Who needs third molars extracted?
Wisdom teeth are another name given to third molars. They usually erupt at around 17 years old to 20 years old. Not every patient needs to have third molars extracted. However, there are many indications to do so.
When patients come in for a third molar evaluation, recommendations may vary depending on the case. However, most of the time there seems to be not enough space for them to erupt. When that is the case, there are certain problems patients will likely have in the future.
When patients come to my practice and I see they have impacted third molars I always give all the benefits vs. disadvantages to have them extracted. For example, I've seen it many times where patients develop cysts around third molars. When patients are 16 to 18 years old I prefer to have them extracted at that age because most of the time they have not fully developed. Since one of the risks of the surgery is to develop permanent paresthesia (numbness of the lip). I would much rather have them extracted at an age when the amount of swelling, pain or injury to the nerve are the least. Since most of the time, the roots of the third molars are not fully developed the chances of 'pushing' against the nerve during extraction are much lower. In addition, young patients have mandibular bone that is significantly 'softer' than older patients. When patients reach the age of 30 years old, their bones are much more mature therefore making the surgery a bit more challenging for extractions. A comparison study by Elfer, 2004 of 5831 patients, stated that those with impacted third molars had a 30% greater chance of having periodontal defects. Common problems associated with impacted third molars are pericoronitis (recurrent local infections) abscess, bleeding, caries to adjacent teeth, pain, swelling periodontal defects, and (bone defects) cyst formations.
The protocol in my office recommends that most patients with impacted third molars from ages between 16 to 25 years old have their wisdom teeth extracted. Those older than 25 are recommended depending on the particular scenario especially if they are symptomatic. For further details and questions feel free to call our office and we will set you for an appointment and answer all your questions regarding third molars.