be surgically removed.
Book an appointment with us at Oris Dental Center for more enquiries and clarifications.