Wisdom teeth can be beneficial if they are healthy and properly aligned. However, they often cause problems due to lack of space in the jaw. When there isn’t enough room, wisdom teeth can become impacted, leading to various oral health concerns such as caries (cavities), gum infections, and damage to adjacent teeth.
Why Braces Are Used in Orthodontics
The Purpose of Braces
Braces are dental devices used to align teeth, improve bite function, and correct jaw positioning. They are commonly recommended for patients with overcrowded teeth, gaps, overbites, underbites, or other malocclusions. Proper alignment also supports better oral hygiene and helps prevent caries.
How Braces Move Teeth
Braces apply continuous pressure to teeth over time, guiding them into a straighter position. This process can take several months to a few years, depending on the severity of the misalignment and the patient’s age.
Do Wisdom Teeth Affect Braces?
Potential Impact of Wisdom Teeth on Teeth Alignment
Many people worry that erupting wisdom teeth may push other teeth out of alignment, especially after braces. While some believe wisdom teeth cause crowding, current research shows limited evidence to support this idea. Studies suggest that any post-braces movement is more likely due to natural shifting rather than pressure from wisdom teeth.
Wisdom Teeth During Braces Treatment
If wisdom teeth start emerging during orthodontic treatment, they are monitored closely. In some cases, they may not pose a threat and do not need removal. However, if they are impacted or at risk of infection, your orthodontist or oral surgeon may recommend tooth extractions to prevent complications.
When Removal of Wisdom Teeth Is Necessary
Common Reasons for Wisdom Teeth Removal
Wisdom teeth removal is often advised in the following scenarios:
- Impacted teeth that cannot erupt properly
- Infection or inflammation in the gums
- Cysts or tumors forming around the tooth
- Damage to adjacent molars
- Risk of caries due to inability to clean the area properly
Role in Orthodontic Planning
In some orthodontic cases, space is limited, and the presence of wisdom teeth can complicate treatment planning.
Removing these teeth allows more room to move others into proper alignment. In such cases, tooth extractions are not only preventive but necessary to achieve optimal results.
Evaluating the Need for Wisdom Teeth Extraction Before Braces
Orthodontist and Oral Surgeon Collaboration
Before starting braces, your orthodontist will likely request a panoramic X-ray or 3D imaging to evaluate your jaw and the position of the wisdom teeth. If these teeth are developing abnormally or appear to pose future issues, you may be referred to an oral surgeon for evaluation.
Timing the Removal
If extraction is necessary, it is best performed before braces are applied or after the orthodontic treatment is completed.
Removing wisdom teeth during braces may disrupt treatment. However, if removal is urgent due to infection or pain, it can be done mid-treatment with adjustments to the braces plan.
Consequences of Not Removing Problematic Wisdom Teeth
Increased Risk of Caries and Infection
Wisdom teeth that are partially erupted or hard to clean may develop caries and gum disease. Infection can spread to other areas of the mouth, potentially requiring emergency dental care.
Potential Damage to Orthodontic Outcomes
Although wisdom teeth alone may not cause crowding, infected or impacted ones can create pressure and pain. This may indirectly affect the position of other teeth and interfere with the results of braces.
Wisdom Teeth Removal Procedure
How Extractions Are Performed
Wisdom tooth removal is a routine outpatient procedure. Depending on the position of the tooth, the procedure may involve:
- Local anesthesia
- Sedation if necessary
- Incision in the gum
- Tooth sectioning for easier removal
- Stitching the site post-extraction
Recovery After Wisdom Tooth Extraction
Healing generally takes about 7–10 days. Patients should follow aftercare instructions, such as avoiding hard foods, using cold compresses for swelling, and taking prescribed medications. Maintaining oral hygiene during recovery is vital to avoid infection and promote healing.
Braces and Wisdom Teeth: Myths vs. Facts
Myth: Wisdom Teeth Always Cause Crowding
There is a common belief that wisdom teeth inevitably push other teeth forward. Scientific studies have shown that crowding can happen with or without wisdom teeth. Tooth movement after braces is natural, and retainers are important to maintain alignment.
Fact: Not All Wisdom Teeth Need Removal
If wisdom teeth are healthy, fully erupted, and easy to clean, they may not need to be removed. A thorough examination helps determine whether tooth extractions are necessary.
Alternatives to Extraction
Monitoring Wisdom Teeth During Braces
If there’s no immediate concern, your dentist may monitor your wisdom teeth throughout the duration of your braces treatment. This involves periodic X-rays and check-ups to identify any changes that could require action.
Use of Retainers Post-Braces
After braces are removed, retainers play a crucial role in preserving alignment. Even if wisdom teeth are not extracted, a retainer will help prevent the natural shifting of teeth over time.
Key Considerations for Patients and Parents
Age and Wisdom Teeth Development
Wisdom teeth usually begin to form during adolescence. Teenagers who need braces often undergo an evaluation to determine if future issues might arise due to third molars. Early assessment allows for better planning and reduced complications.
Cost and Insurance Coverage
The cost of wisdom tooth removal varies depending on complexity and the number of teeth extracted. Insurance may cover part or all of the cost, especially if removal is deemed medically necessary due to infection, cysts, or caries.
Conclusion
The decision to remove wisdom teeth before getting braces depends on individual circumstances. In many cases, if the teeth are healthy and non-impacted, they can remain. However, when there’s a risk of caries, infection, or impaction, tooth extractions may be necessary to ensure successful orthodontic outcomes.
The key is proper evaluation and planning. Always consult with your orthodontist and dental surgeon to determine the best course of action. Regular dental check-ups, X-rays, and oral hygiene are critical components in managing wisdom teeth during orthodontic treatment.
