"These past few months, I've been tormented by toothaches from my wisdom teeth—unable to work during the day and unable to sleep at night. Now, the wisdom tooth on the right side of my lower jaw has mostly erupted, but whenever I eat, it bites into my cheek, causing such pain that I dare not eat anything."Originally, 27-year-old Xiaomin planned to have this wisdom tooth extracted at the hospital. However, some doctors agreed to remove it while others advised against it, leaving her uncertain. Should wisdom teeth be extracted?
Abnormal growth positions or directions of wisdom teeth can lead to pericoronitis, cavities, and other issues.
"Wisdom teeth refer to the teeth closest to the throat that emerge after age 16. A full set consists of four teeth—two on the upper jaw and two on the lower jaw," experts explain. As humans evolved, jawbone size decreased, often leaving insufficient space for all four wisdom teeth to erupt properly. This results in some teeth failing to emerge or growing in abnormal positions or directions, posing significant oral health risks.
First, if a wisdom tooth cannot fully erupt, its crown may become partially covered by gum tissue, forming a pericoronal pocket. This pocket easily traps food debris and bacteria, potentially causing recurrent pericoronitis. Patients may experience tooth pain, limited mouth opening, and difficulty eating.Second, if a wisdom tooth grows crooked, an angle forms between it and the adjacent tooth, making food impaction common. Over time, both the wisdom tooth and the adjacent tooth become prone to cavities and even pulpitis.Third, abnormal positioning or direction of wisdom teeth can disrupt the bite relationship between upper and lower teeth, potentially causing temporomandibular joint clicking, painful opening, or nighttime teeth grinding.
Which wisdom teeth can be preserved, and which must be extracted? Experts explain:
Wisdom teeth that can be preserved:
1. The wisdom tooth is positioned and oriented normally.
2. The wisdom tooth shows no signs of decay, and the surrounding soft tissues exhibit no history of inflammation or pain.
3. The tooth has a corresponding opposing tooth.
Six scenarios necessitate wisdom tooth extraction:
Wisdom teeth that must be removed:
1. Decay: If the wisdom tooth has deep decay, especially requiring root canal treatment, extraction is universally recommended.
2. Impacting adjacent teeth: When space is insufficient, wisdom teeth may forcefully push against neighboring teeth during growth, potentially compromising both teeth.
4. Difficult to clean: Misaligned wisdom teeth are challenging to clean properly, making them prone to decay.
5. Lack of opposing tooth: Not everyone develops all four wisdom teeth. If a wisdom tooth lacks an opposing tooth to balance it, it may disrupt the bite relationship.
6. Impacted teeth: This type of wisdom tooth is typically buried within the alveolar bone. When pain occurs, extraction is necessary. Wisdom teeth requiring removal should be extracted before their roots fully develop. Some individuals believe wisdom teeth can be left untreated or unextracted as long as they cause no pain."This view is incorrect," experts state. Once symptoms like toothache appear, it indicates the wisdom tooth has already caused irreversible damage to other teeth. Extracting it at this stage is somewhat akin to closing the barn door after the horse has bolted. Others delay dental visits due to fear of extraction pain."In reality, under local anesthesia, patients feel no pain during the extraction process," the expert explained. Wisdom teeth that should be removed should be extracted when they first erupt and their roots are not yet fully formed.