*health.usnews.com |
But controversy lingers about when to take action. Most
experts no longer believe that crowding is a concern, but the American
Association of Oral and Maxillofacial Surgeons typically recommends pre-emptive
pulling in young adulthood, before symptoms arise, when roots haven't yet fully
formed and surgical risks are lowest. "If you have to have them out when
you're 45, you will not enjoy that," promises Tony Pogrel, chair of the
department of oral and maxillofacial surgery at the University of California-San
Francisco.
Andrew Ziolkowski, 59, can attest to that. A dental checkup
a couple of years ago revealed that cysts had formed around his impacted wisdom
teeth and damaged his jawbone—a surprise to Ziolkowski, who hadn't experienced
any pain. The necessary surgery required that his jaw be wired shut for weeks
afterward and resulted in some nerve damage, a rare complication. "To this
day I have no sensation in my lower lip and chin," says the architect from
Germantown, Md.
Nonsurgeons are less gung-ho about preventive pulling.
"If they're not causing pain or infection, and they're coming in straight,
I usually take a wait-and-see approach," says Cynthia Sherwood, a general
dentist and national spokesperson for the Academy of General Dentistry. Those
who wait are advised to have their wisdom teeth checked yearly, since they are
tough to keep clean and may get infected or shift position. "You're
committed to that treatment plan until you die," says Thomas Dodson,
associate professor of oral and maxillofacial surgery at Massachusetts General
Hospital.
Because wisdom teeth don't form until around age 5, Anthony
Silvestri, director of dental anatomy and occlusion at Tufts University's
dental school, foresees a day when lasers will be used to prevent that from
happening. He and colleagues have had success in animals. "It doesn't make
sense," he says, "that everyone should be having surgery for a
useless tooth."
Article from: health.usnews.com
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