Wisdom teeth, also known as third molars, typically emerge in late adolescence or early adulthood, usually between the ages of 17 and 25. They are the last set of molars that develop, located at the very back of the mouth. Historically, wisdom teeth were useful for our ancestors, who had larger jaws and needed extra molars for grinding tough plant material.
However, with evolutionary changes and modern diets, these teeth have become less necessary, and many people do not have enough space in their mouths to accommodate them.
Common Issues with Wisdom Teeth
Due to the limited space in the modern human jaw, wisdom teeth often cause various dental issues when they start to emerge. Some common problems include:
Impaction: When there isn’t enough room for the wisdom teeth to erupt properly, they can become impacted. This means they remain trapped in the jawbone or gum tissue, leading to pain, swelling, and infection.
Crowding: Emerging wisdom teeth can push adjacent teeth out of alignment, causing crowding and disrupting the positioning of existing teeth.
Infection and Gum Disease: Partially erupted wisdom teeth can create a flap of gum tissue that is prone to bacterial infection, leading to pericoronitis, an inflammation of the surrounding gum tissue.
Cysts and Tumors: In rare cases, impacted wisdom teeth can lead to the formation of cysts or tumors, which can damage the jawbone and neighboring teeth.
see also: 5 Reasons Why Wisdom Teeth Hurt More at Night
Orthodontic Treatment And Wisdom Teeth
Orthodontic treatment, commonly referred to as braces, aims to correct misaligned teeth, bite issues, and overall dental aesthetics. The decision to remove wisdom teeth before, during, or after orthodontic treatment depends on several factors, including the individual’s dental condition, the position of the wisdom teeth, and the recommendation of the orthodontist or dentist.
Evaluating The Need for Wisdom Teeth Removal Before Braces
Space and Crowding Considerations
One of the primary concerns with wisdom teeth in the context of braces is the potential for crowding. If there is limited space in the mouth, the eruption of wisdom teeth can exacerbate crowding issues, making it difficult to achieve and maintain the desired alignment of teeth. In such cases, an orthodontist may recommend the removal of wisdom teeth before initiating orthodontic treatment to ensure there is adequate space for the proper alignment of teeth.
Impact on Orthodontic Outcomes
Wisdom teeth can potentially affect the results of orthodontic treatment. If wisdom teeth begin to emerge during or after treatment, they may push other teeth out of alignment, undermining the progress achieved with braces. To prevent this, some orthodontists advocate for the proactive removal of wisdom teeth to maintain the stability of the orthodontic results.
Age and Developmental Factors
The timing of orthodontic treatment often coincides with the period when wisdom teeth start to develop. Adolescents and young adults are typically at the ideal age for braces, and this is also when wisdom teeth begin to emerge. In such cases, the orthodontist may closely monitor the development of wisdom teeth and decide on their removal based on the individual’s specific dental needs and the potential impact on orthodontic treatment.
Scenarios Where Wisdom Teeth Removal May Be Necessary
Impacted Wisdom Teeth
If the wisdom teeth are impacted and causing pain, infection, or other dental issues, their removal becomes necessary regardless of orthodontic treatment. Impacted wisdom teeth can negatively affect the overall oral health and the success of braces, making their extraction a priority.
Severe Crowding
In cases of severe crowding, where there is insufficient space for proper alignment, removing wisdom teeth may be essential to create the necessary room for braces to be effective. This is particularly relevant when the wisdom teeth are expected to worsen the crowding as they erupt.
Preventive Measures
Some orthodontists and dentists advocate for the preventive removal of wisdom teeth to avoid potential complications in the future. This approach aims to eliminate the risk of wisdom teeth interfering with orthodontic results or causing other dental issues down the line. While not always necessary, preventive removal can be a proactive step to ensure long-term oral health and stability of orthodontic treatment outcomes.
Scenarios Where Wisdom Teeth Removal May Not Be Necessary
Adequate Space in the Jaw
If the jaw has enough space to accommodate the wisdom teeth without causing crowding or alignment issues, their removal may not be necessary. In such cases, the orthodontist will monitor the development and eruption of wisdom teeth to ensure they do not impact the progress of orthodontic treatment.
Wisdom Teeth Erupting Correctly
When wisdom teeth erupt in a proper position and do not cause any pain, infection, or misalignment of other teeth, they may not need to be removed. Regular dental check-ups and X-rays will help monitor their growth and detect any potential issues early on.
Completed Orthodontic Treatment
If an individual has already completed orthodontic treatment and the wisdom teeth have not caused any problems, their removal may not be required. However, it is essential to continue regular dental visits to monitor the wisdom teeth and address any issues promptly if they arise.
Consultation and Decision-Making
The decision to remove wisdom teeth in the context of braces should be made in consultation with both the orthodontist and the general dentist. They will evaluate various factors, including:
The position and development of wisdom teeth
The alignment and spacing of existing teeth
The overall oral health and potential risks associated with wisdom teeth
The goals and duration of orthodontic treatment
Diagnostic Tools
Orthodontists and dentists use several diagnostic tools to assess the need for wisdom teeth removal, including:
Panoramic X-rays: These provide a comprehensive view of the entire mouth, including the position of wisdom teeth and their relationship to other structures.
Cephalometric X-rays: These focus on the relationship between the teeth, jaws, and skull, helping to evaluate the impact of wisdom teeth on overall dental alignment.
3D Imaging: Advanced imaging techniques, such as cone beam computed tomography (CBCT), offer detailed, three-dimensional views of the mouth, aiding in precise diagnosis and treatment planning.
Post-Extraction Considerations for Braces
Timing of Orthodontic Treatment
The timing of orthodontic treatment in relation to wisdom teeth extraction is important. In some cases, braces may be placed before the extraction, while in others, it may be beneficial to remove the wisdom teeth first and allow some healing time before starting orthodontic treatment. The orthodontist and dentist will collaborate to determine the best approach based on the individual’s needs.
Healing and Orthodontic Adjustments
After wisdom teeth removal, there may be a short healing period before any orthodontic adjustments are made. This allows the extraction site to heal properly and reduces the risk of complications. The orthodontist will monitor the healing process and make adjustments to the braces as needed to ensure continued progress.
Conclusion
Whether wisdom teeth removal is necessary for braces depends on various factors, including the position and development of the wisdom teeth, the alignment and spacing of existing teeth, and the overall goals of orthodontic treatment. While some cases may require the removal of wisdom teeth to prevent crowding and ensure the success of braces, others may not.