Wisdom teeth: extraction or treatment?

Wisdom teeth generally emerge between the ages of 16 and 25 and don’t usually cause any pain or discomfort if there is enough space for them. 

However, this is not the case for many people. In the past, humans tended to consume harder foods that also contained highly abrasive impurities, like traces of sand, earth or bone fragments.  

Due to abrasion, teeth got smaller and so there was enough space for wisdom teeth to come through. Modern food standards mean that food is now properly washed and treated to eliminate these abrasive impurities. Lots of ‘hard’ foods no longer form a part of our daily diet.  

Jaw size has also changed through evolution and varies from individual to individual.  

This is why there is frequently not enough space for a wisdom tooth to grow normally. When this occurs, the tooth cannot break through and remains impacted (covered by the gum) or partially impacted (only partially visible).

Impacted or partially impacted teeth can, under certain conditions, cause problems of varying severity over the course of a person’s life.

Let’s take a look at why it might be necessary to extract wisdom teeth.

Extracting wisdom teeth

There are three reasons to extract wisdom teeth:

1. This is a therapeutic extraction to treat a pathological condition or one that has occurred recently, like:

• Gum inflammation (pericoronitis) around the wisdom tooth: this can be chronic, painless or virtually painless or acute, causing pain, swelling and making it difficult to open your mouth
• Abscess (an advanced stage of pericoronitis, with the formation of pus)
• Follicular cysts (a type of cyst that can form around the crown of the tooth)
• Root reabsorption or decay in a neighbouring tooth
• Wisdom tooth decay 

2. Preventive extraction to avoid the diseases above. Also in the case of:

• A deep periodontal pocket in the neighbouring tooth. In these cases a wisdom tooth creates a pocket that can compromise the survival of a neighbouring molar over time.

• To provide the space needed for teeth to move and align (BEFORE or DURING orthodontic treatment).

• To avoid aligned teeth moving AFTER orthodontic treatment (even if wisdom teeth seem to only play a partial role in this).

It’s always a good idea to consider extracting wisdom teeth when the patient is young, as it has been shown to be an easier operation with less risk of complications in young patients and/or in patients with wisdom teeth that have not fully developed.  

Extracting wisdom teeth: how many visits do you need?

When all four wisdom teeth need to be extracted, it is normally better to extract them in pairs (one upper and the opposite lower one), in two visits a few months apart.  Post-operative discomfort is not too bad, and you have the unoperated side of your mouth to eat with.

Depending on each individual case, all your wisdom teeth can be extracted in a single visit if needed. 

 Extracting a wisdom tooth is a minor surgery performed under local anaesthetic, so it is painless. How long it takes depends on the position and shape of the tooth and the patient’s age. There is also a substantial difference between the upper tooth (in the jaw) and the lower tooth (in the mandible).

Discomfort after the extraction is extremely varied and depends on the patient and type of operation. Pain is usually kept to a minimum with painkillers and anti-inflammatories and by following your dentist’s advice.  

Stitches are taken out a week after the operation and the dentist checks that everything is healing properly.