Thursday, March 26, 2015

Wisdom Teeth

People often ask me if they should have their wisdom teeth removed. Some question if it's really necessary. The basic answer is that not all wisdom teeth need to be removed, but most do.

Dentists refer to wisdom teeth as third molars. We call the first big tooth a first molar. The next one is a second molar and so forth.

If we look at skulls from 10,000 years ago, it was quite common to have a fourth molar. Our diets have changed from when humans were nomadic hunters to when they settled in agricultural civilizations. When our diets softened, the human jaw eventually became smaller. We typically now only have 3rd molars. Fourth molars are now very rare.

In many cases, the size of our jaws are too small to accommodate the 3rd molar. So what is the significance of having a smaller jaw? Well, the 3rd molar is the last tooth to develop and come into the mouth. When there isn't adequate room, several things can happen. One, they don't come in at all because they are crowded out by the other teeth. Two, they come in part of the way. Three, they come in crooked and are extremely difficult to reach with a toothbrush. 

Occasionally wisdom teeth come in straight and are accessible with a toothbrush. If this is the case, then the removal of the wisdom teeth is completely unnecessary.

Decay on posterior surface of second molar
So why do wisdom teeth need to be pulled? People including dentists used to believe that wisdom teeth make the other teeth crooked. This isn't the reason why most of them need to be extracted. The main reasons for removal of wisdom teeth are infection or potential infection of the gums and bone. They are also removed when there is decay on the wisdom tooth itself or on the surface of the tooth that it makes contact with since it is a difficult area to reach.

Discuss concerns with your dentist. I have extensive training in surgery so I extract tons of wisdom teeth. Most dentist however do not feel comfortable with extracting wisdom teeth and will often refer to oral surgeons. They can be extracted at any time in adulthood. I typically prefer to extract them in patients between 18 and 25. This is an ideal time because of the relative ease of the procedure and recovery of the patient. 

Dr. Cisneros maintains a practice in Freeburg and Columbia, IL. Both are in the Greater St Louis, MO area. For more information on a wide variety of subjects, please visit

1 comment:

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