Wisdom teeth coming through and teeth shifting. What is the link?

Monday, 13 Aug 2018 Andrew Chang 328 hits Print it

There are many people who have commented to me and observed their wisdom teeth coming through and teeth shifting. While this is an observation they noted, what does it mean for someone who is considering to have their teeth straightened. Should you worry about wisdom teeth? Are they connected? This blog aims to address these questions.

Teeth moving after braces

We see adults whom had braces before and commented about wisdom teeth coming through and teeth shifting. Wearing retainers after braces has an important role in minimizing teeth moving after braces. If your teeth are crowded or gappy, generally the more crowded or spaced they are, the more important it is following your orthodontist’s recommendations with retainer wear after orthodontic treatment.

So, if your wisdom teeth are coming through, to minimize teeth shifting after, consider asking your orthodontist to place a fixed retainer on the insides of your front teeth (after your orthodontic treatment) and to discuss with you the merits of this to reduce the chances of teeth moving after braces. This is especially so if you can see or feel or sense that you would not be able to wear your removable retainers well.

greatsydneysmiles.com.au

Impacted wisdom teeth- which impacted wisdom teeth are the ones to be concerned about

A large high quality study looked into the effects of wisdom teeth coming through and teeth shifting : they looked at 2 groups (1 group kept their wisdom teeth, while the other had them removed) and the effects on lower front teeth crowding, after retainer wear was stopped. What they found was keeping wisdom teeth had very little effects on lower front teeth crowding after braces, as an average. The study did not look in depth at the nature of the impacted wisdom tooth.

The concern we see in our practice as orthodontists are where the wisdom teeth is in contact with the molar tooth in front or overlaps the molar tooth in front of this, or where the molar tooth in front of the wisdom tooth is leaning back.

greatsydneysmiles.com.au

Our observation has been when this starts to happen, the wisdom teeth are pushing against the molar tooth in front and the wisdom teeth should be removed. Not doing so can cause push the molar tooth up and cause changes in one’s bite, or an open bite to develop, especially if orthodontic retainers are not worn well.

Impacted wisdom tooth below appears to have pushed the molar tooth in front up and back. Wisdom tooth was removed after the x-ray.

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This is particularly the case in people with a front teeth open bite ie: where there is a space between the upper & lower front teeth, before they had their teeth straightened, and have weaker jaw muscles. From this context then of wisdom teeth coming through and teeth shifting, wisdom teeth and crowding can be connected.

So to summarize this issue of wisdom teeth coming through and teeth shifting: when you see on your x-ray that the wisdom teeth lies close to the molar tooth in front, have a conversation with your orthodontist about whether to keep or remove it, and the timing of this to occur. While the above is 1 possible scenario of retained impacted wisdom teeth, 2 other possibilities are:

  1. The wisdom tooth may remain stuck in its position and does not develop more. This is more likely to be the case where the tooth is fully formed, as in adults who are in their 20’s or older.
  2. The wisdom tooth may push into the molar tooth in front, causing pressure contact damage of the roots.

While it is easy to identify a potential problem of wisdom tooth coming through and teeth shifting, it is difficult to know in situations when the potential problem of impacted wisdom teeth has been identified, as to if or when the problem can actually occur ie: to predict which of the 3 pathway scenarios the wisdom tooth may behave. This means if keeping impacted wisdom teeth in place, that your teeth may not shift at all but it could be a potential problem waiting to happen.

So if you are a parent, or yourself considering having your teeth straightened, or in the process or completed this,  and concerned about wisdom teeth coming through and teeth shifting, what should you do?

So to minimize teeth shift after orthodontic treatment, where there is overlap impaction or contact impaction of the wisdom teeth/ tooth, consider a fixed retainer/s, keep up the retainer checks with your orthodontist, wear the removable retainers according to the practice’s recommendation, and consider the merits of having the wisdom tooth/ teeth removed at a more mutually convenient time between you and the oral surgeon.


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