Wisdom Teeth

Oct 142004
Authors: Lindsay Robinson

While wisdom teeth can create a mouthful of problems, a recent

study suggests keeping these third molars may also be a culprit of

gum disease.

University of North Carolina researchers conducted a study that

found gum disease, formally known as periodontal disease, is

significantly more prevalent in adults who have chosen not to have

their wisdom teeth extracted.

Ray White, a maxillofacial surgeon at the University of North

Carolina and a researcher for the study, said the results came as a


“We estimated 10 percent would have gum disease around their

wisdom teeth,” he said. “Instead, 25 percent had a problem with

periodontal disease, and if you add up only the people over 25,

one-third of them had a problem.”

Periodontal disease is a fairly common affliction affecting

millions of Americans. According to the National Institute of

Dental and Craniofacial Research’s Web site, over 80 percent of

Americans have some form of the disease.

Anaerobic, protein-eating bacteria collect around a tooth

causing the disease.

Rick Felton, a surgeon with Northern Colorado Oral and

Maxillofacial Surgery in Fort Collins, 1008 Centre Ave., said one

reason wisdom teeth may cause periodontal disease is because they

often do not fully erupt through the gums, making it easier for

bacteria to infect the gums.

“Once the gum tissue opens up over the wisdom tooth, the food

begins to get caught under that gum tissue flap. This allows

bacteria to grow, which secrete acids, which then begin to dissolve

bone around the wisdom tooth under the gum tissue. This creates a

larger space allowing more food to get caught ultimately resulting

in an infection that necessitates removal of the tooth,” said

Felton in an e-mail interview.

The primary symptoms of periodontal disease include red, puffy

or swollen gums, or gums that bleed easily during brushing and

flossing, according to Sally Cram, a practicing periodontist in

Washington D.C. and an American Dental Association


If left untreated, the disease can eventually cause the

immediate tooth to become loose and fall out altogether, as well as

spread to surrounding teeth.

The study also showed the infection got progressively worse over

time without removal of the wisdom teeth.

“The pockets get deeper and there are more bacteria than there

were before,” White said. “It’s not something where it just stays

the same – it clearly gets worse.”

Furthermore, studies have shown that, untreated, periodontal

disease can lead to more dangerous health problems such as

cardiovascular disease and premature, low birth weight babies,

White said.

“If you keep your (wisdom) teeth over the long haul, you’re at

greater risk,” White said.

Treatments such as antibiotics are available for periodontal

disease, but are costly and tedious and do not fully eliminate the

disease. There is no long-term cure for the infection, other than

pulling the effected teeth.

“Kept wisdom teeth tend to have more gum problems,” Cram said.

“A lot of that is because when wisdom teeth are erupted into the

mouth, they’re so far back there that most people have a real

difficult time flossing, brushing and cleaning them properly.”

The difficulty of correctly maintaining wisdom teeth was also

shown to lead to tooth decay. One-third of the patients in the UNC

study had tooth decay in their wisdom teeth and at least 50 percent

of people with their wisdom teeth experience either periodontal

disease or tooth decay, White said.

“In terms of fillings, it’s a lot cheaper the have the teeth

taken out than have them filled every seven or eight years,” he


White said it is critical for people who choose to keep their

wisdom teeth to go in for regular six-month dental checkups to make

sure problems have not arisen.

“You should have them checked for periodontal pockets on a

regular basis and you should also have them checked for decay,” he

said. “Everything else being equal, you’ve got about two chances

out of three for one of those things happening, assuming you have

no other big health problems.

Felton recommended consulting an oral surgeon on the removal of

wisdom teeth. They can often determine through a simple x-ray

whether the teeth will ever break through the gums and need to be

pulled out.

“Though wisdom teeth are often asymptomatic at the ideal age, it

is usually recommended to remove them when the patient is younger

to prevent a more invasive, riskier surgery when the patient is

older and finally having problems,” Felton said.

White agreed, noting that it is more likely than not that wisdom

teeth will cause problems down the road.

“If you just use odds and you’re a betting person, you’re going

to bet you’re better off having them out than keeping them around

and waiting to see what happens,” he said.

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