Wisdom teeth and orthodontic treatment

Saturday, 21 Sep 2019 Andrew Chang 116 hits Print it

Wisdom teeth and orthodontic treatment

The topic of wisdom teeth and braces or aligner orthodontic treatment is a perennial favorite asked by adults, teenagers and the parents of teenagers who are considering to have their teeth straightened.

Do I need to have wisdom teeth removed before I start my braces or aligner orthodontic treatment?

I get this question asked many times. The short answer is it depends on the position of the wisdom tooth. Generally if we are not moving the back teeth into the wisdom teeth region or if the wisdom teeth have a long way to develop, the wisdom teeth can remain in place.

I heard from my friend that wisdom teeth caused his teeth to shift after braces or aligners orthodontic treatment. Can this happen?

If the wisdom teeth are very close to the molar in front, they can in a very small number of cases, lift the back molars up. This can then change how the upper and lower teeth are biting together and the smile, even with good retainer wear.

Smiles & Faces Orthodontics

Smiles & Faces Orthodontics

The above 2 x-rays are of the same person and show how the lower wisdom teeth appear to be the cause of the sideways positioned 2nd molar teeth in front. Removing the lower wisdom teeth helped the molar teeth in front to straighten.

Smiles & Faces Orthodontics

Fortunately these cases are uncommon and can be identified through a screening x-ray. Your orthodontist can help you identify if you are at risk of this.

In these cases, it may be best to have the wisdom teeth removed during the braces or aligner orthodontic treatment.

Does wisdom teeth need to be removed? Should I do this before or after an orthodontic consultation.

We see many adults who do not like the idea of removing teeth yet do not have enough room for all the wisdom teeth to come through. The upper wisdom tooth is often impacted and removing it can be challenging.

In these instances, there is an alternate option of removing the molar tooth in front of the wisdom tooth. This may not only help with the bite correction but would also allow room for the wisdom tooth to erupt. Occasionally in crowded or deep bite cases, it can also help make the treatment time shorter compared if all the teeth were retained. 

Case 1: as the Before (left) and After (right)  orthodontic treatment images of this young adult show, the large front teeth overlap was corrected and there was enough room for the upper wisdom teeth to develop normally, after the two upper 2nd molar teeth were removed.

Smiles & Faces Orthodontics Smiles & Faces Orthodontics

Case 2: This is another before (left) and after (after) orthodontic treatment example of an adult with a large front teeth overlap.

Smiles & Faces Orthodontics Smiles & Faces Orthodontics Smiles & Faces Orthodontics

Smiles & Faces Orthodontics

For this reason, if you are thinking of having wisdom teeth removed, it is best to delay this till after your orthodontic consultation with our orthodontist Dr Andrew Chang, as it may be possible to avoid needing to have some wisdom teeth out and also simplify your orthodontic treatment.

If you would like to know more about this topic, please click here to listen to a podcast Dr Andrew Chang did with the oral surgeon Dr Sami Haddad on this.

Click here to read a previous blog “Wisdom teeth coming through and teeth shifting. What is the link?” on this.


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