Dental Injection May Interrupt Wisdom Tooth Development

Anyone who has seen The Matrix will never forget the scene involving the character played by Keanu Reeves when he has been presented with two pills.

“This is your last chance. After this, there is no turning back. You take the blue pill – the story ends, you wake up in your bed and believe whatever you want to believe. You take the red pill – you stay in Wonderland and I show you how deep the rabbit-hole goes.”

 What would you do if you were presented with two options by your Dentist: Option 1 involves allowing your wisdom teeth to grow where they may or option 2 is to receive an injection that could prevent your wisdom teeth from developing and therefore, completely eliminate the risk of developing painful wisdom tooth infections, decay, or the need for surgery to extract them.

Which would you choose?

In a recent issue of The Journal of the American Dental Association (JADA, April 2013 144(4):389-395), researchers from Tufts University School of Dental Medicine have discovered a statistically relevant association between the injection of local anesthetic given to young children and evidence of missing lower wisdom teeth.

The interesting point here is that routine dental injections typically used for dental fillings may have an effect on the wisdom teeth and may interrupt their development.

Wisdom teeth do not begin to develop, unlike all other teeth, until after birth, typically between the ages of two and six years. They continue to develop in the four back corners of the mouth until they erupt through the gums between the ages of 18-25 years.  While a small percentage of the population do not develop wisdom teeth at all, most however emerge at odd angles (“impacted”).

Since these teeth are so far back in the mouth, maintaining them in a healthy state is often very difficult for the patient and the dental team. Consequently, wisdom teeth are at a higher risk of developing decay, gum disease, infection and cysts.  For this reason, many dentists recommend surgery to remove wisdom teeth to prevent disease or infection.

A developing tooth, known as a bud, is vulnerable to injury because it has not hardened into tooth structure (“calcified”) and is covered by soft tissue. It is therefore susceptible to physical trauma, such as the tip of a dental needle when treating cavities, or possibly to changes in the chemistry of its environment caused by the local anesthetic (i.e. the anesthetic, vasoconstrictor or other ingredients such as preservatives).

In the Tufts study, 439 sites were observed and were divided into two groups. The first group included children who did not have local injection near the wisdom tooth area, and the second group did have local anesthetic injections into the bone adjacent to where a wisdom tooth would potentially grow.  In the first group, approximately 2% did not have any evidence of wisdom tooth formation which is similar to the average for the general population. Whereas the children who were injected for dental care were four times more likely to be missing a wisdom tooth later in life.

The research team continues to look in the variables that may contribute to this finding and will hopefully better understand how wisdom teeth can be stopped from developing.

There is hope that a procedure preventing wisdom tooth growth can be developed, saving patients from the pain of wisdom tooth infection and surgery to remove them.