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Wise words about wisdom teeth.

In many cases, it is wise to keep wisdom teeth. At one time, perhaps, the human jaw had room for three sets of molars. Today, the removal of third molars is the most commonly performed dental surgery. More than 2 million impacted (meaning they don't grow through the gums) wisdom teeth are removed every year in the U.S. and Canada. Sometimes these teeth are badly positioned in the jaw and crowd the second molars as they grow in. Sometimes they partially erupt and, because they may lie under a flap of skin, are hard to clean--thus they decay quickly. Such teeth may cause pain and swelling, or cysts may develop around them, which can damage bone or adjacent teeth.

Or, in some cases, they do no harm at all.

Many dentists and oral surgeons recommend removing third molars between the ages of 16 and 19 as a preventive. Bone is less dense in younger people and healing is faster. Still, recovery is painful, and the procedure usually costs about $250 per impacted tooth. But surgery is often covered by the parents' insurance--an incentive for all, including the surgeon, to go ahead and do it.

Wisdom teeth that are painful or partially erupted or are causing other problems should certainly be removed. What about the others? A study published in 1990 in the International Journal of Technology Assessment in Health Care strongly recommended against early extraction of wisdom teeth when no symptoms were present. There's no evidence that an impacted molar harms the alignment of other teeth or undoes orthodontic work. The risk of a cyst developing is very low. Athletes in contact sports were once thought to be more vulnerable to jaw fracture if they kept their wisdom teeth, but according to Dr. Larry Peterson, Chairman of the Department of Oral and Maxillofacial Surgery at Ohio State University, there's no evidence that this is so.

Impacted teeth in a 17-year-old that look (on an X-ray) as if they might cause trouble may eventually straighten, grow in, and be healthy, according to the American Dental Association. In any case, after age 25 a tooth won't change position and may remain quiet for life. If your wisdom teeth don't bother you, our advice is don't bother them. If surgery is recommended for "sleeping" molars, at least get a second or even a third opinion.

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Title Annotation:surgical removal of teeth should only be done if they are causing problems
Publication:The University of California, Berkeley Wellness Letter
Date:Feb 1, 1995
Previous Article:Fit for tennis.

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