” I really don’t want this tooth, remove this tooth Doc. It has no problem! The one in front of it has the problem, so remove that one!” He had a vexed expression.
” Let’s look at your X Rays again.” I said. “Your problem began with a third molar that we sometimes call “wisdom tooth” that did not have enough room to grow in. It has grown tilted towards your second molar we call this impaction. It has caused decay in that second tooth because of food sticking between them; and you have been unable to clean that contact properly.
What that means is if we remove your second molar the impacted tooth will remain lying on its side.
It will drift forwards to some extent but you won’t be able to use it to eat. And you will still have a gap between the first molar and third molar it won’t close fully.”
He sighed.” Look Doc you don’t make sense. The one tooth with a cavity is the second one. You say Filling it won’t help long term because of the third molar but the third molar has no cavity!!”
We continued this animated discussion for a while, as I showed him an animation video of the causes of third molar impaction.
The third molars are the last teeth in the mouth and they grow from about 16 years of age and can emerge as late as 40 years of age.
It is postulated that modern man has smaller jaws with the same number of teeth as his predecessors; and therefore, the last entrants into the mouth find very little or no room to grow.
The result is a molar tooth lurking under the gum or partially submerged more or less like a live submarine with toxic consequences.
What would happen if the impacted third molar is left in place?
Plenty and none of them good.
I smiled at my patient after half an hour of vigorous discussion:
” Let me summarize what can go wrong with this kind of impacted third molar
– They can cause infections in the surrounding gum due to bacterial and food buildup. We call these infections Pericoronitis.
– They can cause decay in the tooth in front of them due to abnormal contact points and pockets in the gums.
– They can form cysts which are fluid containing areas in bone which would weaken the affected jaw and would require extensive surgery.
Either way, delay serves Zero purpose, and only increases probability of one or more of these developments.”