One of the most common questions that dental patients in Singapore ask is "Do I have to remove my wisdom teeth?" Rather, it is parents asking "Does my child need to have his/her wisdom teeth removed?" Many parents in Singapore will recall that when they were growing up, they did not remove their wisdom teeth. Yet, more often than not, many kids are having their wisdom teeth removed. Did we evolve that quickly in one generation? Obviously not..
There are several possible reasons why the older generation of Singaporeans did not remove their wisdom teeth while their children now are needing wisdom teeth extractions.
1. Better life
The standard of living in Singapore has risen significantly in the past fifty years, as has been emphasized ad nauseam over the past months of SG50 celebrations. The earlier generation of Singaporeans did not have the benefit of regular dental checkups and many have had their first molar extracted due to decay, well before the wisdom teeth start to erupt at the age of 18. As such, there is sufficient space for the wisdom teeth to erupt properly and so no extraction was needed. Most teenagers in Singapore today will probably not have lost any adult teeth and when the wisdom teeth erupt, there is no space and hence the teeth become impacted ie stuck, causing food trap, infection and decay. So sometimes, a good life does have it drawbacks :-)
It has often been said that the young generation is more pampered, perhaps also due to rising economic status, and that the older generation is more stoic. There may be some truth in this but it is perhaps also the fault of the older generation as today's parents are also more doting on their children and are acutely aware of their pains and aches. When wisdom teeth erupts through the gum, it is usually painful, albeit for a short while. With greater awareness and a lower pain threshold, the young patients today may seek professional help more readily. When confronted with an erupting wisdom tooth, dentists would have to give the option of removal. The older generation may have a higher threshold before seeking professional help and sometimes, after a few weeks, the pain goes away and no surgery was done.
3. The rise of preventive dentistry
Preventive dentistry is perhaps one of the most successful public health initiative other than vaccinations. More and more Singaporeans are seeing their dentists on a regular basis. Impacted wisdom teeth are picked up even before they erupt through routine screening radiographs. Those that are likely to be impacted and potentially compromising to nerves in the jaw due to their orientation may be diagnosed early and removed to prevent future problems.
Along with preventive dentistry, orthodontics is also contributing to the higher incidence of wisdom teeth removal, especially those in the lower jaw. Orthodontists refer their patients for removal of wisdom teeth primarily for two reasons. When the wisdom teeth get in the way of their work, obstructing the proper alignment of the adjacent teeth, orthodontists will need the former to be removed. At other times, even when the wisdom teeth do not obstruct the orthodontic movement, orthodontists may refer the patients for removal of their wisdom teeth after they have completed orthodontic work for fear that the erupting wisdom teeth may push against the teeth in front and undo the hard work they did. There is no good evidence that this happens but there has been some loose correlation of relapse of orthodontic treatment when wisdom teeth erupt.
5. Mount Everest and Sir Edmund Hillary....When Sir Edmund Hillary, the first person to scale Mount Everest, was asked why he did it, his answer was "Because it is there." For some patients and dentists, that is the reason why they remove wisdom teeth, "because they are there." This should not be the case. Surgical removal of wisdom tooth, like any surgical procedure, has its risks and complications and should be undertaken only when there is a good reason for it, be it preventive or therapeutic.
The incidence of wisdom tooth surgery is definitely on the rise in SIngapore for various reasons. However, each patient's needs are different and we should not lapse into an automatic mode of removing impacted wisdom teeth simply because they are there.