To Extract or Not: Navigating Conflicting Dental Advice on Wisdom Teeth

Wisdom teeth

I consulted a dentist about my upper right and upper left wisdom teeth.
The dentist at one clinic said that the X-ray showed decay between the upper right wisdom tooth and the second molar, and there was also some decay in the gap of the upper left wisdom tooth, although it hadn't reached the second molar yet.
The dentist mentioned that it was close (can cavities be contagious?).
Therefore, he recommended that I have my wisdom teeth extracted and suggested I think about it at home.
Later, I went to another clinic, and the dentist there said he didn't see any decay in the upper right wisdom tooth (at least not visibly) and didn't find any issues during the examination (though he didn't take an X-ray).
For the upper left wisdom tooth, he noted that there was a bit of darkness next to it, but it was not a concern.
He said my wisdom teeth were unique because they were all well-aligned and didn't need to be extracted.
So, he only filled another tooth that had decay.
Now, I'm unsure what to do.
One dentist says I need to extract them, while the other says there's no decay or that the slight darkness is not a problem.
I really don't want to have my wisdom teeth extracted because I'm worried that if I do, the upper and lower teeth won't have corresponding teeth, which might lead to further extractions in the future.
I'm also concerned that extracting the wisdom teeth could make the second molars more sensitive or cause alignment issues since all four of my wisdom teeth have erupted and are quite large.
I'm afraid that leaving gaps could cause other teeth to shift.
What should I do? One clinic insists on extraction, while the other says there's no decay or that the slight darkness is acceptable.

chia, 20~29 year old female. Ask Date: 2008/08/13

Dr. Cao Guoqing reply Dentistry

I apologize for the delayed response due to my vacation.
Since the two dentists have differing opinions and I have not seen the site or the X-rays, I cannot provide a definitive diagnosis.
If you feel uncertain, I recommend seeking assistance from a specialist at a dental center.

Reply Date: 2008/08/13

More Info

Navigating conflicting dental advice regarding wisdom teeth can be quite challenging, especially when you receive differing opinions from dental professionals. In your case, one dentist recommends extraction due to potential cavities, while another suggests that your wisdom teeth are healthy enough to keep. This situation is not uncommon, and it highlights the importance of understanding the factors involved in making a decision about wisdom teeth extraction.

Firstly, it is essential to understand the role of wisdom teeth, also known as third molars. They typically emerge in late adolescence or early adulthood and can sometimes cause issues due to lack of space in the jaw. If they are impacted (not fully erupted) or positioned incorrectly, they can lead to various dental problems, including pain, infection, and damage to adjacent teeth. In your case, the concern about cavities in the wisdom teeth and their proximity to the second molars is valid. Cavities can indeed spread from one tooth to another, especially if they are adjacent and if proper oral hygiene is not maintained.

The differing opinions you received could stem from several factors, including the dentists' philosophies regarding wisdom teeth management, their interpretation of your X-rays, and their clinical experiences. The first dentist's recommendation to extract the wisdom teeth may be based on a preventive approach, aiming to avoid future complications, especially if there is any sign of decay. On the other hand, the second dentist may have assessed that your wisdom teeth are not currently causing issues and that they can remain in place as long as you maintain good oral hygiene.

Here are some considerations to help you make an informed decision:
1. Seek a Third Opinion: If you are still uncertain, consider consulting a third dentist, preferably one who specializes in oral surgery or a dental specialist who can provide a more comprehensive evaluation of your wisdom teeth and their condition.

2. X-ray Evaluation: If you haven't had recent X-rays taken, it may be beneficial to get a panoramic X-ray. This imaging can provide a clearer view of the positioning of your wisdom teeth and any potential issues that may not be visible during a standard examination.

3. Monitor Symptoms: Pay attention to any symptoms you may experience, such as pain, swelling, or difficulty opening your mouth. If you notice any changes, it may indicate that extraction is necessary.

4. Oral Hygiene Practices: Regardless of whether you choose to keep or extract your wisdom teeth, maintaining excellent oral hygiene is crucial. This includes regular brushing, flossing, and possibly using an antibacterial mouthwash to help prevent cavities and gum disease.

5. Consider Future Implications: Think about your long-term dental health. If your wisdom teeth are likely to cause problems in the future, it may be worth considering extraction now to avoid more complicated procedures later on.

6. Discuss Concerns with Your Dentist: If you have concerns about the aesthetics of your smile after extraction or the potential for shifting teeth, discuss these with your dentist. They can provide insights into how these issues can be managed, such as through orthodontic treatment if necessary.

In conclusion, the decision to extract wisdom teeth should be based on a thorough evaluation of your dental health, the potential risks and benefits of keeping them, and your personal comfort level with the advice given. It is essential to communicate openly with your dental care providers and ensure that you feel confident in the treatment plan you choose. Remember, your oral health is a priority, and making informed decisions will help you maintain a healthy smile for years to come.

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