When Wisdom Teeth Meet Orthodontics: Clearing Some Common Doubts

Wisdom teeth don't have to be an obstacle to finishing your orthodontic treatment.

We’re sure you’ve heard of annoying wisdom teeth. We also know you’ve already listened that orthodontics serves to model your smile so that you can have better oral health.

Indeed you are intrigued to know if the result of your orthodontic treatment can be affected when your wisdom teeth come in or if it is best to extract them before starting modeling a functional, beautiful smile.

So, to begin clearing your doubts, first, wisdom teeth “serve no function at all” and, therefore, they are not necessary for you to chew your food. Also, wisdom teeth are the last teeth to erupt and reach their stage of root growth when the patient is between 17 and 25 years of age; a little late, right?

In fact, all these issues have to do with a theory of development in humans. As humans evolved, we needed fewer teeth to triturate foods that were softer than the foods that early humans used to consume. That is why some patients don’t have wisdom teeth at all.

Unfortunately, in many cases, wisdom teeth eruption coincides with a clinical recommendation to start or during orthodontic treatment, generating concern about the effectiveness of treatment and an assortment of worrying questions.

This article will guide you through a far less torturous journey than you can imagine. We know there are a lot of questions out there, and luckily, we have a lot of answers for you about wisdom teeth removal and orthodontics. So, with no further introduction, let’s get rolling!

At What Age Do Wisdom Teeth Come In?

Wisdom teeth start their development at approximately age nine. They grow inside the bone in a soft tissue sac covering the tooth.

By the age of fourteen, the first root development ends and starts the second root development, slowly producing an outwards displacement of the tooth.

At age sixteen, in the transition to adulthood, the three fully developed roots push the tooth that shifts its position towards the gum tissue and, in most cases, reach full development and tooth sprouting by age eighteen.

However, for every rule, some exceptions account for cases where adult teeth erupt later or develop but don’t sprout and remain inside the gum and bone or erupt partially.

In many of these scenarios, wisdom teeth come angled towards functional nearby teeth or second molar. These cases are a significant concern as they can negatively affect an orthodontic treatment outcome and deteriorate a patient’s dental health.

What Are Impacted Wisdom Teeth?

Problems with wisdom teeth can arise when there is insufficient space for them to erupt, producing a malposition. When your orthodontist tells you that you have impacted third molars (wisdom teeth), that means that they are in the bone or under the gum or have not erupted appropriately (malposition).

Malpositioned and problematic wisdom teeth can get infected, causing pain, swelling, and jaw stiffness. It can also damage the roots of neighboring second molars or destroy the surrounding bone.

Your orthodontist may suggest removing your wisdom permanent teeth if they cause problems or are likely to. He may also recommend removing wisdom teeth before or during orthodontic treatment when they might cause tooth decay, gum disease, damage to adjacent teeth, or to improve your oral hygiene.

Partially Erupted Wisdom Teeth

A wisdom tooth that partially erupts malpositioned can cause pericoronitis. This gum infection surrounds the wisdom tooth, with symptoms including pain, inflammation, bleeding, and bad breath.

Also, partially erupted malpositioned wisdom teeth form spaces that make it difficult for patients to floss and clean between the second and third molars, causing food to get stuck.

As foods get trapped between teeth and the gums covering the partially erupted wisdom tooth, it starts a cycle for bacteria to grow, tartar formation, and cavities to penetrate the teeth.

In addition, if your oral surgeon does not extract the wisdom tooth in the opposite arch, it will slowly extrude, seeking contact with its opposite counterpart, and causing unwanted gum inflammation.

Wisdom Teeth in Horizontal Position

If the wisdom tooth is in a horizontal position, it can come into contact with the second molar, causing damage that can invade the pulp area, which can even end with a patient losing both teeth.

An impacted wisdom tooth, malpositioned in a horizontal direction, may remain under the gum, and you might not see it when you open your mouth. You might not even know it’s there until you get an X-ray.

However, in all cases, before starting orthodontic treatment, a specialist will recommend you to get an X-ray to assess whether it is necessary to extract your wisdom teeth for prevention or to create space for the displacement of functional teeth and their alignment.

Should I Get Braces Before or After Wisdom Teeth Removal?

You can get braces before, during, or after wisdom teeth removal. Consequently, it is not always necessary to remove wisdom teeth before orthodontic treatment. Likewise, removing wisdom teeth to start orthodontic treatment is not a general rule.

However, in exceptional circumstances removing dental pieces followed by orthodontic treatment produce impressive results by leaving space to mode crooked teeth. 

In most cases, an orthodontist might recommend the extraction of the upper wisdom teeth. However, lower wisdom teeth often no longer have a counterpart to make contact with (occlusion). Consequently, the orthodontist suggests extracting the lower wisdom teeth as well.

In addition, wisdom teeth serve no function at all. In many cases, wisdom teeth produce complications such as cavities, periodontal problems, infections, and pain. You can even lose other teeth when wisdom teeth become infected or impacted, damaging the second molars.

So, if your orthodontist recommends you extract your wisdom teeth, you can rest assured that it is in your best interest to prevent potential damage to other teeth, and also you will get a beautiful and functional smile.

When Are Wisdom Teeth Removed for Orthodontic Treatment?

Your orthodontist might recommend removing upper wisdom teeth to create space for other teeth and facilitate alignment in type 2 malocclusion cases.

Moreover, type 3 malocclusions require detailed attention to enhance functionality by reshaping the lower arch and sometimes extracting lower wisdom teeth.

Aligning teeth is the most straightforward task in orthodontics, but achieving a perfectly functional bite is a complex process.

Can I Wear Braces While Having Wisdom Teeth?

Yes, you can wear braces while having wisdom teeth. But, as you might remember, your orthodontist not only evaluates how to model crooked teeth but also your overall oral health condition before starting your treatment.

First, your orthodontist will derive you to a periodontist to examine your gums condition and bone structure. You might also need to visit a dentist who will evaluate and curate any trace of cavities formation.

With the assistance of a hygienist, they will clear up plaque and revise your X-rays to help determine if you require a preventive wisdom teeth extraction. However, if no extraction is required, and there is no need to create space for other teeth displacements, you will be good to start your orthodontic treatment with no single wisdom tooth extraction.

Your orthodontist might also cement brackets on your fully sprouted wisdom teeth. So, getting back to early adulthood and the questions about wisdom teeth removal, impacted wisdom teeth, wisdom teeth pain, and when do wisdom teeth come in? You now know that you might need to get them extracted when:

  • You have impacted, and problematic wisdom teeth;
  • You have impacted wisdom teeth, and you want to get them removed for prevention;
  • Your orthodontist recommends an extraction before starting an orthodontic treatment;

You also know that sometimes wisdom teeth cause no oral health problems, and you don’t need to get them extracted before orthodontic treatment.

Can I Have Wisdom Teeth Removed While Wearing Braces?

Yes, you can have wisdom teeth removed while wearing braces. But, your orthodontist can first remove the brackets from your wisdom teeth and detach the wires. If you don’t have brackets cemented on your wisdom teeth, your orthodontist will immediately refer you to an oral surgeon.

Wisdom Teeth Extraction

To remove a wisdom tooth that has not erupted, a maxillofacial surgeon makes an incision, releases the bone that covers it, and then extracts the tooth.

As a complementary measure, the surgeon can place rich in growth factors plasma in the alveolus to accelerate healing and proceed to suture. This will help you recover promptly and resume your orthodontic treatment.

Get an Orthodontic Diagnostic That Includes a Check-up of Your Wisdom Teeth

At Hong Orthodontics, you will have no more intrigues and concerns about wisdom teeth and orthodontics. We will ensure you have no doubts, giving you straightforward information about the most advanced orthodontic treatment options. Patients of all ages can choose from traditional metal braces, clear ceramic braces, and Invisalign clear aligner trays. So make an appointment and start enjoying a beautiful and lifelong smile.