Getting Wise to Wisdom Teeth

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For many of us wisdom teeth can seem unnecessary, costly and even painful. Here Dr Christina Liew tell us why we have wisdom teeth, when they appear and when we should see a dentist.

Wisdom teeth, or third molars, are thought to have been bequeathed to us by our stone-age ancestors, whose jawbones were larger and accommodated 32 teeth comfortably.  Many thousands of years later we have evolved with a smaller jaw and most of us don’t have the room for these extra molars.

They usually erupt between 17 and 25 years of age, but they can emerge any time after that, and they can be visible on an x-ray as early as 14 years of age.

Because of our smaller jaw wisdom teeth often do not erupt properly and can become impacted.  They may grow sideways, emerge only part way out of the gum, or remain trapped beneath the gum and bone.  Any of these outcomes can cause problems.  In addition, gum infection and cyst formation around the impacted tooth can cause permanent damage to the jaw, adjacent teeth and nerves.

An impacted tooth can become decayed even though not visible.  It may also cause decay and periodontal (bone and gum) disease in the adjacent healthy tooth because food debris becomes trapped and is unable to be removed through normal brushing and flossing.  Sometimes chronic pain is the result, and migraines, headaches and facial pain become a daily occurrence.  Even when your wisdom teeth do erupt properly, they may be jammed tightly in the back of the mouth making it very hard to clean them properly, leading to decay which is then very difficult to treat.

The surprise of wisdom teeth problems is that you may not know you have a problem – there may be no pain at all.  Hence extraction may be advised by your dentist to treat current problems or to prevent potential problems that your dentist knows are likely to occur.

The younger you are (under 30) the easier it is to have wisdom teeth removed as the bone is more elastic.   Also, problems tend to become worse as you get older and it is more likely you will need to be treated for pain and infection before having them removed.  Researchers have found that older patients may be at greater risk for disease, including periodontitis, in the tissues surrounding the third molars and adjacent teeth.  It is well known, too, that periodontal infections can affect your general health.  To avert such problems, it is best not to wait until your wisdom teeth cause trouble before seeking help.

Your dentist will assess each wisdom tooth as to the advantages and disadvantages of its removal.  Of course, the decision to have your wisdom teeth removed is always yours and you should feel comfortable making the decision knowing you have been well informed beforehand.


Originally from Australia, Dr Christina Liew BDSc (Melbourne) relocated to Singapore in 2003.

Dr Liew’s interest is cosmetic work and minor oral surgery, such as wisdom teeth extraction. She is a general dentist who treats both adults and children.