What Should I Do If My Wisdom Tooth Grows Crooked?

Wisdom teeth, also known as the third molars, are the last teeth to erupt in our mouths and, when normal, they pose no harm to our oral cavity. However, some individuals may experience the misalignment of wisdom teeth, which can range from minor discomfort to significant wear and tear on the inner cheek. Depending on the severity of the misalignment, different approaches are recommended. Let's explore what to do when wisdom teeth are misaligned.

Wisdom teeth that are misaligned may require extraction in the following situations:

1. Repeated inflammation of the surrounding soft tissue caused by the wisdom tooth.
2. Damage to neighboring teeth, leading to cavities, pulpitis, apicitis, or even resorption of the neighboring tooth roots and tooth loosening.
3. Absence of an opposing tooth, resulting in elongation of the wisdom tooth and biting into the opposing mucosal membrane or gums, causing ulceration and pain.
4. Elongation of the wisdom tooth due to the absence of an opposing tooth.
5. Severe apicitis in the wisdom tooth that cannot be treated, necessitating extraction.

In cases where wisdom teeth require extraction due to misalignment, a detailed examination is necessary to assess the difficulty of extraction and the relationship with important structures such as the inferior alveolar nerve canal and maxillary sinus. This helps to mitigate the risks associated with tooth extraction and ensure a smooth surgical procedure.

There are certain scenarios where wisdom teeth may be retained:

1. When the wisdom tooth has not yet erupted but is estimated to have sufficient space for normal eruption and has a normal occlusion relationship.
2. When there is a normal opposing tooth and the wisdom tooth has erupted in a normal position, with soft tissue covering its surface. After excision of the soft tissue, the crown of the wisdom tooth can be fully exposed and establish an occlusion relationship with the opposing tooth.
3. For wisdom teeth that are inclined towards the midline, if the angle of inclination is not significant and the roots are not fully formed, and there is a normally erupted opposing tooth, the wisdom tooth can be gently repositioned to its normal position using dental instruments, rather than extracting it.
4. When the second molar is severely decayed and needs to be extracted, if an X-ray confirms that the roots of the wisdom tooth are not fully formed, the second molar can be extracted, and the wisdom tooth can be retained to replace the missing second molar.
5. Wisdom teeth that are completely embedded within the jawbone and asymptomatic can be temporarily retained with close and regular observation.

In conclusion, the management of wisdom teeth depends on their condition and the impact they have on the oral cavity. Proper assessment and treatment are crucial to ensure oral health and comfort.