The decision of whether one can have braces while still having wisdom teeth is a common concern among patients and their parents. Wisdom teeth, also known as third molars, typically erupt between the ages of 17 and 25, which often coincides with the age when many individuals are considering or undergoing orthodontic treatment with braces. Understanding the relationship between braces and wisdom teeth is crucial for making informed decisions about oral health and orthodontic care.
The Growth and Impact of Wisdom Teeth
Wisdom teeth can vary greatly in their growth patterns and the potential problems they may cause.
Normal Eruption:
In some cases, wisdom teeth may erupt without any issues. They emerge in the proper position, align with the other teeth, and do not disrupt the existing dental alignment. When this occurs, having braces while the wisdom teeth are erupting may not pose a significant problem. The orthodontist can monitor the progress of the wisdom teeth and make any necessary adjustments to the braces to accommodate their growth.
Impaction:
However, a more common scenario is that wisdom teeth become impacted. This means they do not have enough space to fully emerge and can grow at an angle, either towards the front of the mouth, sideways, or even remain completely buried beneath the gum line. Impacted wisdom teeth can cause several complications. They may push against adjacent teeth, leading to crowding or misalignment. This can undo the progress made with braces or even cause new orthodontic problems. For example, if a wisdom tooth is pushing on the molars that have been carefully aligned with braces, it can shift their position and create gaps or crookedness.
Infection and Gum Disease:
Impacted wisdom teeth are also prone to developing infections and causing gum disease. The partial eruption or the presence of the tooth beneath the gum can create pockets where bacteria can accumulate. This can lead to inflammation of the gums, pain, swelling, and in severe cases, abscess formation. If a patient has braces and also develops an infection around a wisdom tooth, it can further complicate the orthodontic treatment. The infection may require treatment such as antibiotics or even extraction of the wisdom tooth, which can affect the overall treatment plan and timeline of the braces.
Orthodontic Considerations
Orthodontists take several factors into account when dealing with the presence of wisdom teeth during braces treatment.
Pre-Treatment Evaluation:
Before starting braces, an orthodontist will usually conduct a comprehensive examination that includes X-rays to assess the position and development of the wisdom teeth. If the wisdom teeth are likely to cause problems during the course of braces treatment, the orthodontist may recommend extraction prior to or during the orthodontic process. For example, if the X-rays show that the wisdom teeth are already starting to impact the adjacent teeth or are in a position that is likely to cause crowding in the near future, extraction may be advised.
Treatment Plan Adjustments:
If the wisdom teeth are not causing immediate problems and are expected to erupt without significant issues, the orthodontist may proceed with the braces treatment while closely monitoring the wisdom teeth. The treatment plan may need to be adjusted based on any changes in the position of the wisdom teeth. For instance, if a wisdom tooth starts to emerge and causes a slight shift in the alignment of the teeth, the orthodontist may modify the forces applied by the braces to correct the new misalignment.
Post-Treatment Stability:
Even after the braces are removed, the presence of wisdom teeth can affect the long-term stability of the straightened teeth. If the wisdom teeth erupt after the braces treatment is completed and cause crowding or other alignment issues, the results of the orthodontic treatment may be compromised. Orthodontists may recommend keeping an eye on the wisdom teeth for a period after braces removal and considering extraction if any problems arise.
The Role of Extraction
Extraction of wisdom teeth is a common approach in many cases.
When to Extract:
Wisdom teeth are often extracted if they are impacted, show signs of potential problems such as being close to the roots of other teeth, or if there is not enough space in the mouth for them to erupt properly. In the context of braces treatment, extraction may be done before starting braces to create more space for the other teeth to move into their proper positions. It can also be done during braces treatment if a problem with the wisdom teeth arises. For example, if a patient has been wearing braces for a year and suddenly an impacted wisdom tooth starts to cause pain and crowding, extraction may be necessary to continue the orthodontic treatment smoothly.
Recovery and Impact on Braces:
After wisdom tooth extraction, there is a recovery period. During this time, the patient may experience swelling, pain, and some limitations in eating. The orthodontist will need to take this into account and may adjust the braces or postpone certain procedures. For instance, if the swelling in the mouth is significant after extraction, it may be difficult to make adjustments to the braces. The orthodontist may wait until the swelling subsides to ensure accurate placement of the braces components and to avoid causing additional discomfort to the patient.
Patient’s Perspective and Decision-Making
Patients and their families also have an important role in the decision-making process.
Understanding the Risks:
Patients need to be aware of the potential risks associated with having braces and wisdom teeth. They should understand that if the wisdom teeth are not properly managed, it could lead to a longer and more complicated orthodontic treatment, as well as potential dental problems in the future. For example, if a patient decides to keep their wisdom teeth without proper evaluation and they end up causing misalignment after braces removal, they may need to undergo further orthodontic treatment or deal with dental pain and discomfort.
Consulting with Specialists:
It is crucial to have in-depth consultations with both the orthodontist and an oral surgeon if extraction is being considered. The orthodontist can explain the orthodontic implications, while the oral surgeon can provide details about the extraction procedure, the recovery process, and any potential complications. For instance, the oral surgeon can discuss the type of anesthesia used, the expected recovery time, and the likelihood of any post-operative infections.
Long-Term Planning:
Patients should also consider their long-term dental health goals. If they want to maintain the results of their braces treatment and have a healthy and stable dentition in the long run, they may need to make decisions that prioritize the proper management of their wisdom teeth. This could include following the orthodontist’s and oral surgeon’s recommendations, whether it is extraction or close monitoring.
Conclusion
In conclusion, the question of whether one can have braces with wisdom teeth is not a simple yes or no. It depends on various factors such as the position and growth pattern of the wisdom teeth, the stage of orthodontic treatment, and the overall oral health of the patient. Through proper evaluation, communication between the patient, orthodontist, and oral surgeon, and a well-planned treatment approach, it is possible to manage the presence of wisdom teeth while undergoing braces treatment and achieve optimal oral health and a beautiful, straight smile.
