Wisdom Teeth: Small Jaw Issues and Extraction Decisions

Wisdom teeth, the jawbone is too small?

Hello Dr.
Chang, I have been experiencing some issues with my teeth recently.
My four wisdom teeth are all normal (fully erupted, not impacted, and not horizontal).
Previously, I had two upper wisdom teeth that erupted first, and since they were easy to accidentally bite into the inside of my mouth, I had them extracted (they were fully erupted, so the extraction was straightforward and not very painful).
The dentist took X-rays of my lower wisdom teeth and said that because my jaw is too small, they cannot erupt properly, and recommended extraction.
However, I was initially concerned about the need for surgical intervention and since the lower wisdom teeth have not been causing me much trouble, I decided to wait and see without having them removed.
Recently, I noticed that my lower left and right wisdom teeth have started to show some eruption (I can see 3/4 of the tooth surface on the left side, and a corner on the right side)!!! I am confused because my jaw is supposed to be too small, so how are they erupting? Should I wait for them to fully erupt before having them extracted (which would avoid the need for surgical intervention), or is it unlikely that they will fully erupt, and I should have them extracted immediately? Additionally, I have been experiencing discomfort when biting down on the fourth tooth behind my upper right molar, and at first glance, it does not appear to have any cavities (I have never had cavities before).
Could this discomfort be related to my wisdom teeth? I apologize for bothering you, Dr.
Chang.
Thank you (I am really afraid of having teeth extracted).

Miss Zhou, 20~29 year old female. Ask Date: 2015/09/09

Dr. Zhang Xiangyuan reply Dentistry

Dear user, based on your description, the upper wisdom tooth has been extracted, and the lower wisdom tooth is partially erupted.
Partially erupted wisdom teeth can make it difficult to maintain oral hygiene, which may sometimes lead to inflammation or cavities.
It is advisable to consider your personal situation and needs and consult a dentist for evaluation and potential extraction at the appropriate time.
If necessary, both partially erupted and fully erupted wisdom teeth can be extracted.
For the discomfort in the upper right molar, it is recommended that you have a dentist examine it to determine if there are any other underlying issues causing the discomfort.
Thank you for your inquiry.

Reply Date: 2015/09/09

More Info

Hello! Thank you for your detailed question regarding your wisdom teeth and the concerns surrounding their extraction. It’s understandable to feel apprehensive about dental procedures, especially when it involves surgery. Let’s break down your situation and address your concerns step by step.

Firstly, it’s important to understand that wisdom teeth, or third molars, often pose challenges due to the size of the jaw and the positioning of the teeth. In many cases, individuals have smaller jaws that can lead to impaction, where the teeth do not have enough space to emerge properly. This can result in various complications, including pain, infection, and damage to adjacent teeth.

In your case, you mentioned that your lower wisdom teeth are starting to emerge despite previous assessments indicating that your jaw might be too small for them to grow in completely. This can happen for several reasons. Sometimes, the jaw can undergo slight changes over time, or the teeth may find a way to erupt partially even in a constrained space. However, it’s crucial to monitor their development closely.

Regarding your question about whether to wait for the teeth to fully emerge before extraction or to proceed with removal now, there are a few factors to consider:
1. Potential for Impaction: If your lower wisdom teeth are emerging but are still partially impacted, they could lead to complications such as infection or damage to neighboring teeth. If they are not fully erupted, they may still pose a risk of becoming impacted later on.

2. Current Symptoms: You mentioned discomfort when biting down on your upper right molar, which could indeed be related to the positioning of your wisdom teeth. If the wisdom teeth are pressing against adjacent teeth or causing misalignment, it may be wise to consider extraction sooner rather than later.

3. Surgical Considerations: While it’s true that extracting fully erupted teeth can be less complicated, waiting too long can lead to more complex surgical procedures if the teeth become impacted. If your dentist or oral surgeon has recommended extraction, it’s likely based on the potential risks associated with keeping them.

4. Anxiety About Extraction: It’s completely normal to feel anxious about dental procedures. Communicating your fears with your dentist can help. They can provide sedation options or other methods to make the procedure more comfortable for you.

5. Follow-Up Care: If you decide to wait for the teeth to emerge fully, ensure that you maintain excellent oral hygiene to prevent any infections. Regular check-ups with your dentist will also help monitor the situation.

In conclusion, while it may seem daunting, the decision to extract wisdom teeth is often made to prevent future complications. It’s essential to weigh the risks and benefits with your dental care provider. They can provide personalized advice based on your specific dental health and the current state of your wisdom teeth. Remember, addressing these issues sooner rather than later can lead to better long-term outcomes for your oral health. If you have further questions or need reassurance, don’t hesitate to reach out to your dentist. They are there to help you navigate these decisions with your best interests in mind.

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