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Wisdom teeth: To remove or not to remove?

In partnership with Dr Rakesh Jivan

For those of us who avoid the dentist at the best of times, being told that you may have to have your wisdom teeth removed can be a daunting prospect likely resulting in a roller-coaster of emotions such as anxiety, fear or denial.

But, do you really need to have them removed? We talk to Dr Rakesh Jivan from Pacific Smiles Dental to find out.

Wisdom teeth 101

Let’s start with the basics.

Wisdom teeth, also known as third molars, are the last teeth to erupt into the mouth, usually around the age of 18-24.

In the same way that babies will get teething pains as new teeth develop and emerge in the mouth, wisdom teeth are known to cause some pain or discomfort as they grow.

If you’re currently experiencing pain, tenderness or soreness at the back of the mouth, or even difficulty opening or chewing, your wisdom teeth might be the cause.

Due to a lack of space at the back of the mouth, wisdom teeth often fail to erupt properly into the mouth and can become stuck, either under the gum, or as it pushes through the gum – this is referred to as an impacted wisdom tooth.

It’s always better to address wisdom teeth issues before they become painful.

Impacted wisdom teeth are often found and diagnosed during dental examinations, via x-rays known as OPGs or as a result of pain from impaction. It’s always better to address wisdom teeth issues before they become painful.

With regular dental check-ups from childhood, your dentist will usually monitor the growth and movement of your dormant wisdom teeth, providing you with ongoing advice as to whether they should be left alone or removed.

6 signs your wisdom teeth might need to be removed

If you have one or more of the following symptoms, it might be time to book in with your dentist for further investigation.

1. Pain and discomfort

One of the most common signs that there might be something wrong with your wisdom teeth is pain and irritation. Wisdom teeth can cause pain and discomfort for a number of reasons, which is why it’s so important to get your teeth looked at by your dentist to identify the exact cause of pain.

2. Infection and inflammation

Infection of the gum around the impacted or partially erupted wisdom tooth is known as pericoronitis and is the most common reason that wisdom teeth are removed.

This type of infection can range from mild to severe and cause constant pain and swelling. It’s important to see your dentist at the earliest possible opportunity to prevent this type of infection spreading or worsening.

3. Tooth decay

Tooth decay (dental cavities) can occur in the wisdom tooth or the tooth in front. This is seen in about 25-30% of patients and is more common if the wisdom tooth is impacted at an angle against the tooth in front. This may not cause immediate problems however, as tooth decay spreads through the tooth and approaches the nerve of the tooth, an abscess can form. In most situations, removal of just the wisdom tooth will resolve the problem, however, if the tooth decay has affected the tooth in front, it might also have to be removed as a result of the impacted wisdom tooth.

4. Stiffness and pain in jaw

Stiffness and pain in the jaw is also common; as wisdom teeth emerge, they can start to shift the teeth and jawline. Experiencing difficulty moving and opening the jaw can also be an indicator.

5. Cysts

All teeth form within a ‘sack’ in the jaw bone. Occasionally this sack can expand like a balloon, which is called a cyst. Over time this can become larger and cause problems. We see this in less than one percent of patients and it’s generally diagnosed from x-rays. Symptoms of a cyst can range from nothing at all to severe pain.

6. Sinus issues

The upper wisdom teeth can sometimes grow upwards into the sinus area. This growth upwards puts pressure on your sinuses, which can cause sinus pain, headaches and general sinus issues.

A dentist shows his patient and X-ray of his teeth

Symptoms associated with wisdom teeth are best addressed early, given that wisdom teeth don’t usually cause any pain until they start to do damage. The roots of a wisdom tooth are still forming as a teenager, so it’s easier to have them removed at this stage before they create more problems when the roots are fully formed.

However, it’s important to fully understand the risks, benefits and costs involved before agreeing to any medical procedure. Check out our article 7 questions you need to ask your doctor to avoid unnecessary surgery for more information.

When you’re ready to book your dental appointment, our nib First Choice Network should be your first port of call to keep your out-of-pocket expenses low. It’s our community of specially-selected health providers who have agreed to provide nib members with quality healthcare and great customer service at an affordable price.