For quite some time, there has been a popular belief that wisdom teeth “push” the teeth in front of them as they come into the mouth, causing the front teeth to crowd. Consequently, some general dentists, orthodontists and oral surgeons recommend the extraction of wisdom teeth as a preventative measure to safeguard against the recurrence of crowding after orthodontic treatment. There is now a large and well-documented body of research
evidence disproving the theory that wisdom teeth exert enough pressure to affect the movement of the front teeth. Current well-validated studies tracking patients for over 25 years have determined that teeth will drift forward throughout life naturally, regardless of whether or not orthodontic treatment has been done or if wisdom teeth are present. Two phenomena seem to occur, with the teeth all moving slightly forward over time (called “mesial drift”), and the distance between the lower canine
teeth constricting or getting narrower over the years. This seems to happen even in people who are missing all their back teeth This is why many adult patients who have had their wisdom teeth removed still see crowding of their front teeth occur as time goes on. We see many adult patients who had relatively straight teeth as teenagers coming to correct new crowding that has developed, especially in the lower front teeth. It is still not completely understood why this happens, but we do
know that presence of the wisdom teeth are not usually directly related. Tooth-size, tooth-shape, original tooth-position, changing soft tissue pressures from varying tongue and lip postures all can play significant roles in the development of tooth crowding.
Today, the premise no longer exists for the extraction of all wisdom teeth simply to minimize future crowding of front teeth. Frequently, however, wisdom teeth do need to be removed for reasons of dental health, such as impacted wisdom teeth that don’t have room to erupt properly.
What problems can occur with NOT removing impacted/retained wisdom teeth?
- Bone and soft tissue defects behind the second molars
- Root resorption of second molars
- Decay due to inability to brush and floss properly
- An infection (pericoronitis) that occurs around partially erupted lower third molars
- Cysts and tumors around impacted third molar
At Davis Orthodontics, we always stress the importance of proper retainer wear after your treatment is complete. If you wear your retainers as instructed after braces, the teeth will not move regardless of whether wisdom teeth are there or not. So it’s retainers that will keep your teeth straight, not having your wisdom teeth out. Your family dentist can advise you if they recommend removal of the wisdom teeth for any of the other reasons mentioned above.
There has been extensive dental research conducted to determine if there is a relationship between these two occurrences. What was found is that there are a fair number of adults who aren’t born with wisdom teeth but who still exhibit crowding of the teeth. There are also adults whose wisdom teeth never erupt, and they also sometimes have crowding.
What then, is the cause of crowding. There are several things that contribute to crowding of the teeth. For starters, growth of the jaw can continue well into the middle and later years of life, and it is known that the lower jaw tends to grow more than the upper. This is why many people notice that while their upper front teeth are straight, their lowers are crooked. It is also known that the muscles around the mouth, the lips, and the tongue exert pressure on the teeth which can cause crowding.
If it has been shown through research that wisdom teeth do not cause crowding, one might wonder if it is necessary to remove them. The answer is yes. And the reasons for removing them would be the presence of tooth decay, infection, gum disease, pain, or sometimes just the inability to properly clean those teeth due to their position in the back of the mouth.
If you have questions or concerns about your wisdom teeth and about any crowding that you notice in your mouth, the best thing to do is to see your dentist.