Our second molars erupt when we’re 12 or 13 and then, once we’re finally settled into having all of our permanent teeth, the third molars, commonly called the wisdom teeth, suddenly make an appearance, typically between the ages of 17 and 21. Orthodontic treatment frequently falls in the middle of these two milestones and at Hawley Orthodontics, most of our teenage patients are finished with braces or Invisalign Teen a while before their wisdom teeth come in.
Obviously, no one wants their brand new smile to get disrupted by these late-blooming molars, which is why it’s not uncommon for patients and parents to ask, “Do you need your wisdom teeth removed before braces?” or, “Will wisdom teeth mess up my braces?” and “Is it possible to have wisdom teeth and braces at the same time.” The good news is, if they aren’t causing issues, it’s rare that asymptomatic wisdom teeth are pulled before braces or Invisalign treatment or that when they erupt later, they’ll ruin your straight smile.
What are Wisdom Teeth?
As we mentioned, wisdom teeth are the third molars and they get their name because they erupt in the late teens or early 20s when we’re older and supposedly wiser. Fully-erupted wisdom teeth can be straight and healthy and while they’re not a necessity, they can be helpful for chewing. Unfortunately, this isn’t always the case and they often come in crooked, get impacted (stuck beneath the bone) or only erupt partially. When wisdom teeth are poorly positioned or fully or partially impacted, there is a chance they can lead to issues like infection, pain or excessive tooth decay.
Wisdom Teeth and Braces or Invisalign
One of the reasons wisdom teeth have gotten such a bad rap for years is that conventional wisdom (pun intended) says that when these molars erupted, they would exert pressure on the other teeth in front of them and cause lower crowding or even a relapse following successful orthodontic treatment.
More recent studies have shown the wisdom teeth don’t usually possess enough force to achieve this and when the teeth erupt, they won’t undo your results from braces or Invisalign. The fact that people often experience a change in the way their teeth fit together around the same age they get their wisdom teeth can be due to other factors, such as a natural deepening of the bite and some residual jaw growth. The best way to prevent your teeth from moving after orthodontic treatment, whether you’re keeping your wisdom teeth or not, is to wear your retainer as directed.
While it’s never too late to get your dream smile and plenty of our Omaha Invisalign and braces patients are adults, the teenage years are a really, really excellent time for treatment. Once the permanent teeth are in at age 12 or 13, we have a clear picture of the teeth, jaw and facial structure.
Since teenagers are still growing, directing the teeth and jaw into their proper positions is easier and the results can be dramatic. Therefore, we wouldn’t have patients wait until after their wisdom teeth erupted to start treatment. Instead, we always do a comprehensive exam prior to braces or Invisalign and take x-rays so we can see the positioning of all of the teeth – the wisdom teeth included.
In the unlikely event your wisdom teeth come in while you’re wearing braces or aligners and there’s a complication, such as an infection or pain, you can still get them removed. We’d coordinate with your dentist or oral surgeon to make sure your orthodontic treatment stayed on course. Now, what about older patients? Can you get braces with wisdom teeth already in place? Of course. However, in certain instances, which we’ll cover shortly, having them extracted first would be recommended.
When Should You Have Your Wisdom Teeth Removed?
There has been some debate about the merits of removing wisdom teeth as a preventative measure. It’s fairly common for wisdom teeth to be extracted before they erupt when there aren’t any complications with them in an effort to preserve oral health down the road.
While the evidence suggests that prophylactic wisdom tooth extraction won’t prevent crowding of the lower teeth, sometimes, if there’s clearly no room for wisdom teeth to erupt or the way in which they’re developing will interfere with other teeth, removing them, even when they’re not infected or painful, could be the best bet. However, usually, they can stay in place if they aren’t problematic.
At your regular dental checkups, your dentist will keep an eye on the progress of your wisdom teeth. They may refer you to an oral surgeon to have them taken out if their awkward location makes them hard to keep clean or they’re partially or fully impacted, especially if:
- The soft tissue in the area gets infected or inflamed
- You experience pain
- They consistently trap food and bacteria, causing cavities and gum disease
- The roots of impacted teeth create sinus pain or headaches
- You develop cysts or benign tumors in the jaw, which is rare
An experienced orthodontist wouldn’t just send patients off to have their wisdom teeth removed before Invisalign or braces just “in case.” However, if impacted teeth hurt or compromise your oral health before, during or after treatment, there is a good chance you’ll need to have them extracted.
Every patient is unique and as a Papillion, NE orthodontist, Dr. Hawley is an expert at evaluating smiles and developing customized treatment plans that take into account things like the eventual eruption of the wisdom teeth. This ensures results are stable and lasting.