What to do with your wisdom teeth?
Large studies find association between wisdom teeth and developing gum diseases. But a few experts disagree to pull the teeth as a routine case.
Whether and when to pull out or not the wisdom teeth — the debate still goes on. Series of large studies found that young adults who keep their wisdom teeth often develop gum disease quickly, which appears increasing the risk of pregnancy complications and possibly other health problems. But a few experts disagree on the issue that the wisdom teeth should be removed as a routine part before they cause problems. Wisdom teeth, also known as third molar are the last teeth to emerge usually between ages 15 and 25. Until recently, few studies have evaluated the issue. For the first time, a series of study have been conducted in large scale by the American Association of Oral and Maxillofacial Surgeons (AAOMS) that launched in the late 1990s at the University of North Carolina in Chapel Hill and the University of Kentucky in Lexington. It found the significant association between wisdom teeth and development of gum disease. Data from 254 patients in their 20s who opted to keep all four wisdom teeth and underwent follow-up exams found 60 percent had signs of gum disease around those teeth when the study began, and for 25 percent it worsened in the next two years. Even in symptom-free patients, the AAOMS reported that nearly 30 percent of wisdom teeth had cavities and about 25 percent had inflammation that signaled gum disease, which unchecked can lead to tooth and bone loss. This research is very important to dentistry; it indicates that there are both general oral health and over-all health implications related to the wisdom teeth that were not known before. It also indicates it should prompt more dentists and patients to closely monitor the extra molars and consider removing them — even if they are not causing obvious problems. Gum disease occurs when bacteria grow in the tissue supporting teeth, damaging the tissue and causing spaces known as pockets to form around the roots. The infection can loosen and damage the teeth, eventually requiring them to be pulled out. Wisdom teeth are particularly vulnerable because they are difficult to reach and keep clean. Growing evidence has also linked inflammation from chronic infections, including gum disease, to an increased risk of more serious problems, including heart disease, diabetes complications and pregnancy difficulties. Scientists suspect chronic inflammation releases bacteria or toxic substances that can have adverse effects elsewhere like heart and kidney. Moreover, people who have gum disease typically do not have a problem until they are 35 or 40 years old. It was found that it was much more prevalent than anyone believed at a much younger age than anyone thought. However, this is an association. It does not demonstrate cause and effect. We need more research to get clear proof to see whether treating gum disease reduces the risk of preterm birth. There are areas of agreement regarding when wisdom teeth should go. The two sides taking part in the debate generally agree that wisdom teeth should be pulled if a cyst forms around their roots, if they are damaging an adjacent tooth or if they are a persistent source of pain or subject to repeated gum infections. The two camps disagree even more dramatically about whether wisdom teeth should be removed before they cause any problems or even erupt through the gums. In favour of pulling out wisdom teeth, there are concerning large studies suggesting that as wisdom teeth causes more gum diseases, as it may be impacted, may be a cause of intense pain or a potent source of infection; it is better to remove to it before they cause any problem. But for routine extraction, we need more evidence in favour of it. Extraction of wisdom teeth depends on whether the teeth have erupted — grown out of the gums — or are impacted and how deep the roots are. About 20 percent of people get impacted wisdom teeth. You should always consult a dentist to take any decision regarding your wisdom teeth. ....................................... The writer is Senior Consultant and Head, Department of Dentistry, BIRDEM Hospital. E-mail: aratan@dab-bd.org
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