Unnecessary removal of wisdom teeth?

Sad Professor

I went to the dentist today to get a filling and he proceeded to tell me that I needed all I my wisdom teeth removed. I've never had any issues with them (now or ever) but he says if they are not removed they will cause my my front teeth to be pushed out. There is, indeed, some overcrowding at the front but it's always been like this, hasn't gotten any worse that I can see, and previous dentists have never drawn my attention to it.

The last time I was at a dentist (which was a couple of years ago, I admit) I actually asked her about the front overcrowding and whether any extraction/correction was needed and she discouraged me from going down either route, saying they were fine.

Any advice on this? I was under the impression that wisdom teeth should be left alone unless they are causing you problems. Should I seek a second opinion? This guy wanted to take one out right there and then.

ballsymchugh

don't do it if you don't want to, and always feel free to get a second opinion. by the way, how old are you??

Sad Professor

Hi, ballsymchugh.

I'm 26. I don't mind having them removed if what he says is true, I'm just a bit suspicious given what I was told in the past.

ballsymchugh

crowding of lower incisors can happen between mid 20's and mid 30's, so it's not unusual. since you've had it long enough it's not going to be a whole ton of difference.
check this
http://www.bracesguide.com/contoversial/controversial4.html

Sad Professor

Thanks for that. Would the same apply to the upper ones?

ballsymchugh

upper wisdom teeth, while constrained, aren't under the same constraints as lower wisdoms, so they very rarely cause any kind of problems, never mind crowding. but some dentists prefer to take the opposing ones out anyway. when you have a space, the tooth opposite the space will erupt into it and may cause it's own problems.
but like i said, don't do it if you don't want to.

kkth0360

In the past, extraction of wisdom teeth was sometimes recommended to prevent the development of crowding of the lower incisors. However, research has shown that this crowding is a normal process, and is caused by a number of factors.

The best currently available evidence suggests that whilst the wisdom teeth may have a very small effect, their removal does not prevent the crowding to any significant extent, and indeed the crowding occurs even in people who don't have any wisdom teeth, as well as in people who have had them extracted. On this basis, the extraction of wisdom teeth solely to prevent crowding of the front teeth cannot be justified (see this paper by Harradine (1998) for further details).

It may be that your dentist has other concerns about your wisdom teeth, such as decay of the wisdom teeth themselves or of the adjacent teeth, or periodontal (gum) problems. If, however, the only reason for the treatment is to prevent worsening of the crowding, my advice would be not to have them out - there are a number of possible risks involved in removing wisdom teeth and inevitably a bit of discomfort afterwards, so if there's no significant benefit to having the procedure, it doesn't make sense to put yourself through it.

Hope this helps.

Sad Professor

kkth0360 wrote: »

It may be that your dentist has other concerns about your wisdom teeth, such as decay of the wisdom teeth themselves or of the adjacent teeth, or periodontal (gum) problems.

No, he didn't suggest there was anything wrong with the wisdoms or surrounding teeth. When he was checking all my teeth he just declared all the wisdoms as requiring removal without much consideration - again because he said they would cause the front teeth and incisors to be pushed out. Maybe he's just of the old school, or looking for a quick buck.

I still have another tooth that requires attention. A cavity formed in it very recently. Apart from some sensitivity at the time, I haven't had any pain with it, but he said it requires root canal. Maybe it does but tbh I didn't really trust the guy, so I think I'll be going elsewhere about that as well.

Dirk Gently

I've had a similar issue with a particular dentist trying to give me the hard sell on extracting wisdom teeth. His colleague told me I'd be fine and come back if they give me any trouble. I've already had one out but it was handy and done in a minute. The others will require a more expensive procedure. The orthodontist looking after my braces said the same thing when I asked him and that everything seemed fine but the other guy keeps insisting I get them out and recommending his mate to me. I haven't actually gone back in a while because I feel like I have a euro sign on my head walking into the place.

Hard to tell when his colleague in the same practice and an orthodontist are telling me no and the other guy is insisting on it.

georgieporgy

OP, did your dentist recommend the extractions because the teeth were partially errupted and impacted? If the answer is yes, he knows his stuff.

Waiting for trouble just means you will be worse off when it happens. Generally dentists (me included) don't push people into having their wisdom teeth extracted because the whole thing is a bit unpleasant. There is no easy money in it but there is a good chance you will lose a patient if you hurt them so why bother. It's easier to wait for the patient to come in when his jaw is swollen from infection and begging for an extraction.

Sad Professor

georgieporgy wrote: »

OP, did your dentist recommend the extractions because the teeth were partially errupted and impacted? If the answer is yes, he knows his stuff.

No, afaik all my wisdom teeth are perfectly fine (fully erupted and straight, and have been that way for several years). And the dentist said nothing to suggest otherwise. Besides, at that point he hadn't even examined them yet. He looked at the upper front teeth first and said the wisdoms needed to come out. He was quite keen to do one immediately but I told him no.

As I said, I brought this up with another dentist a few years ago. I even asked her if extraction would help but she seemed to indicate the front overcrowding was cosmetic and told me to go to an orthodontist if I was really bothered about it. This guy today however said my upper front teeth would eventually start protruding if the wisdoms weren't removed.

I'm sure if I wanted to get braces and correct the front teeth, it would probably mean extracting the wisdoms first. But given that I've had no trouble with them, surely this guy was a bit too eager to take them out?

georgieporgy

In that case I agree with the opinions expressed by the other dentists above. Wisdom teeth have little or no influence on the degree of crowding in your front teeth.

btkm8unsl0w5r4

late lower incisor crowding happens (or does not happen) regardless of the presence or absence of wisdom teeth.

Sad Professor

Was I right then be distrustful of this dentist? Why else would he recommend this? Or is it common for some dentists to be of this opinion about the removal of wisdom teeth? Does training make a difference?

BryanL

Opinion is still split on the issue , I get requests from orthodontists asking for wisdom tooth extraction to prevent crowding!
Almost every American patient is see has had their wisdom teeth removed.
I only extract wisdom teeth that are decayed,causing decay, have gum disease or are impacted and causing problem for the patient.
But everyone's experience and training will be different.
Extracting wisdom teeth isn't really a practice builder and i would imagine your dentist is recommending it more for what he believes would be your benefit rather than his.
Bryan