Orthodontic treatment is recommended for correcting a wide range of issues in the orofacial system, thus contributing to the achievement of a beautiful smile. However, for it to be successful, it is important not only to have a thorough treatment plan but also to ensure the maintenance of the results after the treatment ends. But what happens when an unwanted condition threatens both the success and the maintenance of the orthodontic treatment outcome? One such issue is the presence of an impacted wisdom tooth. In fact, its presence can complicate the treatment planning and affect not only the stability of the final result but also overall oral and dental health. Wisdom teeth usually appear between the ages of 17 and 25, often when orthodontic treatment is nearing completion or has already been completed. An impacted or newly erupted wisdom tooth can exert undesirable forces on the adjacent teeth, potentially disrupting the alignment achieved through orthodontic treatment.
Potential issues that wisdom teeth cause
Wisdom teeth are the last set of molars that develop in both the upper and lower jaws. They are remnants of a time when human ancestors needed larger, stronger jaws to help consume tougher foods, including raw meat. Modern human jaws are smaller and often lack the necessary space to accommodate these teeth. As a result, wisdom teeth frequently become impacted, meaning they cannot fully emerge into the oral cavity. An impacted wisdom tooth can cause a variety of problems, as it exerts pressure on adjacent structures, leading to pain, inflammation, and other issues.
How an impacted wisdom tooth can affect orthodontic treatment
An impacted wisdom tooth can affect orthodontic treatment in several ways. First, as the wisdom tooth attempts to emerge, it can exert pressure on the adjacent teeth. This pressure may cause shifting or crowding of the teeth, potentially reversing the alignment that has been achieved or is being pursued through orthodontic treatment. Additionally, the presence of impacted wisdom teeth can alter the natural process of bone remodeling in the jaw. Bone remodeling is a critical part of orthodontic treatment, as it allows the teeth to move into their new positions. Impacted wisdom teeth can disrupt this process, leading to compromised orthodontic outcomes. Moreover, impacted wisdom teeth can cause resorption of the roots of neighboring teeth. Root resorption is a process where the body breaks down and absorbs the structure of a tooth’s root. Finally, an impacted wisdom tooth is prone to infection and inflammation, particularly if it has partially erupted and created a pocket that is difficult to clean. This inflammation, known as pericoronitis, is an infection of the tissue surrounding the tooth, which can complicate not only orthodontic treatment but also the maintenance of oral hygiene.
Management strategies
The management of impacted wisdom teeth within the context of orthodontic treatment requires a comprehensive approach. Initially, before starting orthodontic treatment, a detailed assessment of the patient’s dentition, including the wisdom teeth, is essential. This should involve radiographic imaging to evaluate the position and development of the wisdom teeth. Following this, decisions about their management must be made. One of the most critical decisions is the timing of extraction. Extracting impacted wisdom teeth before or during orthodontic treatment can prevent future complications. However, premature extraction may also result in bone loss, which could affect the outcome of the orthodontic treatment. At the same time, patients should be informed about the potential impact that an impacted wisdom tooth could have on their orthodontic treatment. This information should cover the overall influence of wisdom teeth on orthodontics, whether or not there is enough space for them to erupt. Lastly, appropriate retainers should be placed to prevent any disruption in the alignment of the teeth, even if an impacted wisdom tooth is present. Therefore, ensuring the long-term stability of the orthodontic results is crucial. Dr. Angeliki Nikolopoulou, an Invisalign orthodontist in Athens, employs a comprehensive approach to monitoring and managing wisdom teeth. This ensures not only the success and longevity of orthodontic treatment but also that patients enjoy the benefits of a healthy, beautiful smile for many years.