Should My Child Have Her Wisdom Teeth Removed?

This question has many different answers, depending on who you talk to. Why? Removal of wisdom teeth is predominantly a practice philosophy rather than an exact science. Meaning, there is much leeway, discussion and debate among all types of dentists as to what is the best treatment for wisdom teeth.

Wisdom teeth are the last teeth to erupt and are the teeth furthest toward the back of the mouth. They are also referred to as “third molars,” and will frequently never appear in mouth. This can be due to lack of space in the mouth or simply because many people are born without them. Often times, there is no room for the wisdom teeth to erupt, leaving them trapped in the jaw or only partially erupted.

If the wisdom teeth do have space to come in completely, then a few different things could happen. If your child is able to reach all the way back there and keep them immaculately brushed, then typically there are not any problems with keeping them. However, few adults are able to keep them clean enough to avoid cavities or gum disease around the teeth.

Once a cavity is present, the tooth either needs to be filled or extracted. Because the teeth are so close the jaw-joint, it is very difficult for the dentist to see if all the decay has been removed, or keep the tooth dry enough to retain the filling.

In most cases, the filling eventually fails and the tooth has to be extracted anyway. The same holds true for gum disease. Because they are hard to clean, they very often are afflicted with moderate to severe gum disease. If left, the gum disease can cause bone loss around the tooth, bad breath and possibly increase the risk for spreading the disease to the rest of the mouth.

If you remove the wisdom teeth before they are completely developed, they are actually much easier to remove. This results in less pain after surgery, faster healing time and less of a risk of complications from the procedure.

Let’s suppose that the wisdom tooth is not in at all, partially in (but stuck that way), or has no space whatsoever to come in. An x-ray (a panorex or panoramic film) will have to be evaluated by the dentist or oral surgeon before a decision can be made. Most times the teeth can still be removed with relative ease and without complication. However, there are situations which may predispose your child to temporary or permanent complications.

Close proximity of the lower wisdom teeth to the main nerve supplying all the teeth can be a concern. Injury to this or any other nerves in the areas can cause partial or complete, permanent or temporary numbness to the lip, chin, teeth, gums, tongue or skin in the area. In addition, the top teeth may be so high up in the jaw that risk of damage to the sinuses and other structures can occur. Your oral surgeon will be aware of these complications and any others as they apply to your child.

The benefits of extraction must be carefully measured against the risks involved. Be sure to discuss them in detail with your surgeon.

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