Wisdom Teeth: Should Everyone Get Them Out? Does the operation have any risks?

Wisdoms are teeth known as third molars and have the function of crushing food and leaving the well-chewed food bolus to be swallowed.

They form late in the mouth, around the age of 15, their eruption usually occurs at 18 or 19. Hence the origin of the popular name “wisdom tooth”, since the period of its appearance coincides with the civil age.

However, human evolution has caused wisdom teeth to lose function to some extent. This is because food began to be cooked to make it softer for consumption, requiring less chewing and jaw strength.

The result is that many people have not even managed to develop third molars. Others, however, undergo surgery to remove these teeth on the advice of the dentist. But after all, should everyone really have wisdom teeth removed?

So, check out the myths and truths on the subject.

Does everyone need to remove the inside of wisdom?

Myth. Wisdom removal should only be indicated if this tooth is causing a problem, and in most cases, whether or not orthodontists guide the procedure.

The professional will carry out an evaluation to verify if the tooth has space and conditions to be born, as well as investigate if there are problems that justify the removal surgery through examinations (panoramic X-ray of the face and / or tomography).

Pericoronitis, a gum infection that partially covers the wisdom tooth during its eruption, is another condition with an indication for surgery, as it causes a lot of pain, as well as being able to generate bone resorption and even difficulty opening the mouth .

Does wisdom affect the alignment of other teeth?

Myth. Despite this belief among dental professionals, the most current and robust studies show that there is no significant association between the presence of third molars and dental misalignment.

The main cause suggested by scientists is that the misalignment of the teeth is caused by a natural process of constriction of the mandibular arch, which narrows due to chewing itself and the small wear and tear that occurs over time on the faces of the teeth.

Can wisdom be extracted only in the young?

Myth. Generally the operation is indicated when the patient is still young, as the root of the third molar is not fully formed and the procedure becomes more peaceful. However, adults can also have their wisdom teeth removed if advised by a trained professional. And usually the indication occurs when the tooth is doing more harm than good.

Is it possible to remove all wisdom teeth at once?

Truth. But the dental surgeon is the one who will evaluate and plan the procedure, indicating the removal of two wisdom teeth or four at the same time. It is more comfortable for the patient when only two wisdom teeth on the same side are extracted at a time, as it allows the patient to have one side to chew on during recovery.

However, this decision will depend on each patient’s situation and the degree of difficulty of the surgery, as wisdom teeth that have already “born” are generally easier to extract than those that are still in the gums.

Are some people with specific health conditions not recommended for wisdom tooth extraction surgery?

Truth. This group includes patients with systemic and autoimmune diseases, those with coagulation deficiencies or those using immunosuppressants.

They should be accompanied by the professional, who will request an X-ray or CT scan annually to check for the formation of any pathologies (cysts and tumors), which can lead to bone resorption in the region or affect the health of other teeth.

Is wisdom tooth removal surgery performed under local anesthesia?

Depends. In general, the procedure is performed in a dental office with local anesthesia by a dentist, with low risk. But, in exceptional cases, when the tooth is lying down and has not yet “appeared”, the degree of difficulty of the procedure increases. So, surgery can be scheduled in a hospital setting using general anesthesia.

Can wisdom tooth extraction surgery impact other structures?

Truth. Even dental offices carry some risks, such as a nervous disorder, an infection, a hemorrhage, in addition to the expected discomforts: pain, swelling and limited opening of the mouth.

For example, paraesthesia, or loss of sensation in certain regions of the mouth, such as the tongue or lower lip, may occur. But this condition can be easily treated with the application of lasers to stimulate regeneration of the nerves in the region and medications that help regain sensation.

Can patients with diabetes or high blood pressure have wisdom tooth removal surgery?

Truth. But as long as the comorbidity is controlled. If not, the dental surgeon will refer the patient to the accompanying doctor so that the condition stabilizes.

Can pregnant women have wisdom teeth extracted?

Truth. If the intervention is really necessary, it should be performed in the second trimester of pregnancy, when there is greater fetal stability. However, if it is possible to control the situation, the pregnant woman will be instructed to perform proper hygiene to avoid complications and the procedure will be deferred to her after delivery and, if possible, when she stops breastfeeding. This is because the medications can interfere with breast milk.

Should I use antibiotics before wisdom tooth removal?

Myth. While this is the guidance of some professionals in order to avoid future local infection, there is no scientific evidence that this procedure prevents an infectious condition in healthy patients.

The exceptions are those who are immunosuppressed or who are undergoing chemotherapy and will undergo more complicated surgery.

It is important to remember that unnecessary use of antibiotics has a large impact on the development of superbugs in the environment and on the body’s response to future infections. In addition, it is important that the dentist leaves the mouth prepared to receive surgery, by performing a cleaning of tartar and treating any existing cavities.

Is it more correct to stitch up the wisdom tooth extraction site?

Truth. The suture has the function of immobilizing the gum that has involved the tooth, preventing the forming clot from being affected, as well as contributing to the repair of the gingival tissues. Otherwise, the risk of a foreign body entering the cavity where the tooth was is greater, as is the risk of further bleeding or hemorrhaging.

Unless the suture is absorbable, the suture should be removed after seven days. Until then, the priority should be good oral hygiene.

Sources: Maria Cristina Deboniassociate professor at the Department of Surgery of the FO-USP (Faculty of Dentistry of the University of São Paulo); Martinho Dinoà Medeiros Junior, associate professor of the course of dentistry at the UFPE (Federal University of Pernambuco); Murilo Fernando Neuppmann Feresprofessor of orthodontics and evidence-based practice at FORP-USP (Faculty of Dentistry of Ribeirão Preto). Technical Review: Martinho Dinoá Medeiros Junior.

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