Wisdom teeth are the enigma of the modern day patient. In the past, wisdom teeth were extracted commonly as they erupted. And although, wisdom teeth extractions can lead to permanent , long term complications, the prophylactic extraction of wisdom teeth was the norm.
Possible long term complications of wisdom tooth extractions include, permanent damage to the I.D. nerve which supplies feeling to the lip, chin and tongue. Trauma, bruising or damage of any nature to the I.D. nerve can lead to paraesthesia or completed anaesthesia of the I.D. nerve, something which is can occur in up to 3% of patients.
However, this practice changed drastically with the issuing of the NICE guidelines in 2000 which proposed clear guidelines to help dentists and oral surgeons decide whether not to extract wisdom teeth.
If a wisdom tooth has evidence of pathology, i.e. decay, infection, unrestorable caries, is a plaque trap, is causing decay on an adjacent tooth, is fractured or has internal or external resorption associated with it, then it is recommended that the wisdom tooth be extracted. If the wisdom tooth has had one serious bout of infection (requiring antibiotics) or 2 non serious bouts of infections, these are also grounds for extraction .
So there you have it! As a result of the NICE guidelines, we as dentists are seeing far more adults with troublesome wisdom teeth that are needing to be dealt with , however fewer patients are suffering from the potential long term complications of ID nerve damage!