Accidental Nip of the Wisdom Tooth Bud

Wisdom tooth buds may be vulnerable to damage in childhood dental procedures

(RxWiki News) Wisdom teeth don’t fully form until several years after other adult teeth. But the bud that eventually blooms into a full grown molar may be vulnerable to damage from childhood dental injections.

In a recent study, a team of dentists looked at back molar X-rays of a group of young children.

The dentists compared X-rays from kids who had been injected with anesthesia behind their second molar to those who did not have injections. 

The results showed that anesthesia injections increased the odds of damaging the bud that eventually forms a wisdom tooth.

"Talk to your dentist about any wisdom tooth pain."

Jerry Swee, MS, DMD, clinical professor in the department of pediatric dentistry, and Anthony R. Silvestri, DMD, clinical professor in the department of prosthodontics and operative dentistry, at the Tufts University School of Dental Medicine in Massachusetts, led an investigation into the risk of children losing the ability to develop wisdom teeth due to anesthesia injections.

The third molars, or wisdom teeth, begin as tiny buds buried beneath the gum tissue behind the second molars during early childhood. Wisdom teeth don’t typically mature into molars until later adolescence.

Routine dental work often requires an injection of anesthesia to numb the pain involved with filling a cavity. In small children, dentists often inject the gum area behind the second molar with anesthesia, where the third molar bud is buried.  

The third molar bud is smaller than the needle used for the injection, according to the authors.

For this study, researchers looked at 439 lower third molar bud areas in 220 dental patients, aged 2 to 6, for the presence of third molar buds. The researchers used X-rays to look for the buds.

Out of the 439 areas, 376 of the areas had never been injected with anesthesia. These non-injected areas were compared to 63 areas that had been injected with anesthesia.

The X-ray results showed that 1.9 percent of the areas in the kids who had never had anesthesia injections did not have third molar buds, while 7.9 percent of the kids who did have anesthesia injections had no X-ray evidence of third molar buds.

“Dentists have been giving local anesthesia to children for nearly 100 years and may have been preventing wisdom teeth from forming without even knowing it, “ Dr. Silvestri said in a press release.

The researchers concluded that anesthesia injections in the third molar area could increase the odds of not developing wisdom teeth four-fold.

"An absence of wisdom teeth of 7.9 percent versus 1.9 percent between the injection group and the non-injection group translates to a reduction of wisdom tooth formation from 98.1 percent to 92.1 percent,” said Mark Bornfeld, DDS, a practicing dentist in New York City for 37 years. 

“This falls short of a usable strategy for preventing wisdom tooth formation. However, the study does suggest a useful model for studying the effects of environmental factors on the development of embryonic tissue,” continued Dr. Bornfeld, who was not involved with this study.

This study was published in April in The Journal of the American Dental Association.

No outside funding was used for this study. No conflicts of interest were declared.

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Review Date: 
April 9, 2013