Wisdom Teeth And Braces

Wisdom teeth are named for the fact that they develop after the other permanent teeth, typically between the ages 17 and 21. Adults are designed to have three sets of molars, for a complete set of 32 teeth. Some dental experts have theorized that through the evolutionary process, our jaws grew smaller as our diets changed, food became easier to chew, and dental hygiene developed. This is why, for a significant percentage of people, the wisdom teeth never fully grow in, or don’t erupt at all.

While wisdom teeth are more likely than other teeth to have trouble developing, they generally aren’t as bad as their reputation would have you believe. Research has shown that hundreds of wisdom teeth are unnecessarily removed each year, in an effort to prevent problems before they occur. In most cases, it is better to monitor the wisdom teeth at regular checkups than to remove them when no dental issues exist. And don’t worry about wisdom teeth affecting your child’s results after braces. Wisdom teeth are usually not responsible for any shifting in alignment that occurs later in life.

Potential Problems With Wisdom Teeth

Wisdom teeth do not exert enough force to push out existing teeth, or even to cause them to shift. However, wisdom teeth are more likely than other teeth to grow in the wrong position, grow in only partially, or become fully impacted.

Wisdom teeth that grow in the wrong position can allow food to become easily trapped between the teeth, making it difficult for floss to penetrate the gap. This ultimately could lead to bacteria buildup between the teeth, even if you exercise good oral hygiene habits.

Wisdom teeth that are partially impacted–meaning only a portion of the tooth erupts through the gums–can allow bacteria to become trapped underneath the gums and can lead to infections. This third set of molars can also can cause pain and swelling around the gums, as well as jaw stiffness.

An impacted wisdom tooth occurs when there is no room for the tooth to grow and the tooth never erupts at the gumline. Your dentist will diagnose an impacted tooth using X-ray technology. Based on how far the tooth is from the surface and its positioning relative to your jawbone, the dentist can determine whether the tooth poses a risk of infection or not.

If your wisdom teeth have room to grow and develop normally, you will not need a dentist to extract them. It is a common myth that all people remove their wisdom teeth. Professionals today largely agree that preventative removal is not necessary. Before making the decision to remove any wisdom teeth, make sure to ask your dentist precisely why he wants to remove them and don’t be afraid to seek a second opinion.

Wisdom Tooth Extraction

If you or your child are among the patients that need wisdom tooth extraction, knowing what to expect can help ease anxiety about the procedure.

During a wisdom tooth extraction, the dentist makes a small incision into the gum tissue to expose the tooth and bone. She then pulls out the tooth either whole or in pieces, and will disinfect the area where the tooth was removed. If necessary, she will stitch the wound closed to promote healing and place gauze over the site of the extraction to stop bleeding.

Many dentists perform wisdom tooth extraction right in their office. If the wisdom tooth is deeply impacted, your dentist might refer you to an oral surgeon. Depending on how complicated your extraction will be, your dentist might either recommend using oral numbing medication or sedation.

If you are receiving a local numbing medication, your dentist will first apply a numbing gel to your gums and then administer injections around each of the teeth he will be extracting. You will be fully awake for the procedure. It is normal to experience the sensation of pressure and movement, but you should not feel any pain.

If you are receiving sedation, the dentist either will instruct you to take a medication prior to the procedure or will administer it through an IV. The medication will cause you to relax during the surgery. You will technically be awake during the procedure, but you likely won’t remember any of it. If you are using sedation, the dentist will give instructions for restricting food and water prior to the procedure.

In rare cases, an oral surgeon may need to perform the procedure using general anesthesia. General anesthesia is not used in a dental office setting, as you will be unconscious and will need a surgical team to monitor your heart rate, breathing and blood pressure throughout the procedure.

Before undergoing any surgical procedure including tooth extraction, there are a few helpful questions to ask your doctor: Why is the wisdom tooth is coming out?

  • What type of anesthesia will be used?
  • How many teeth will be removed?
  • How long is the procedure likely to last?
  • How complicated does your doctor anticipate the procedure to be?
  • Is there a risk of temporary nerve damage as a result of the surgery?

After the procedure, your dentist may prescribe pain medication or instruct you to take over-the-counter anti-inflammatory drugs. You will have swelling and possibly bruising for 2-3 days post surgery, so you will need to apply an ice pack as directed. Your dentist also will provide guidelines about what to eat and drink after the surgery.

Will Braces Affect My Wisdom Teeth?

If you have a child who is or will be wearing braces, you might wonder whether the future development of wisdom teeth will affect the orthodontic work your teen is receiving now. In short, the answer is no.

You do not need to wait for wisdom teeth to develop to begin orthodontic treatment. Most first-time orthodontic patients complete treatment prior to wisdom teeth develop, and the late-developing molars pose no risk to the new alignment of the teeth.

Because wisdom teeth exert so little force, they won’t push other teeth out of the way. They will only grow in if there is sufficient space in the mouth already. If sufficient space does not exist, they either will break through the gumline partially or not come in at all.

If wisdom teeth need to be extracted in the future, the procedure will not disrupt the progress made with braces, as wisdom teeth do not affect the alignment of the other teeth. Any future movement of teeth after braces is due to natural shifting of our teeth as we age (which is why wearing your retainer is so important), not the wisdom teeth.

If you already have your wisdom teeth, it should not change the approach to braces. Your orthodontist can easily apply braces to your third molars as well as your other teeth. If you have impacted wisdom teeth that you’ve chosen not to remove, it is still possible to proceed with orthodontic treatment. Wisdom teeth also can be removed while the patient is wearing braces.


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