My Wisdom Teeth Don’t Hurt.  Should I Have Them Taken Out?

Montrose Star interviews trusted dental authority Dr Randy Mitchmore from his Montrose practice called LifeSmiles.

M.S.  Ever since I was 16 the dentist would tell me that it was time to get my wisdom teeth out.   They were not bothering me so I did not bother them.  Now, I am starting to get a little funny feeling down there, but only every once in a while.

Dr M  Most people take the position “If it ain’t broke, don’t fix it!”.    Problems happen when that position runs in to that river in Egypt – DeNial !  Denial is a common ailment that I typically see more in men than women.  Pain is a “symptom” that you feel when a problem gets to a crisis point.  “Signs” are things we can see that tell us danger is ahead.  Much like a highway Sign can tell you there is a sharp curve ahead, there are “signs” around some wisdom teeth that tell us problems are coming.

M.S.  Got it!  What are some of the signs of trouble that I should look for?01

Dr M The actual patient photo below is a very common situation I see in my adult patients.  You can see two tilted wisdom teeth in the very back and some yucky rotted food/plaque down where they are jammed into the next tooth forward.   They have been sitting that way for twenty years.  The thing to notice is the gums might bleed if you poke around – that could be your toothbrush turns pink or red from blood when you use it.  Or you just can’t seem to get the piece of lettuce or popcorn out.  The flashing red light with the obnoxious alarm “symptom” is when you start feeling PAIN!

M.S.  What signs do you look for as a dentist? 

Dr M The same ones I just told you plus I have some things you don’t have – an x-ray machine, microscopes build onto my eyeglasses, fiber optic lights and mirrors.  Here are the same teeth you see above on a digital x-ray:

digital x-ray

There is an extremely large cavity not on the wisdom tooth, but on the good tooth in front of the wisdom tooth.  The cavity is way down below the gum line, even below the bone level.  The cavity is NOT visible to the by looking in the mouth.  It can only be seen on x-ray.  It is so big that it has gotten into the nerve of the tooth and now the good tooth is the one that is hurting.  It is in danger of being so badly decayed in an inaccessible area, that is may be lost.

 M.S.  Yikes!  That is bad.  So do all wisdom teeth need to be removed?

Dr M. I do not believe that.  Many times a wisdom teeth can be completely impacted below the gum.  They can sleep there an entire lifetime with no trouble at all.  However, it is wise to have an x-ray made of them every few years to make sure nothing has woken the sleeping bad boy.  The worse kind of wisdom tooth situation is where they are just peeking through the gums.  That break in the gum tissue allows bacterial plaque to creep in around them causing either the tooth or the gums or both to rot.  The other challenging situation is where the wisdom tooth is pretty much in and seems to be living a happy life.  They are typically hard as heck to get a toothbrush around them and I frequently see gingivitis simply because a toothbrush cannot really get to where it needs to go.

M.S. I have a friend whose lower teeth have gotten crooked because there wisdom teeth have come in.  Is that true and will they get straight by taking out the wisdom teeth?

Dr M  No.  and No.  Unfortunately, teeth will only migrate forward toward the front of the mouth.  Those front teeth will never unravel and become straight by taking out the wisdom teeth.  You can quote me on that!  The wisdom teeth probably need to be taken out for the above reasons.  The teeth will only become straight through orthodontics or my favorite treatment called Invisalign.

Dr Mitchmore is active in the community.  He serves as Vice-Chairman of the Montrose Management District.  His passion is Dentistry.  He has also been a City Councilman and Chairman of the American Academy of Cosmetic Dentistry’s Charitable Foundation, Give Back A Smile.  The foundation helps survivors of intimate partner abuse regain their smile.

 
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