Wisdom teeth

In My Humble Opinion
21

I believe you, I am a dentist and had one patient with a fourth molar behind each third molar(wisdom tooth) and two fifth molars(mandibular).

For what it is worth a lot of wisdom teeth don’t need to come out, Broomstick got it pretty much dead on. I fill a lot of wisdom teeth v. pulling them, it’s cheaper for the patient, however the average life of a filling is about 10 years (although many last much longer) if you start replacing the fillings it ends up costing more in the long run. Also most people don’t chew with the wisdom teeth even if the are in straight because the cheek usually folds over them. That’s why you bite your cheek and why they are hard to clean and therefore get cavities. Healing is much easier when young so I always give patient the choice of extraction v. filling. In the long run it is often better to pull than fill but by no means is removal always indicated.

22

I’m 37 and have three of four wisdom teeth. Had my first one pulled last year, when the crown on my bottom left rear molar fell out and my dentist said that she’d very strongly recommend pulling the wisdom tooth, as she can’t confidently fit the crown into its place with it crowding the space. She showed me xrays from months earlier compared with that day and, it was true, the wisdom tooth had pushed in and left almost no space for a crown.
So she signed me up with the in-office oral surgeon.

The extraction was an ordeal. I’ve had a root canal done before, and it was completely painless. The wisdom tooth extraction was just an awful, awful experience, and I’m not one anxious about dental work. They didn’t have to put me under, but they were considering it after about 10 shots of lidocaine and some other -caine suffixed drug was still leaving one of my nerves receptive. It took over an hour of oral surgery to get the tooth out, and he still left a couple pieces in there. My mouth looked like I had a golfball embedded in my jaw for two days. Ugh.

23

I have the wisdom teeth on the the right side of my mouth, had the left ones out as needed.
The top one erupted and retracted off and on for about 2 years, eventually erupting so far it scraped the inside of my cheek. In a 25 minute dental appointment it was ‘elevated’ out from behind and when the novacaine wore off I had no further pain. It left a dent in my gum that has gotten smaller over the years, no decay.
The bottom one erupted enough to shove the tooth in front of it so I had it removed. That recovery hurt for a few days as it was surgery into the gum. I still went to a smelt dinner that night, ate myself sick on the other side of my mouth and whipped asses at Balderdash.
My vote is fill it and keep it till it’s an impediment. We can’t grow teeth quite yet and one never knows when one’s mouth may suffer a trauma and that spare tooth isn’t so spare as before.

24

I had all four out at the age of 16. However, the suggestion came from my orthodontist, who then referred me to a maxillofacial surgeon. It was a clearcut decision, as I recall – two of them were impacted and even though the other two weren’t, it was obvious there wasn’t room for them in my jaw. I had the surgery done under general anaesthetic and everything healed beautifully.

In your case, I’d get the situation evaluated by someone other than the hygienist – tooth extraction seems outside their scope of practice.

25

I wish I could have kept mine. The dentists always say what very nice teeth I have, including my 4 wisdom teeth, which looked to be on track for coming in nice and straight. Sadly, there was no room at the inn, so off they went, along with 4 other perfectly good teeth. (not all at the same time) I didn’t have any problems before or after with them.

Better than my friend - she has some sort of inherited genetic syndrome thingie that made her very teethful, and she had to have 14 of them out in order to make the remainders fit nicely in her mouth. :eek:

26

I had to have braces as a kid, and the ortho told my mom we had to wait until all my baby teeth came out. Then later, he said we had to wait until my wisdom teeth came in so he could pull them otherwise the braces wouldn’t be worth it (this is all hearsay from dear old mom). So we waited. I had all four pulled, and then had braces put on later. Quite a success.

About ten years later, a second set of wisdom teeth came to light. I was in the army at this time. Why the first ortho couldn’t see this, I don’t know, but the army pulled them with no problem.

I guess the 2nd set just made me a wise ass. :slight_smile:

I had a g/f once who had to have all four of hers pulled when she was in her 40’s. It was quite painful for her, both the procedure and recovery.

My opinion: Get it done sooner rather than later. I had no probs, but my g/f suffered for days.

27

I got all 4 pulled out when I was 23 or 24, I forget. They had all grown sideways underneath my gums and was in the beginning stages of causing me a lot of pain.

28

I had my bottom two wisdom teeth pulled in my late 20’s and will have the upper pulled out in two days!! I will be completely out this time and I am looking forward to the drugs, before and after!

29

My wife has a completely numb area on her chin from nerve damage during a wisdom tooth extraction 30 years ago. Of course, the oral surgeon had her sign a release before the procedure.

Anyone who is considering getting their wisdom teeth out should definitely read this article:

“The Prophylactic Extraction of Third Molars: A Public Health Hazard” by Jay W. Friedman

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1963310/pdf/0971554.pdf (PDF version)

According to this article, there is a significant risk of the permanent nerve damage my wife experienced, and in most cases the extraction simply isn’t necessary and the teeth will never be a problem if they’re left alone. Friedman asserts that wisdom teeth extractions are a major cash cow for oral surgeons, and that’s the sole reason it’s such a common procedure.

Before your dentist talks you into having those wisdom teeth removed, think about how your face and lips feel after you’ve been shot with novocaine for a filling. Now imagine your face staying that way for the rest of your life.

30

I hear of very few purely prophylactic wisdom tooth removals (I’m sure some dentists recommend them, but most people can’t afford to drop 2k+ on surgery they don’t need). Sometimes the xrays show them coming in at an angle, but they don’t hurt yet. I wouldn’t call that a prophylactic removal. Eventually its going to fuck up your mouth and hurt like hell.

Mine were coming crosswise causing me agonizing pain. It was like my head was going to explode. I was around 25, and had it done by an oral surgeon under conscious sedation/twilight sedation. One of the better dental experiences of my life.

31

The article steveroo linked to seems to be challenging the widespread notion that wisdom teeth are inevitably going to cause problems. From the article: " 50% of upper third molars classified as impactions are normally developing teeth, most of which will erupt with minimal discomfort if not extracted prematurely."

I had a few years of x-rays showing my wisdom teeth seemingly coming in sideways, and my dentist adopted a “wait and see” strategy. They straightened themselves out and in my 40s I now have 4 healthy fully erupted wisdom teeth.

32

Missed the edit window - my wisdom teeth (unlike Hello Again’s! :slight_smile: ) came in with little or no pain while they were fixing themselves. I had a weekend where I could eat nothing but soft foods because I had a little swelling, but that was it.

33

This is not a fun thread to read… I had 3 of my 4 wisdom teeth removed when I was 21, and it was a relatively painless experience for me. I got tons of local anesthesia, they stitched up the holes, I had gauze in my mouth and an ice cream shake for dinner, and was in fact eating a hot dog by the next day.

Why 3 of 4? Because of clerical error. They said they should come out 2 at a time, and took out my right 2 wisdom teeth on pass #1. On pass #2 the guy started prepping my bottom two gum lines. I asked him why he was prepping my lower right and he said, “to remove the wisdom tooth”. I assured him there wasn’t one there. He insisted the paperwork said “remaining lower 2 to be removed today” and I insisted dude, look at my gums and take an x-ray if you have to. Finally they did and admitted I was right, but they were only authorized by the insurance company to do the lower two and so would only remove the lower one (they were not authorized to remove the upper left).

I never went back to have that upper left one removed, but my periodontist said I should get it out because I’m developing gum disease (a whole 'nother fun ball of wax) and the straggler is just another avenue for gingivitis to dig in.

I’m having that done tomorrow and wasn’t particularly concerned until I read all these posts about how having it done later in life is much harder than earlier. I’m 41 now. Eeek.

34

If it’s the dentist, make sure they have XRays that show the entire root. My wife went through hell because she insisted on letting her dentist extract one and it turned out the roots were curved at the bottom below what showed up on the XRay. I think at 41 you’d want to go to an oral surgeon for that, any molar can be tough to extract in a fully grown adult. Best of luck with it. Let us know how it turns out.

35

I’ve had all four out (and two others!). I still have them though - I made a bracelet using them. :wink:

36

We poor dentites can sure be villianized by the general public. You guys are slightly better than some because at least some of you have some understanding about things.

We normally recommend wisdom teeth get removed for a number of reasons:

-they are harder to remove and harder to heal up from the older you get

-they are not cleaned by the owners as good as needed 99% of the time

-this leads to decay (cavities, holes) that usually recurrs again and again

-this leads to expense for the patient/owner of the teeth again and again which costs more than just removing them

-not cleaning them also leads to gum disease around them

-if they aren’t in all the way you can develop a horrible infection known as Ludwig’s Angina which will put you in the hospital. It can pop up out of the blue and land you in the hospital in as little as 24 hours depending on your hygiene.

-if they come in crooked, they can damage your 2nd molars, which you want to keep

-if they come in crooked, they can cause ulcerations of the cheek…very painful

-if we cannot get access to them because the patient gags uncontrollably while trying to work back that far in the mouth, then we cannot do our job. Don’t forget, we are not working on a foot, we work in the airway!

-we often calmly and lightly recommend because if we get too assertive in our recommendations we are accused of being aggressive money grubbers.

-panolipse xrays are usually recommended for 3rd molar removal because that type of film shows the entire jaw, the nerve canal included. We like to know how close the roots of the 3rds are in relation to that nerve canal as some patients can be left with either temporary or permanent numbness to a small part of the lower lip if those roots run deep.

If you can’t afford to get them all out at once, do one at a time or two at a time.

37

Gosh, slightly better than some - what an honor and a privilege to get such a compliment from someone like you, who’s probably never seen a wisdom tooth that could be allowed to stay in the mouth of such imbeciles as those who come to you for treatment. I imagine your time’s more profitably spent pulling them than educating their owner on proper care of them earlier in life. Do you realize you make no exceptions in your list for any teeth to remain? Why not simply say ‘Pull them all and just brush dentures, you moron, you’re too stupid for teeth anyway.’?

38

That’s what happened to me. Over Christmas last year I had terrible toothache, and when I finally went to the dentist (for the first time in about 8 years) they took some x-rays they saw that the lower right wisdom tooth was coming in at an angle and was pushing the molar forward. This had damaged the molar and led to a pretty nasty infection. My dentist said that they could remove the wisdom tooth and do a root canal on the molar, but there was a good chance they’d end up removing the molar at a later date, or the could remove the molar and leave the wisdom tooth to grow into the gap, which is what I went with. After I had the tooth out I booked myself in for a 6-month checkup, which was due next week, but unfortunately last month I had toothache again and when I went to have it looked at it turned out to be exactly the same problem on the lower left side, so I’ve had to have another molar extracted on that side. If I could go back to when I was 16 and just have the wisdom teeth taken out I’d jump at the chance.

39

I was in my early twenties when my three wisdom teeth were removed. None of them were fully developed…one looked like a tiny carrot, one had virtually no enamel, and the last one was deformed.

They were very easy to remove.

No loss in my opinion.

My other teeth are perfectly normal

40

And, I’m sorry you feel that way, but this is just a blog so I didn’t feel I needed to go into all the details of how hard most dentists, including myself, try to educate their patients about this stuff. Hate to tell you, but the majority of people are really not very receptive. Most people come in thinking they already know all they need to know about teeth…their friends and neighbors have taught them don’t you know? And if we tell them something they don’t want to hear, they can really get mad, defensive, etc. You can educate people, but habits are habits. If you have a habit and someone tries to get you to alter that habit even for your betterment, have you changed?? You must really want to change and have the discipline to change. Nobody can do that for you.

There are some wisdom teeth that can be kept, but the majority are better off being removed for all the reasons I stated.

I’m just saying that exactly like you did, we are villianized. It is always our fault. We are somehow defective or quacks or lousy at our jobs. And you went ahead and confirmed what I said. Thanks.