Is it always wise to keep your wisdom teeth?   by Eveline Gan WHILE various cultures mark the coming of age differently, there is one universal indicator of maturity - our wisdom teeth.   Wisdom teeth, the molars furthest back in the mouth, usually come in any time between the ages of 17 to 30 years.   Unfortunately for me, I haven't felt any wiser since my wisdom teeth intruded into my oral cavity at 21. Rather, they've been a constant source of discomfort, stress and swollen gums.   Like more than 80 per cent of people around the world, I have one particularly bothersome lower impacted wisdom tooth which has failed to fully emerge.   Instead of erupting vertically like all good, obedient teeth ought to, it is tilted forward at an angle that impacts against my second molar.   According to Dr Leong Hon Chiew, a dental surgeon who runs his own practice, Dr H C Leong Dental Surgeon LLP, it is a common situation and unfortunately, also the most problematic.   The hard-to-reach space between the impacted wisdom tooth and the molar next to it becomes a "food trap" and a breeding ground for rotting crumbs leftover from lunch. This explains why swollen, inflamed gums are so common in such cases, said Dr Leong.   "When you start getting recurrent gum infections, it is an early warning sign that something wrong is going on around your wisdom tooth area," he said.   The worst case scenario, he warned, is that the wisdom tooth and the molar in front of it (the second molar) get so decayed, you end up losing two teeth.   The trouble with losing your second molar, he added, is that you lose 15 per cent of your biting surface. That means that crispy piece of fried chicken will be awfully harder to chew on.   Dr Leong added: "Occasionally, when you lose the lower molar, the upper one shifts down, creating an uneven biting surface and more food traps."       WHEN TO GET RID OF IT   While he does not advocate that every wisdom tooth be removed, especially for those which are deeply buried in the jaw bone, Dr Leong said the wisest thing to do when a wisdom tooth starts causing problems is to get rid of it.   Extraction of an impacted wisdom tooth typically involves a minor surgery. Dr Leong described the process - following an x-ray to determine the position of the tooth, a cut is made on the gums. The tooth is trimmed and cut into two to four pieces and taken out separately to prevent damage to the bone and surrounding tissues.   Risks of the procedure include post-surgical bleeding, bruising or damage to the inferior dental nerve, which is sometimes located near the roots of a wisdom tooth.   "The earlier you get rid of it, the better," said Dr Leong, although he agreed it this advice is often dismissed by patients.   He said his patients who remove their impacted wisdom teeth in their teens to early 20s almost never have problems with their adjacent molar.   "More than 50 per cent of those in their mid to late 30s will come in with a lot of pain and often, it is from their second molar," he said.   Wendy Khoo, 39, who finally decided to bid her impacted wisdom tooth farewell last year, wondered why she had put up with recurrent gum infections for almost a decade.   "I feared the extraction so much that I put up with on-and-off pain for so long. But if you think about it, what's half an hour of surgery compared to 10 years of discomfort? Without my wisdom tooth, I feel so much better now," she said.   Indeed, those are wise words I should heed.           This article was featured in Today June 21, 2011. http://www.todayonline.com/Health/EDC110621-0000003/Words-of-wisdom