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DxD Admin from Singapore asked a question

How do I know if my wisdom tooth needs to be extracted?

Hi doctors, thanks so much for this QnA – I have learnt a lot from browsing it, and really love how it is a neutral site so I can trust the opinions provided here!

2 of my wisdom teeth at the bottom are impacted and growing below the gum, but they are not causing me any pain.

Different dentists have told me different things – some tell me I need to take it out ASAP, others say I do not need to remove them, unless they are causing me problems. The ones who told me to remove them tell me things like they will grow into the neighbouring teeth, can cause cavity and infections, will affect the alignment of my teeth, etc.

The first dentist I went to who told me to remove them was close to 10 years ago now, but I have not had any problems since then. Yet recently during a check up, another dentist told me I should remove them again.

How will I know when I DO actually have to remove them, and what’s the different between removing now or later on when it’s actually causing problems? It’s very confusing when different doctors tell me different things, and I don’t know if the ones who told me to take them out now just want to do an additional procedure to bill me for. Thank you.

DOCTOR’S ANSWER (2)
Dr Huang Shiming
Dentist
Singapore
(8 Ratings)
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Dr Huang Shiming
Dentist
Singapore
(8 Ratings)
Answered on 26 Jan 2018

Hi Queenie,

This is a very valid question and also an age old one!

Though it may sound like a cop out, I am going to say all the dentists you have consulted prior to this have not been wrong. Be it whether it was advice to remove or to leave it status quo.

Without the benefit of radiographs and a clinical examination of your teeth, I am however hesitant to weigh in with my own opinion.

The need to remove wisdom teeth can at times be discretional and not so clear cut. At times it is a definite must while at other times, surgical risk of removal may outweigh the benefits.

At the end of the day, our role as dentists is to provide you with the appropriate advice and treatment options and for you as the captain of your own ship to make the final decision.

As a patient, you should never feel forced or pressured into a procedure, especially one such as this.

I hope that my colleagues you have seen in the past have been able to give you enough advice to make an informed decision. If not, I strongly encourage seeking a second opinion before you take the leap!

0 142 views 0 Doctors agree 26 Jan 2018
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Dr Joanne Lam
Dentist
Singapore
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Dr Joanne Lam
Dentist
Singapore
Answered on 26 Jan 2018

Hey Queenie,

In terms of giving you any personable advice, I completely agree with Dr Shiming. It’s really hard for us to comment until we’ve done an examination for yourself.

However, I thought I’d share with you some common reasons why wisdom teeth are extracted. If any apply to you or anyone else reading, then maybe you should consider to remove them.

  1. Pericoronitis. If the wisdom can’t erupt fully, there may be a flap of loose gum which lies over or around the erupted portion of the wisdom tooth. Food and bacteria can get stuck under this flap and cause a localised gum infection. NICE guidelines advise 2 counts or more of pericoronitis is an indication for removal of the wisdom tooth.
  2. Dental decay. That flap of gum I was talking about, when food gets stuck repeatedly under the gum, then the wisdom tooth is at risk of decay. Even if the tooth has fully come out of the gum, it might be at at funny angle, again causing food packing. Even if it’s fully straight, it’s furthest back in the mouth and some patients struggle to clean this area properly.
  3. Damage to other teeth. If food repeatedly gets stuck around the wisdom tooth, the tooth next to it has a higher risk of developing decay. Also, if the wisdom tooth has no opposing tooth, it can erupt into the space, possibly causing trauma to the opposing soft tissue.
  4. Dentigerous cyst. The most common location of a dentigerious cyst are the lower third molars (wisdom teeth). Early detection and removal of dentigerous cysts is important to reduce further morbidity.

Hope this has at least provided some useful information 🙂

0 142 views 0 Doctors agree 26 Jan 2018
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