SHOULD YOU HAVE YOUR WISDOM TEETH REMOVED?
Wisdom teeth are the molar teeth in the very back of your upper and lower jaws. They are also known as third molars. A few people are born without wisdom teeth. Many people have enough room in their mouths for the teeth to come in, but some do not. Therefore, some of us get our wisdom teeth taken out as teenagers or young adults.
Often, the first sign that something is wrong is when an X-ray shows that one or more of the wisdom teeth can't come in all the way. Sometimes this leads to symptoms such as infection, pain or other teeth changing position. Part of the wisdom tooth may be covered by a flap of gum. Bits of food and bacteria can get trapped under the flap. This can cause swelling and a low-grade infection called pericoronitis. Infection, and the pain it causes, are the most common reasons people need wisdom teeth taken out.
There are other reasons to have your wisdom teeth removed. In many people, the teeth are blocked from coming in, usually by bone or other teeth. Sometimes the teeth are tilted under the gum or jawbone. Dentists call these "impacted" teeth. They may cause pain, but not always. You may feel nothing at all for years. But problems may occur later.
Regular dental visits are important during your teens and early 20s. If you visit your dentist regularly, he or she can use X-rays to follow the progress of your wisdom teeth to identify problems early.
HOW CAN YOU KNOW IF YOUR WISDOM TEETH REALLY NEED TO COME OUT?
The American Dental Association says wisdom teeth may need to be removed if you have changes or problems in your mouth such as:
- Pain
- Infection
- Cysts
- Tumors
- Damage to nearby teeth
- Gum disease
- Tooth decay (if a filling or crown won't fix the problem)
Wisdom teeth also may need to come out if your mouth doesn't have room for all your teeth. Then you may get braces to adjust the spacing of the other teeth.
The American Association of Oral and Maxillofacial Surgeons advises that if wisdom teeth are associated with these problems or are at high risk for developing problems; they should be removed. If there is no risk of developing a problem, then it should be sufficient to have regular examinations and x-rays to monitor the third molars.
The most common problems that can occur with impacted wisdom teeth are decay, infection and crowding or damage to other teeth. Teeth next to the wisdom teeth are more prone to developing gum problems. Cysts (fluid-filled growths) are much less likely to occur. But if they do, they can grow and cause permanent damage to bone, teeth and nerves.
HOW SHOULD YOU DECIDE?
If you don't have any of these issues, your dentist will assess your risk of developing them if your wisdom teeth remain in place. Your dentist also will consider the risks of removing the teeth. These risks include:
- Infection
- Bleeding
- Dry socket (the blood clot in the socket dissolves before healing is complete)
- Nerve injury that affects the sense of taste and/or feeling in the lower lip, chin and tongue
- Difficulty in opening the jaw for a long period of time
- Potential damage to adjacent teeth
- Compromised overall health status
In addition, reasons for retaining wisdom teeth are:
- Adequate jaw space for eruption of the wisdom tooth into the mouth
- Patients greater than 30 years of age with no symptoms
- Wisdom teeth that can be used as an anchor for replacement of other missing teeth
- Erupted wisdom teeth in the mouth that are in proper occlusion (bite).
If there's a strong chance that the teeth will cause problems, it's easier to take them out when you're young. That's because the roots of the teeth are not fully developed yet, and the bone around the teeth is less dense. Younger people heal faster than older people. They also are less likely to have problems after surgery or miss essential time from work or school. As you age, it will take longer to recover from the surgery. If wisdom teeth need to be removed, it should be done before age 25 if possible.
Last updated June 30, 2021
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