Should having your child’s wisdom teeth removed be an important preparatory step before they get braces? Among some dentists, the thinking is that pulling wisdom teeth before adding braces will save later trauma and remove teeth that are likely to grow in crooked, crowd out other teeth in the mouth, and ultimately will require pulling. The current thinking is that each individual case requires an evaluation about the state of the teeth before automatically removing them.
Most Wisdom Teeth Cause no Problems
Wisdom teeth, located at the back of the mouth, are third molars that have no necessity in the modern world, given that the diets of most humans no longer includes large leaves that necessitated bigger jaws and more teeth. However, there are several myths about them that have led to the practice of removing them, even when asymptomatic:
- They will lead to future troubles that will require extraction. While they can cause problems for some patients if they come in crooked or become infected, wisdom teeth function as additional molars for the majority of the population. About 12% require extraction after becoming problematic, which is no higher than the percentage of appendixes that develop appendicitis and require removal.
- There is minimal trauma involved in their early removal. To the contrary, problems that result from tooth extraction, such as secondary infections, dry socket, and numbness in the cheek, tongue, and lip (paresthesia) are more prevalent in young patients than in older ones.
- They crowd other teeth. Studies show that when other teeth have firm vertical roots, wisdom teeth do not exert enough force to crowd other teeth.
- The teeth become more problematic with age, and often develop cysts or tumors around them. Recent research questions whether this is true, and shows evidence of less than 1% of adults with wisdom teeth developing cysts.
When Wisdom Teeth Should Come Out
Myths aside, there are circumstances that call for wisdom tooth removal before installing braces:
- The current teeth are already blocking the mouth before the wisdom teeth have erupted.
- The teeth are developing in such a way that they will exert pressure on other teeth.
- The teeth are causing discomfort, only grow in part way, or become infected.
- The back molars cannot be effectively cleaned, especially with braces in place, which can lead to bacteria formation and infection.
Prior to removing asymptomatic wisdom teeth, a good dentist will examine your child’s mouth and take x-rays to determine the status of wisdom teeth if they have not yet erupted. As braces are a sizable investment, it makes good sense to remove troublesome teeth before proceeding with the braces; this does not hold true if the teeth are causing no problems. Only a thorough evaluation by an experienced professional can determine whether removing back molar teeth that are causing no problem is worth the expense or not.
Choose an Experienced Dentist
With years of experience in managing wisdom teeth, Dr. Partridge or Dr. Maxfield of Oral and Maxillofacial Surgery of Utah will show you the evidence to help you make a good decision about whether to have your child’s wisdom teeth extracted before braces.