Do I Need to Have My Wisdom Teeth Removed?

Wisdom tooth removal is incredibly common, with an estimated 10 million removed each year. Until recently, the popular school of thought claimed that these teeth were inherently prone to problems, and that it was better just to get them out of the way as soon as possible. Today, however, dentists are rethinking that philosophy. Whether or not your wisdom teeth need to be removed depends on a number of individual factors.

If you are blessed with extremely good overall oral health and naturally straight teeth, you might be able to keep your wisdom teeth. In general, there is no need to remove teeth that are straight and healthy, and do not crowd your other teeth. To keep your wisdom teeth, you must be able to easily reach them for oral hygiene, and they must not affect your bite, or the way your teeth come together.

Sometimes wisdom teeth do not seem to be causing any problems, but preventive removal is still recommended. This is often the case when they do not fully emerge from the gums, push too tightly against the neighboring teeth, or grow in at an angle that makes them difficult to clean. In addition, your current level of oral health can play a role. If you are especially prone to cavities or gum disease, it is often better to remove your wisdom teeth before they become a problem. The reason is that the bones tend to harden with age. If you have issues with your wisdom teeth down the road, extraction could be more difficult or painful.

In many cases, watchful waiting is recommended, with a plan to extract the wisdom teeth only if they become a problem. Sometimes, however, issues develop that make it important to remove them right away. These include, but are not limited to:

Damage to the surrounding teeth: If X-rays show that your wisdom teeth are pushing on their neighbors, it is important to take them out. Allowing your teeth to become crowded can cause shifting, problems with your bite, and pain, and can put you at an increased risk for tooth decay.

Jaw problems: Sometimes emerging teeth cause cysts to form. Over time, these cysts can damage the jaw and the surrounding nerves. Depending on the location and severity of the cysts, your wisdom teeth may need to be removed.

Sinus trouble: Wisdom tooth problems can cause pressure on the sinuses. Depending on exactly what the issue is, you might experience chronic sinus pain and congestion. In these cases, extraction is usually the best choice.

Cavities or gum disease: If you have trouble cleaning your wisdom teeth and the surrounding gum tissue, you might experience inflammation and tooth decay. Once this sets in, extracting the teeth is often the best road to recovery.

Alignment issues: If you have had previous dental work, your wisdom teeth can undo the effects if they are not perfectly straight. Many people with braces, bridges, or partial dentures find that they do not fit as well when the wisdom teeth start coming in. As your prior dental work was deemed necessary, it is very important not to undo it. Alignment issues are a very common reason to extract otherwise healthy wisdom teeth.

While it was once a routine procedure, today, whether or not to remove your wisdom teeth is a complex decision based on a number of individual factors. Your dentist will take X-rays, perform a thorough examination, and review your current and prior dental health. If you need to have your teeth extracted, your dentist will explain why. While the decision on whether or not to go through with an extraction is always yours, you are strongly encouraged to follow your dentist’s advice. In some cases, there is no need to remove wisdom teeth, but extraction can become necessary for many reasons that might not be immediately obvious to you.