One of the most common things that I hear from my adult patients who come in for an exam is, “I had braces as a teen and my teeth were straight. But then my wisdom teeth came in and caused my front teeth to become crowded.” This belief that wisdom teeth “push” the others forward has existed with patients as long as I have been involved with dentistry, and many patients are encouraged by their dental professionals to have their wisdom teeth (third molars) extracted to prevent future crowding. Is there any validity to this theory?
In short, current research does not support the belief that wisdom teeth cause crowding of the teeth in front of them, or “push” on them enough to cause movement. The vast majority of peer reviewed research shows that even if people have their wisdom teeth removed, teeth (especially the lower anteriors or front teeth) continue to crowd as we age. This is the case whether a person has had braces or not. Research has shown that teeth tend to drift forward throughout life, even in the absence of posterior teeth or molars.
If the wisdom teeth are not major contributors to increased dental crowding as we age, where does it come from? Current theories include late mandibular growth, or continued forward growth of the lower jaw as we grow older, and changing pressures from the tongue, lips and cheeks. Also commonly overlooked is the age that people stop wearing their retainers. Many adults remember being told by their orthodontist to wear their retainers for only several years after they had their braces removed. By the late teen years a large percentage of orthodontic patients are no longer in retention, and this is the age that the wisdom teeth first start to erupt, or become impacted (stuck below the gums). We have learned that without retention, teeth that were previously crowded will start to revert back towards their previous position (see an earlier blog about why teeth do this). Often wisdom tooth issues that arise at this age are mistakenly blamed, or correlated with the crowding that occurs during these years after retention is stopped.
The take home message, and current standard of care, is that wisdom teeth should not be extracted to decrease the chances of future crowding. There are a number of other reasons that may indicate the need for extracting these teeth, including the inability to properly clean these teeth, tooth decay, pericoronitis (inflammation of the gingiva around partially erupted third molars), and impacted positions that may cause damage to the surrounding jaw structures. Each person is an individual, and the decision to extract the third molars should be discussed with your dentist, orthodontist, or oral surgeon.
Dr. Dan Rejman is the owner of Meadows Orthodontics in Castle Rock, Colorado. He is a Board Certified Diplomate of the American Board of Orthodontics, and is a Councilman on the College of Diplomates of the American Board of Orthodontics, representing the Rocky Mountain and Southwest regions.