by peterpan

Created on: April 03, 2008

The third molars commonly known as the wisdom teeth usually erupt at the age of 18. It functions just like the other molars that erupted earlier in life. However, many people suffer from impaction due to small jaw or histological alterations during the tooth formation.

Third molars do not necessarily need to be extracted. If the tooth is sound and it does not cause any harm to the surrounding oral structures, it should be left undisturbed. The location of third molars, being on the most posterior parts of the jaws, could pose problems in maintenance like brushing or flossing so extra care should be exercised.

The only treatment for impacted third molars is odontectomy. It is performed by creating an adequate flap of the soft tissues as well as the removal of the overlying bone to provide better access on the tooth that needs to be pulled. It is more complicated than ordinary tooth extractions since the crown area of the latter is fully exposed and access does not pose as a problem.

When would you then know if the wisdom tooth needs to be pulled out?

If the tooth had caused periodontal disease such that probing depths in the area had been constantly deep even after stringent periodontal therapy, then it would be better to just have the tooth removed. If the tooth causes pain of unknown origin, then extraction can also be an option.

Carious and non-restorable third molars should also be extracted. They may not just cause pain but carious teeth especially those caries extending subgingivally becomes a predisposing factor to periodontal disease.

If the tooth had caused painful pericoronitis and other mouth infections, it needs to be removed. This approach is performed as a preventive measure to possible more severe complications like the involvement of sublingual or submandibular spaces that could pose more harm to the patient.

Patients who are also undergoing orthodontic treatment may also need to have their third molars removed depending on the treatment plan as well as the the space needed for the alignment of the teeth. Some patients may also need to have this teeth removed when they would need to have dental prosthesis especially if this tooth will be underneath the denture borders.

During routine radiographs, dentists may also see root resorption of the tooth adjacent to the impacted tooth due to the latter's erupting position. So to prevent further damage to the adjacent tooth, the impacted tooth should be removed.

On severe cases, the tooth sac of an unerupted third

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