DR. S.C. SELVAMUTHUKUMAR
They are the last to erupt but cause the most discomfort.
BLESSED are the ones whose third molars (Wisdom teeth) are congenitally missing. The third molars, or wisdom teeth, usually erupt after the age of 18, but they play no role in the primary functions of the teeth. They are the last of the teeth to erupt but are usually the ones that cause the most discomfort. There are usually four teeth; one in each corner of the mouth. But each can be in varying stages of eruption and position. Often there is not enough space for them to erupt the right way primarily because our jaws are now smaller than that of the early humans. They grow in the wrong direction causing inflammation in the gums and severe pain. Sometimes there may be no symptoms but the adjacent teeth could be at risk of damage.
Case studies
Nithya had to go through her engagement with a lot of pain and discomfort in her jaws due to her wisdom teeth. She was to be married soon and go abroad. She was sedated and her wisdom teeth were removed in one sitting. She went through the procedure with minimal discomfort. She would have been in far greater trouble had her teeth caused her pain during her pregnancy. Another young girl got three teeth removed though only one was hurting the gums to prevent the adjacent teeth from decaying. Early removal of wisdom teeth can be advantageous, as they tend to get more firmly anchored as the jawbone becomes denser with age. However, preventive removal of these teeth will have to be considered only after clinical and radiographic evaluation. Wisdom teeth, which are lying close to or in actual contact with nerves and do not cause any symptoms are better left alone, as removal may damage the nerve resulting in numbness or tingling in the region. This is usually temporary and rarely permanent.
Impacting other teeth
Wisdom teeth that grow in the wrong direction and meet an obstruction (usually the adjacent tooth), due to which there is no further scope for eruption, are called impacted. An unclean sable area may occur between the teeth, due to which decay occurs in one or both the teeth. The second molar, which is an important tooth for chewing can decay. A filling or root canal treatment can save the second molar, but if the decay is extensive they have to be removed. Losing a second molar due to the wisdom tooth is extremely unfortunate and traumatic. If impacted wisdom teeth are allowed to remain after completion of orthodontic treatment, they may exert pressure on adjacent teeth causing them to shift and could ruin good results.Thanks to better equipment in the form of high speed drills, burs and the availability of sedation, removal of wisdom teeth has become a lot easier for the dentist and that much more tolerable and comfortable for the patient.The writer is Professor and Head of Department, Sree Balaji Dental College, Chennai. E-mail: enamelpearl@gmail.com