Prophylactic removal of impacted third molars to avoid the development of a wisdom teeth cyst is not without controversy. The controversy arises over the fact that there is a low incidence and prevalence of the development of cysts and tumors around impacted teeth. As they develop in the growing jaws, teeth are encased in a sac of folllicular tissue. It is from this follicular tissue that a cyst or tumor can develop.
Types of Third Molar Cysts
The most common pathologic lesions found around impacted third molars are in descending order: dentigerous cysts, keratocystic odontogenic tumors and ameloblastomas, per a study in SpringerPlus. The incidences of such occurrence is in the range of 1 percent to about 6.7 percent. The higher incidence of 6.7 percent is found in individuals older than 50, according to the Journal of International Oral Health.
Reasons for Extraction
Third molars may need to be extracted to avoid damage to the second molars, infection or erupting only partially, creating a risk for painful inflammation called pericoronitis. However, an impacted third molar may never create a problem for the patient. It may be more prudent to monitor asymptomatic wisdom teeth rather than immediately extracting them, according to a review published by Cochrane.
Impacted Third Molars and Associated Wisdom Teeth Cyst
The surgery is usually an in-office out-patient procedure. It can be performed under local anesthesia but patients may opt for sedation or general anesthesia to limit anxiety. Because the molar is covered with gum tissue and sometimes bone, a surgical opening or flap needs to be created on the cheek side of the tooth. With a drill, bone is removed and the tooth may be split into pieces to remove it. Then the area is sutured closed. If an extremely large tumor or cyst is discovered, multiple procedures may be required, including potential jaw reconstruction.
The controversy in removal of third molars without any symptoms or pathology centers around the potential risks from the surgery. The biggest risk is numbness of the jaw or tongue. The nerves that giving feeling to the jaw and tongue are in very close proximity to the third molars. Proper radiographic analysis and surgical techniques are required to avoid damaging the nerves. Severe pain, swelling and infection are also possible complications. Limited opening and chewing ability for a period of time may be a postoperative complication for some patients. This may limit the patient's ability to brush, so it's advised to gently swish with a quality mouthwash, such as Colgate Total Advanced Health mouthwash. It kills 99 percent of germs on contact with the added benefit of no burn of alcohol.
The risks and benefits of removing third molars to avoid a wisdom teeth cyst should be fully discussed with your dentist or oral surgeon.