Dental Education Lecture: Risks of Wisdom Tooth

Fig.1	Fig.2	Fig.3

In the last lecture,the malpositioned wisdom tooth can cause the adjacent tooth to get cavity in relatively short period of time (in term of years).  We recommend early extraction of the offending wisdom tooth as early as possible.

Today, we would like to introduce another case to demonstrate risks of the wisdom tooth may be overlooked for much longer period of time (in term of decades).  In the end the wisdom tooth and its neighbor can bite you,causing severe discomfort.

Several months ago, a 67-year-old lady presented to our clinic with chief complaint of severe toothache on the left side of her face.  Careful clinical and radiographic exam showed that the lower left wisdom tooth is severely malpositioned (side-way) (#17 in Fig.1) .  The neighboring tooth, the 2nd molar (#18) has a large, but hidden cavity (C) between these two teeth.  After discussion, we decide to remove these two teeth (Fig.2, side view and Fig.3 back view).  The big cavity is quite striking.  The arrrowhead point to tartar (calculus) attached to these two teeth.  Due to malposition of the wisdom tooth and difficulty in brushing the hidden area, the two teeth also suffer from gum disease.  Tartar and plaque are the causes of gum diseases.  

It appears that we should remove malpositoned wisdom teeth to prevent long-term risks.  When we get old, we may develop diabetes and cardiovascular dieases such as high blood pressure, heart dieases and/or stroke.  These systemic dieases may increase the chance of complications associated with extraction, for example, infection, delayed wound healing and bleeding.

Xin Wei, DDS, PhD, MS 1st edition 05/03/2009, last revision 05/30/2010