2 February 2017THE DEBATE
So you want to know the truth about wisdom teeth? There has been a long debate to whether wisdom teeth cause crowding to the front teeth. For some time, general dentists, orthodontists as well as dental surgeons recommended extraction as a preventative measure against crowding. Especially seen in those who have had orthodontic treatment previously. Let’s compare wisdom teeth, to let’s say your appendix, everyone has the risk of developing appendicitis, but should everyone have his or her appendix removed? This article is an exploration of whether extraction for the sole purpose of preventing crowding is justifiable. As well as, if there are greater factors which can cause crowding and if there is any evidence to support the benefits of having an asymptomatic (non-problematic) wisdom tooth removed.
Studies have shown that many adults who have had their wisdom teeth removed still see crowding of their teeth occurring over time. This proves that whether or not wisdom teeth have been removed, patients have the possibility of their teeth moving and shifting as they get older. This suggests that even if wisdom teeth do play a role in crowding, wisdom teeth are not the main cause.
Now, if we actually have a look at our anatomy, adults usually have 32 teeth, with 75% of people having wisdom teeth. Even though most adults have 32 teeth, it is very rare that an adult’s mouth and jaw will be able to accommodate this number of teeth. Evolution has given us smaller jaws and bigger brains, giving us dental health, but not enough room for 32 teeth. With more wisdom teeth becoming impacted than less, impacted meaning problematic, means that many wisdom teeth are extracted anyway – besides crowding.
So where does this leave us in the debate?
what actually causes crowding?
CAUSES OF CROWDING
Crowding is a common problem, which occurs in various stages in the development of teeth.
The main factors which cause tooth crowding are:
Tooth size.
Tooth shape.
Size of a person’s jaw.
Pressure on teeth.
Bite.
Crowding can also be caused by…
Residual growth
This can occur in our late teens or early 20s. This is where the lower jaw can have some final stages of growth development. This forces the bottom teeth slightly forward and upward into the backs of the upper teeth. The result is added pressure that crowds previously straight teeth.
Jaw regression due to ageing
Yes it’s true! As we age our skin wrinkles, our hair thins, we ‘appear’ to shrink due to a change in our vertebrae and our jaws also shrink. Even though residual growth can occur in our 20s. After this, due to ageing, our jaws do eventually shrink with age. This can, therefore, cause teeth crowding in adults, as there becomes less room for teeth.
Extra teeth
Out of the 32 teeth that adults usually have, some adults have in fact more than this. Some adults have extra teeth, known as supernumerary, which can eventually cause crowding.
Prolonged retention of milk teeth
Some children do not lose their milk teeth for a long time. This can cause problems for the alignment of their adult teeth and in some cases cause their adult teeth to erupt in front or behind the deciduous tooth. This can cause crowding later because of the original position of the tooth.
Premature loss of the milk teeth
Opposite to the above, this is where a child will lose a milk tooth too early. This can lead to other teeth shifting and moving into the space where the tooth was lost. Again this can cause crowding later because of the original positions of teeth.
Large/ small teeth syndromes –
If a tooth is particularly bigger or smaller, this can cause crowding as the teeth are misshapen which makes them more prone to crowding later on in life.
Many people mistakenly believe that wisdom teeth cause crowding through lack of space, and the wisdom tooth ‘pushing’ through. This is not necessarily true, because even though one of the major problems with wisdom teeth is the lack of space, wisdom teeth are failing to erupt or erupt fully. This means, they will not obstruct or cause prolonged pressure to other teeth as if they do they will have to be removed regardless due to other dental problems (putting crowding aside). There is also no evidence supporting that an adult who has not had their wisdom tooth extracted is more prone to teeth crowding.
There is not enough justifiable evidence to remove wisdom teeth, for the sole purpose of avoiding teeth crowding.
In addition to this, there are risks of extracting wisdom teeth such as dry socket, infection, bone loss and nerve damage. Although these risks are rare and are only seen in severe cases, we should always try to avoid unnecessary risks.
In terms of teeth crowding it would seem that there are so many other proven, contributing factors, which cause crowding to adult teeth, which have almost nothing to do with wisdom teeth.
If you would like more information on wisdom teeth, check out our article on wisdom teeth – what you need to know!
The Brighton Implant Clinic was established in 2009, Hove, East Sussex. The award – winning clinic now spans over four sites in Hove, Brighton, Worthing, and Hailsham. Founder and principal dentist Dr Bruno Silva has created a clinic with state of the art facilities and equipment including its own dental laboratory. We provide personalised and affordable dental care, including dental implants and cosmetic dentistry solutions, with additional services such as sedative dentistry. Dr Silva and his team believe a smile is a gift that keeps on giving, confidence in your smile is confidence in you. Their promise is to provide patients with first class dental treatments with first class patient care.