For young adults, wisdom tooth removal can be scheduled at a convenient time for patients and their families. While this may seem like a gift of time, it is unwise to delay surgery indefinitely. To do so may invite a variety of problems including damage to adjacent structures, such as sensory nerves, the maxillary sinus, and neighboring jawbones.
Postponed surgery may be more complicated and require a lengthier recovery. Further, damage caused by wisdom teeth to adjacent teeth may not be easily repaired.
Keeping the back of your mouth clean with daily brushing and flossing is difficult in the best of circumstances. When wisdom teeth are present, good oral hygiene in this area is virtually impossible; a situation that often leads to cavities and tooth loss. Research has shown that more young adults have decay in the wisdom tooth area than previously thought. Of those studied between 23 and 34 years of age, over 40% had experienced cavities in their wisdom teeth, a condition difficult to treat.
Wisdom teeth are not like other teeth in that they generally do not have adequate space to erupt. This is due not only to limited space, but also to the fact that gum tissues in the area are not designed to attach to the tooth in a normal manner like other teeth. No matter how well you brush or floss, it is virtually impossible to keep the wisdom tooth area clean and bacteria free. Bacterial infection and inflammation often results in gum recession, bone loss and the possibility of loosened teeth. Of additional concern is the possibility that oral inflammation may extend to other parts of the body either directly or indirectly.
A young adult's wisdom teeth generally have incomplete root systems, making surgery relatively uncomplicated. As wisdom teeth mature, their roots lengthen and may become involved with the surrounding structures such as sensory nerves and/or the maxillary sinus. In such cases, surgery may be more involved with a greater chance of complications.
A fully impacted wisdom tooth sits in the jawbone surrounded by the sac in which teeth develop. Over time, however, this sac may enlarge and even develop unhealthy changes in the cells from which it is made. Problems occur when the sac surrounding the impacted tooth becomes filled with fluid and enlarges to form a cyst. As the cyst grows it may damage the jaw, neighboring teeth and other surrounding structures. Occasionally, tumors develop from the same tissues that surround an impacted tooth, requiring extensive surgery and reconstructions.
If after discussing your situation with your family dentist or one of our doctors, you decide to keep your wisdom teeth for the time being, it is important to agree on a long-term plan for monitoring the health and condition of the teeth and gum tissue in the third molar area. While an accepted protocol for monitoring retained wisdom teeth is still being investigated, researchers believe that, at a minimum, x-rays to see the wisdom tooth and surrounding bone and a clinical examination to determine whether an impacted wisdom tooth can be probed should be performed every two years. For your part, it is critical that you take particular care in cleaning and flossing the area as part of your oral healthcare regimen.
In the case of wisdom teeth, good things don't come to those who wait. A lot of bad things can happen in that time. Why wait for bigger problems later on?