 | Paul F. Mitsch, D.M.D. believes that this is such an exciting time to be a dentist. Innovations and refinements in technology and treatment options are introduced continually. To maintain a leading edge, he has added to his educational foundation with advanced training in the newest of the new techniques. Education: D.M.D. Washington University, St. Louis, Missouri. B.A., Biology, University of California at San Diego. Fellowships: Academy of General Dentistry, Academy of Dentistry International, and The International Congress of Oral Implantologists. Associate Fellowships: American College of Oral Implantology, American Society of Osseointegration. You can reach Dr. Paul Mitsch at (316) 775-2482 or stop by his office in Augusta at 401 State Street in the historical downtown district. |
Dental
2004-05-01 08:19:00
Why do I have wisdom teeth?
Question: I was told I need to have my wisdom teeth removed. I have never understood why I have them if they serve no real purpose?
ANSWER: Wisdom teeth are third molar teeth. They begin to erupt into the mouth between the ages of 12 and 18. Thus the term "wisdom teeth", this is the time when one considers themselves most wise.However, the incidence of third molar difficulty is no casual joke. If these teeth do not erupt (and in most cases there will not be sufficient space for them to come into the mouth) the problems they produce and the difficulties patients experience are certainly a risk. When asked about third molar teeth it is often a common answer that seldom are third molar teeth seen in people over 40! They have been lost or they are impacted and in many cases causing problems. Over the age of 60 it is extremely rare for one to still have their third molar teeth. So, why is there a range of opinions from dentists regarding wisdom teeth? To consider this it is important to understand the location of the teeth, the development of the teeth and the problems a patient may encounter with these teeth.The location of wisdom teeth is at the very back part of the mouth or the dental arch. These teeth are located in a part of the lower jaw that usually inhibits their eruption (ability to erupt completely into the mouth). The lower wisdom tooth is also in the angle where the nerve to the jaw and tongue run. This makes the lower wisdom tooth painful up to the ear and sometimes under the eye when it becomes infected. The upper wisdom tooth is in the back part of the jaw and when it erupts sometimes it will cut into the cheek. The upper wisdom tooth is also close to the sinus and may cause sinusitis or conditions that make all the upper teeth hurt. Because it is so far back in the mouth the upper wisdom tooth is difficult to clean and many times will decay and break or abscess. The development of wisdom teeth begins at about 12-14 years of age and continues through late teen years to the mid-twenties, generally. The first part of the tooth to develop is the crown or the top part of the tooth followed by the roots. The tooth develops encased in bone or impacted. As the roots develop, if the tooth does not erupt the roots become involved in the lower jaw with the nerve that innervates the lip and tongue and in the upper jaw with the sinus. This usually occurs between 16 and 25 years of age. The impacted tooth may also rest against the roots of the second molar teeth and if so may cause periodontal or gum tissue problems with these teeth and sometimes the loss of second molar teeth due to complications.The complications or problems occurring with third molar teeth include the things we have mentioned above. However there are more subtle problems that we should include as risk factors when evaluating a patient. Young patients heal much more quickly and better than older patients with this type of surgery, especially when it is elective. Women present with an increased risk during pregnancy due to the drugs that must be used and the potential trauma they would have to experience with infection and pain. Other health risks, like diabetes, heart problems or cancer usually are not present until the third or forth decades in life. Finally the social atmosphere or the ability for a young person to take time off and heal as well as the preparation for payment by their family is important to consider. Often it is a college student coming home with emergencies and needing their wisdom teeth out at difficult times for them, during finals or in the middle of important semesters. When we determine that someone has wisdom teeth (using x-rays) the advice for the patient is explained by both the benefits of removal compared to the risks associated with keeping the teeth. The American Board of Oral and Maxillofacial Surgeons have strict criteria for the recommendation of the removal of third molar teeth. If there is any hesitation with the determination of this issue one should consult their dentist or make an appointment with an oral surgeon and ask if their wisdom teeth exist and if or when they should be removed. Once again, the web site at the American Dental Association is a great place to get more information. The address is http://www.ada.org/
