Third molar- a nuisance? – of course yes, at times it has just nuisance value. I want to illustrate it with the help of this lady in her thirties. In her case, lower third molar(wisdom tooth) is missing. As a result of this the upper wisdom tooth has drifted downwards (‘supra-eruption’). You can see her dental x-ray also to see how a space has been created due to this ‘downward drifting’ betweent the wisdom tooth and the second molar lying infront of this.
Her problem is that food (particularly fibrous foodstuff) is getting impacted there in between these two molars.
She feels this food impaction is not a big issue — however, wherever food gets impacted, the teeth in its vaccinity are bound to get dental caries or periodontal problem with time.
The best option at this stage for such patients is to get the wisdom tooth removed because it is not serving any purpose lying there without its antogonist(third molar in the opposite arch!). However, i have experienced no amount of convincing can influence a patient’s mind in so far as extraction of such so-called ‘symptomless’ third molars is concerned.
However, with time the perpetual food impaction takes its toll –could be on the healthy second molar or it could be third molar. A carious cavity develops in any or both of these teeth and if left unattended leads to a situation where for either the second molar has to be extracted if the patient is not willing for root canal treatment.
I have told this lady also to get this wisdom tooth removed. But the way she looked at me when i uttered ‘extraction’ conveyed her dissent to me. It was not at all new to me!