Questions About Wisdom Teeth

Why Remove Wisdom Teeth?

This is actually a much more complicated question than you probably realize. Since we make a living removing teeth, you would expect us to be biased in our opinion. We are, but not in the way you might automatically assume.

  • Does everyone need to have their wisdom teeth removed?
  • How do you know if your wisdom teeth will come in all the way?
  • What about those "experts" who say we should wait until problems arise to justify wisdom tooth removal?
  • Does everyone need to have their wisdom teeth removed?

No. Although it is not very common, there are people who have the space for their wisdom teeth to come in all the way. 

BUT they must come in far enough forward to be as easy to clean as the other teeth.  If not, cavities and/or gum disease will force their removal later when the surgery is generally more difficult and the time available to get it done is more scarce.

Impacted teeth

Wisdom teeth that come only partially through the gum cannot be left that way; they must be removed.  They will either cause the surrounding gum to get infected or they will quickly decay and eventually abscess.

For wisdom teeth that never come in, unfortunately, they can still cause a number of problems later in life: infection, a cyst or tumor that develops from the tissue surrounding the wisdom tooth, or even a fracture of the lower jaw from a blow to the face that might not have happened if the wisdom tooth were not there to weaken the jaw.

In adults whose impacted wisdom teeth appear to be completely covered with bone (deeply impacted in the jaw), the difficulty and risks of removing these impacted wisdom teeth will, over time, outweigh the benefits of doing so.  But...

...the issue with keeping them, is that problems can develop that may not cause symptoms until too late. These impacted teeth need to be checked regularly for developing problems (like a cyst, for example). Though uncommon, a cyst that is ignored can grow to become quite large before you ever know it is there.

How do you know if your wisdom teeth will come in all the way?

You don't, and it is often very difficult for your dentist to know.

Unless you are already missing a permanent back tooth early in life to allow space for the wisdom tooth to come in all the way and straight, most people don't generally have the room for them.  As a result of this crowding, they will end up in a variety of different positions in the jaw, often causing problems.

Here is our dilemma -   Over the many years of removing wisdom teeth from patients of all ages (12-100) and having to deal with the many problems that wisdom teeth can cause, we have come to this conclusion:

Since so few wisdom teeth come in well enough to not cause eventual problems, and since it is so much easier and less risky to remove wisdom teeth from younger patients (giving them a far better experience than they will ever have later), by the time it's realized that the wisdom teeth are not going to come in properly, that "easiest and least risky" time to remove them will have long since passed.  This statement is so important that you may want to reread it to fully understand it.

For most people, there seems to be little benefit to waiting until problems arise, requiring their removal when it is harder and riskier to do later in life.  When problems do arise, they may have already caused permanent damage to either the adjacent tooth or jawbone.

If you want to experience the fewest problems and risks with your wisdom teeth, both before and after wisdom teeth removal, and at a stage where the surgery is generally the easiest it will ever be, we have come to the conclusion that TIMING is the critical factor.

We will discuss this TIMING issue in more detail farther down on the Wisdom Teeth? page."

What about those "experts" who say we should wait until problems arise to justify wisdom tooth removal?

Recently I received a mass email from a well known publisher of "secrets" that buck established, time-tested principles.  This issue was drawn from an article written by a retired general dentist with a degree in public health who had proclaimed in a 2007 article that "prophylactic extraction of third molars (wisdom teeth) was a public health hazard".

If, instead of practicing general dentistry, the author of that article had practiced oral and maxillofacial surgery, experiencing all of the problems associated with wisdom teeth that we do over a career, I am confident his article would have been very different.

He did, however, make one point that I have to agree on: there are many possible (though uncommon) complications of wisdom tooth surgery, some of which are serious (permanent nerve injuries, jaw fracture, injury to the temporomandibular joint, for example).

His error was in concluding that we (the public) should wait until the wisdom teeth show evidence of infection or permanent damage to the jaw bone or adjacent teeth (or other problems) before removing them so as to avoid "unnecessary" surgery and it's possible risks.

What's wrong with his conclusion?

First, damage such as this won't show up until one is older, at a time when removal is much more difficult and the very risks he wanted to avoid are more likely to occur.

Second, most of the risks he was so concerned about can be greatly reduced or eliminated by the very procedure he advocates against: early prophylactic removal of the wisdom teeth. Why?

There is a brief period of time, usually in our teens (about 2-3 years in length), when removal of the growing wisdom teeth is surgically less difficult and much less risky than it may ever be later in life with regard to the complications mentioned above.

My 3-part video lecture will show you when this "ideal" time for wisdom teeth removal is, all the potential problems and risks your son / daughter will avoid by doing so(including the damage / cavities to adjacent teeth and periodontal loss of bone caused by the wisdom teeth), and why this "ideal" time only comes once in a lifetime.

The teens who will benefit most from the information on this site are those whose wisdom teeth have not yet started to come into the mouth.  (read more on "proper timing")

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