Yes, Teens Should Have Their Wisdom Teeth Removed Before College

There seems to be a lot of confusion and concern about why one would choose to remove wisdom teeth if they’re not causing acute pain or other issues.

Scarsdale Moms @ Scarsdale10583.com Contacted Dr. Kur for some honest answers to this endless debate…

Dr. Kur is in his tenth year of practice as a board-certified Oral and Maxillofacial Surgeon. I had a chance to chat with him to find out about the risks and benefits of the procedure and who should consider it, and here is his response…

Why is the third or final set of molars called wisdom teeth?

Because they usually grow when people are in their late teens or early twenties. In and of themselves, wisdom teeth are not a problem, but more often than not they are misaligned or cause other issues in the mouth.

Wisdom Tooth Removal has become a popular rite of passage for graduating high school students because many dentists and surgeons recommend removal of these teeth prior to, during, or just after college.

What Are The Indications For Wisdom Tooth Removal?

Indications for wisdom tooth removal include:

• Making Room In The Mouth | Crowding in the mouth (not allowing second molars to erupt properly)
• Stopping Pain
• Wisdom teeth growing in at an angle (or incorrectly positioned making second molars susceptible to bone loss because it’s hard to clean between the second and third molars)
• Cysts (these are benign but also contribute to bone loss in the second molars)
• Why is potential bone loss an issue and therefore an indication to remove wisdom teeth?

There are several different situations in which wisdom tooth extraction is the best option. When that’s the case, it’s time to act.

Making Room

Sometimes there simply isn’t enough room in your mouth for your third molars, which are commonly called wisdom teeth. When there’s not enough room for the new teeth to emerge the way they want to, they’ll crowd your other teeth. The constant pushing from these new molars can move the teeth in front of them out of alignment, undoing years of orthodontic work or misaligning your bite.

Sometimes, too, the wisdom teeth get in the way of orthodontic devices, and removing the teeth is the only way to ensure that your other teeth can be properly aligned.

Stopping Pain

All that tooth movement, as subtle and slow as it is, can cause pain in your jaw, sinuses, and other teeth. Wisdom teeth can be especially problematic when they sit in your jaw at an angle. As the teeth try to emerge, they move sideways rather than upward and push against the roots of the adjacent teeth, a situation that is both painful and potentially damaging to the other teeth. If you don’t have them removed, the pain is likely to get worse, and you could be in for even bigger problems down the road.

Preventing Other Problems

Wisdom teeth that are impacted in your jaw or otherwise don’t emerge properly can cause all sorts of problems in your mouth. Teeth that emerge partially can create hard-to-clean pockets in your gum tissue or between teeth that provide great places for bacteria to grow, leading to tooth decay, gum disease, and bone loss. In severe cases, an infection can result.

Many times a cyst will form in the jaw bone around an impacted wisdom tooth, and the cyst will cause a loss of bone in the area.

Sometimes the problems caused by wisdom teeth extend even beyond the mouth and the jaw itself. The upper wisdom teeth lie very close to the maxillary sinus, a cavity behind your nose and beneath your eye. Inflammation or infection of wisdom teeth can have an adverse effect on the sinus cavity, leading to sinus congestion, headaches, or infections.

According to the literature and the American Association of Maxillofacial Surgery, if a person 26 or younger has their wisdom teeth removed, the body will regenerate bone and it is much more likely that there will not be severe issues related to bone loss like a periodontal pocket, for example. Bone will actually regrow on the back of the second molars through age 26. A lot of times we see patients in their 30,s, 40’s and 50’s who still have their wisdom teeth with irreversible damage. The second molar becomes susceptible to loss, a much more serious problem. ~ Dr. Kur

Is the preventative removal of wisdom teeth elective surgery?

Dr. Kur reiterated that there are specific indications for wisdom tooth removal. Even if a patient is not currently in pain, it does not mean the surgery is elective. “It’s a necessary surgery for many people,” he said.

“The whole reason we encourage parents to have their kids’ wisdom teeth removed before age 26 is not just prophylactic. The evidence suggests that after the age of 26 the body’s ability to regenerate bone is diminished. Preventative is not the same as elective. In my professional opinion impacted wisdom teeth should be removed if indicated in 14 to 26-year-olds.”

Surgery is only indicated for specific situations, according to Dr. Kur. “For example, if a 43-year-old came into my office with impacted molars and they weren’t bothering him, we wouldn’t recommend removal; his body’s ability to regenerate bone if there was bone loss in his second molars would be minimal and the benefit of the procedure would not outweigh the risks. However,” he added, “this would not be the same recommendation we would make for a healthy 15 or 24-year-old because the benefits of removing the wisdom teeth would exceed the risks based on bone regeneration potential, among other things.”

What are the risks associated with wisdom tooth removal surgery?

Dr. Kur explained that there is a common misconception about the procedure.

“There’s a nerve that is housed in the mandible or lower jaw. That nerve provides sensation but no movement. So, one common misconception is that a person will have a droopy lip or a part of their face won’t be able to move. The numbness that persists for a short period of time can be an issue in a small number of people who are predisposed to this,” Dr. Kur said.  “Sometimes we take a Cone Beam CT Scan to see where the nerve is in relation to the roots and therefore the nerve. We may also do a partial tooth removal so as not to potentially disturb the nerve. We always remind patients that this nerve does not supply motor function, just sensation, so the only nerve-related risk is related to sensation and not movement.”

Whereas there are risks to this and any surgical procedure, Dr. Kur also emphasized the risks of not removing wisdom teeth can be substantial and should be understood by the patient and his/her parent or guardian.

Can a patient have their wisdom teeth removed by a dentist?
How may this procedure differ from having it done by an oral maxillofacial surgeon?

According to Dr. Kur, a patient can have their wisdom teeth removed by a general dentist. However, Dr. Kur of Westchester Oral and Maxillofacial Surgeon is highly trained in anesthesiology. “We recommend that patients are IV-sedated for this procedure. It relieves patient anxiety and fear and makes the experience much more pleasurable for the patient. Although the patient is sedated, they are conscious and breathing on their own. Being sedated is also related to patients using less pain medication post-operatively. The majority of patients do choose IV sedation/anesthesia and are glad they did for both their comfort and safety, both of which are our priorities.”

What is done to make patients comfortable post-operatively and what is the recovery like after wisdom tooth removal?

In most cases, Dr. Kur uses dissolvable stitches and the recovery period is usually 3-5 days of post-operative swelling and soreness. “We are very cautious with pain medication these days and we usually recommend prescription-strength ibuprofen.” He added that most people return to work or school within two to three days.

From A Mom’s Experience & Perspective

Don’t wait until the last minute though! My son had his wisdom teeth out about a week or so before he left for college. He developed an infection (brushing teeth in those grimy dorm bathrooms?) and we had to arrange for the oral surgeon to send antibiotics twice to the school pharmacy after he admitted not taking the first round correctly.  ~ Deb R.

The Risks Of Not Removing Wisdom Teeth Can Be Substantial. It’s Better To Be Proactive Than Reactive.

+ Contact Dr. Kur Today for Consultation
Or, Feel Free to Call Us @ 914-592-0440