Get Wise about Wisdom Teeth

Do Wisdom Teeth cause crowding on your front teeth?

How many times have you heard this? Did you know this all started after a paper was written on by an orthodontist over 50 years ago?

In 1961, orthodontist Dr. Leroy Vego, published an article, “A Longitudinal Study of Mandibular Arch Perimeter” which examined the role of wisdom teeth on lower front tooth crowding. This study was run over six years with patients from ages 13 to 19. He reported that there was a significantly greater degree of crowding in patients with wisdom teeth. Dr. Vego concluded: “that the erupting lower third molar can exert a force on approximating teeth.”

wisdom teeth by age

From this statement, it was decided that lower wisdom teeth “push” the teeth in front of them as they come into the mouth, causing the front teeth to crowd. Consequently, general dentists, orthodontists, and oral surgeons recommended the extraction of wisdom teeth to prevent the recurrence of crowding after orthodontic treatment.

Later research disproves Dr Vego’s theory that wisdom teeth exert enough pressure to affect the movement of anterior teeth. Later studies tracking patients for 25 years determined that aging was also a major factor whether a patient went through orthodontic treatment or not and that teeth drift forward throughout life naturally, along with other factors. Tooth-size, tooth-shape, and original tooth-position also play a significant role in crowding.

Today, the premise no longer exists for the extraction of wisdom teeth simply to minimize future crowding of front teeth. However, timing of the removal of suspect wisdom teeth, especially impacted wisdom teeth that don’t have room to erupt properly, is still recommended no later than late teens through early 20’s. Wisdom teeth can easily cause future dental problems.

wisdom teeth crowding

What problems can occur with NOT removing impacted/retained wisdom teeth?

  • Bone and soft tissue defects behind the second molars
  • Root resorption of second molars
  • Decay due to inability to brush and floss properly
  • Crowding or shifting of posterior teeth affecting orthodontic results
  • An infection (periocornitis) that occurs around partially erupted lower third molars
  • Cysts and tumors around impacted third molars

Consequently is it generally recommended wisdom teeth be extracted before these problems develop.

At Robinson and Ries Orthodontics, we typically encourage the extraction of wisdom teeth for many patients, prior to college. As teens complete final growth, jaw bones become increasingly more dense. This may result in higher post-operative pain following wisdom tooth removal, especially after the roots of the third molars are fully developed. Typically, after the age of 25, wisdom teeth are not extracted and simply monitored by your general dentist with routine periodic x-rays to address any cause for concern.

Dr. Scott Robinson and Dr. Dave Ries monitor third molar development throughout treatment and will make recommendations when appropriate based on individual circumstances. Feel free to contact our office or leave a comment below regarding more information about the extraction of wisdom teeth. We look forward to your questions, comments, or feedback.


Retention is Forever

The day you get to say bye to your braces is an exciting day. You get to see that new beautiful smile you have been waiting and working for. However, this doesn’t mean your orthodontic care is complete. Maintaining your smile is just as important as creating it.

retentionIt has been the experience of orthodontists that about 95% of the correction will be retained.  If we could put the teeth on a shelf and let them stay there, they would remain perfectly straight.  This, of course, is not possible and because of the chewing forces at work, the teeth will need to make some adaptive changes in order to function best.  We cannot expect them to stay exactly as we placed them.  This is not a failure of the correction, but nature’s changes that we learn to expect, just as we learn to expect changes in other parts of our body as we grow older.

A common question we get is “how long do I have to wear my retainer?” When your braces are removed, they must be retained to their new position. You will typically be given two retainers: a removable upper retainer and sometimes a permanent lower retainer that is glued to your teeth.

It is imperative to wear your retainers as directed or the teeth may begin to shift. For some teeth, it only takes days to begin shifting back to their original position, especially within the first year of removing your braces. We suggest wearing your retainer day and night for the first six months after braces, then nights only. However, that amount of time depends on the patient.

Now that we understand that teeth are unstable and unpredictable, it is logical to say that lifetime retention is the best way to maintain straight teeth and a beautiful smile. If you feel your retainers aren’t fitting correctly or may need adjustment, call our office immediately. You have worked hard to get your new smile. We hope you are as proud of it as we are!

Staff Spotlight: Lexi

Alexis (Lexi) Wren is our bubbly, upbeat orthodontic assistant who is rarely seen without a smile. She currently lives in Ashland with her husband Kyle and two adorable boxers.Lexi, Kyle and their boxers

Lexi grew up in Hartsburg as an only child and attended Moberly Area Community College. She wanted to work in orthodontics to make a difference in people’s lives. She says, “A smile changes your attitude, the way you feel, everything! It’s worth a million bucks!”

As an orthodontic assistant, Lexi has many duties around the office. She is usually with patients working on their braces and Invisalign. She also is a CPR instructor at Robinson and Ries for people from other dental/orthodontics offices.

She said her favorite thing about working at Robinson and Ries is the atmosphere and co-workers. “I really do love and care for each of my co-workers as family,” Lexi says. “We are always having fun and joking around with each other!”

In her free time, Lexi enjoys spending time with her family and friends. Her and Kyle love DIY projects around the house. They started a large vegetable garden and multiple flower gardens this past spring. They even made their own coffee table out of pallets!

Next time you see Lexi, be sure to ask her to show you her special talent… she can do the wave with her eyebrows. Needless to say, Lexi is a woman of many talents!

Thumbs Down to Thumb Sucking

Thumb sucking seems to be natural for infants and toddlers. Kids do this as a comforting measure and to self soothe, but parents need to pay close attention to this habit.

Thumb sucking, finger sucking or the use of a pacifier puts unnecessary pressure on the teeth, as well as the bone and soft tissues of the mouth. It can be an easy habit to stop before any damage is done. Most children will stop sucking their thumbs on their own and using pacifiers by the ages of 2 – 4. However, doing this beyond a certain age can lead to significant damage. Dr. Ries says, “If severe enough, there will be a need for early orthodontic intervention, which is timely and costly.”

According to American Dental Association, parents should do whatever is necessary to prevent their child from developing a finger or thumb sucking habit, even if that means encouraging a pacifier habit for a while. The reason for this is that when the child is 2 to 3 years old the pacifier can be thrown away and the habit stopped, it’s very difficult to stop a finger or thumb habit, so it’s best to avoid them.

The intensity of thumb sucking is a factor that determines whether or not dental problems may occur.  Vigorous thumb suckers will have more dental problems.   This may lead to improper alignment and mouth and jaw growth. It can even affect the shape of the face if not stopped early enough. Specifically, this can lead to protrusive upper front teeth, tipped back lower front teeth, open bite and cross bite.

Fortunately, there are strategies to resolve thumb sucking. Dr. Ries says he has two approaches for fixing this problem: a carrot and stick approach. A carrot approach is using an incentive to help the child break the habit. You can reward them with something they want when they don’t do thumb sucking for a certain amount of time. The stick approach is using something to deter the finger sucking habit. For example, he suggests using a sock on their hands while they sleep to keep them from sucking their thumbs. Also, Mavala Stop that has showed success, which is a bitter-tasting lotion that is put on the hands and nails.

Some other tips to help break the habit are:

  • Don’t pressure your child to stop, this can reinforce the habit
  • Talk to them about the reasons and ways to work together to stop the habit
  • Don’t punish your child when they do suck their thumb
  • Remind your child of his/her habit by bandaging the thumb
This patient of ours sucked her thumb as a young child. She started treatment at age 13. She had braces and a special appliance — called a crib — to retrain the tongue, for 28 months. Now she can bite the lettuce out of a sandwich.

This patient of ours sucked her thumb as a young child. She started treatment at age 13. She had braces and a special appliance — called a crib — to retrain the tongue, for 28 months. Now she can bite the lettuce out of a sandwich.

You want the best for your child, which means a healthy teeth and a pleasing smile. If you are not able to help your child with this, contact our orthodontists for suggestions. There are options for us to help break the thumb sucking habit as well as correcting any damage already done.