One of the questions we hear most often at our clinic is: "Do I need to have my wisdom tooth removed?" The answer is not the same for everyone. Some wisdom teeth stay in the mouth for a lifetime without causing any problems, while others can damage neighbouring teeth and surrounding tissue if they are not treated in time.
What Are Wisdom Teeth?
Wisdom teeth, known medically as third molars, are the teeth at the very back of the mouth. They usually start to come through between the ages of 17 and 25. Most people have four, but some people never develop them or develop only some of them.
Because our jaws today are smaller than those of our ancestors, wisdom teeth often do not have enough room to come through. Teeth that stay fully or partly inside the bone and gum are called impacted or partially impacted wisdom teeth.
Does Every Wisdom Tooth Need to Be Removed?
No. A wisdom tooth that has fully come through, meets the opposing tooth correctly, can be cleaned and is surrounded by healthy gum does not have to be removed. Teeth that cause no symptoms and pose no risk can be monitored with regular check-ups and X-rays at intervals your dentist recommends. Partially impacted teeth, however, should be watched more closely even when they cause no symptoms.
When Should a Wisdom Tooth Be Removed?
Your dentist may recommend extraction in any of the following situations:
- Recurring gum infection (pericoronitis): Food debris and bacteria that collect under the gum flap over a partially erupted tooth can cause pain, swelling, difficulty opening the mouth and bad breath.
- Decay that cannot be treated: Because they sit at the very back and are hard to clean, wisdom teeth often decay, and a filling or root canal treatment is often not a suitable option.
- Damage to the neighbouring tooth: A wisdom tooth lying horizontally or at an angle can cause root resorption, decay or bone loss around the neighbouring tooth in front of it.
- Cysts and similar lesions: Although rare, cysts that can damage the jawbone may develop around impacted teeth.
- Orthodontic or prosthetic planning: For patients about to have braces or a prosthesis, extraction may be needed depending on the treatment plan.
Contrary to popular belief, there is no scientific proof that wisdom teeth cause crowding of the front teeth; this alone is not a reason for extraction. You can read about the real causes of crowding in our article on crooked teeth.
When Should You See a Dentist?
If you have pain at the back of your mouth, swollen gums, difficulty opening your mouth or a bad taste, we recommend an examination. If you have noticeable facial swelling, fever or difficulty swallowing, see your dentist without delay; if the swelling spreads to your neck or you have difficulty breathing, go to the nearest emergency department.
What Is the Best Time for Extraction?
If extraction is needed, it is best done at a young age, usually in the late teens or early twenties. At this stage the roots may not yet be fully formed, the bone is more flexible and healing is faster.
With age, the roots finish forming, the bone becomes harder and the procedure can become more complex. So rather than waiting "until it starts to hurt", a wisdom tooth that is expected to cause problems is usually more comfortably removed in a planned way at the right time. The decision is made after an examination and a panoramic X-ray, and where needed a 3D scan (CBCT), to assess the tooth's position and its relationship with the surrounding tissue.
Conclusion
Whether a wisdom tooth should be removed is a personal decision. A healthy wisdom tooth that causes no problems can be monitored, while infection, decay, damage to the neighbouring tooth or a cyst usually make extraction the recommended treatment. If extraction is needed, having it done at a young age and in a planned way makes the process easier.
If you have a complaint or question about your wisdom teeth, you can request an appointment through our contact page. Phone: +90 216 766 73 86 | WhatsApp: +90 505 766 73 86. You can learn more about the author, Dr. Dt. Ayse Saatman Yildiz, on her profile page.
This article is for general information only and is not medical advice. Please consult a dentist about your personal health situation.