More than Wisdom in those Wisdom Teeth

NEW YORK — Young adults in their 20s and 30s who can’t part with their third molars (a.k.a., wisdom teeth) may be at risk for chronic oral inflammation, increasing the risk of inflammation in other areas of the body as well.

That’s according to a long-term study presented this week at the opening of the American Association of Oral and Maxillofacial Surgeons annual meeting in Boston.

This study shows that the wisdom teeth are “an area of potential chronic inflammation with little continuing observation or actually early recognition,” Dr. Robert S. Glickman from New York University College of Dentistry who was not affiliated with the study told Reuters Health.

“Everyone should know the status of their third molars,” he said. “It doesn’t necessarily mean that they should come out at that time, or ever, but because there is this potential for early inflammation to start and obviously that can have long-term health consequences — most dramatically, in pregnant women who deliver preterm babies.”

The primary health concern with wisdom teeth is infection, just like with the other teeth, Glickman explained. However, because of the unique location — in the back of the jaws — infection in the third molar region can spread down the neck in the lower jaw to the sinuses or up the neck from the upper jaw to the brain.

While many prior studies have linked periodontal, or gum disease, with systemic effects in older populations, the current study called the Third Molar Clinical Trial is unique in that it takes a look at the risks posed by keeping the wisdom teeth in a younger population.

In the ongoing trial, a team of dentists led by Dr. Raymond P. White, Jr., of the University of North Carolina, Chapel Hill, are tracking the health of the tissues supporting the teeth throughout the mouth, including the third molars, in more than 300 healthy subjects between the ages of 14 and 45, who at the outset had four, symptom-free third molars. The researchers have just completed the seventh year of the study.

Unexpectedly, they found that roughly 25 percent of these young adults with “healthy” wisdom teeth had considerable periodontal disease in this region. This finding flies in the face of national epidemiologic surveys that suggest a much lower rate of oral inflammation in people under age 35. The researchers had expected to find a rate of only about 10 percent in this young study set.

Additionally, the results suggest that third molars that have broken through the tissue and erupted in a normal, upright position are just as likely to exhibit inflammation as those that remain impacted or buried.

Glickman’s advice: “If your wisdom teeth are not in, you want someone to tell you where they are and what position they are in. If they are in or if they are impacted, you want someone to examine the tissues on a regular basis.”

“You’re not necessarily going to see infection or pain,” he added, but the dentist could spot “inflammatory events that could have long-term health consequences.”

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