Expert: Steven C. Scherr, D.D.S. - 12/8/2005

Question
I'm 22 years old, and I recently went in for a checkup because my upper right wisdom tooth is starting to erupt.  My lower wisdom teeth were removed about 4 years ago, but both uppers remain.  At the checkup, I was informed that my companies insurance doesn't cover removal of wisdom teeth unless they are diseased (mine are not).  However, there isn't enough room for them in my mouth, and the right one aches all day.  I know problems will be caused later if I don't do something about it.

I also found out at the checkup that my #3 tooth needs an onlay (also not covered).  So, I was wondering if I could kill 2 birds with one stone, and get the #3 tooth pulled (is covered) allowing the #2 tooth to shift forward and the #1 to drop down with room to spare.  It seems like a great idea in that I'm keeping the virtually brand new tooth, and eliminating the already damaged one.

Would the teeth work in their new places?  How long would the shift take?  What complications might arrise?  I tried searching online, but I couldn't find really any evidence of this having been done before, which makes me think there must be some really obvious reason against it, but to me it seems logical, and it will cost me basically $0 instead of $2000.  

Answer
Kristin,

On the surface, it seems like a good idea.  Replace the bad tooth with the original equipment.  There is a catch though.  Teeth don't tend to shift the way one would want.  Though the desired result is possible, it is unfortunately unlikely.  It is far more likely that the #2 tooth would lean forward, and continue to block the eruption of the wisdom tooth.  The opposing teeth, and possibly additional teeth in that jaw, are likely to also drift over time.

In a best case scenario, it would take several years to accomplish the desired result.  In a worst case scenario, the strain created on the remaining teeth may accelerate the loss of additioinal teeth.

If it were me, I would do whatever is needed to save the #3 tooth.

Best wishes,

Steve