Wisdom teeth — must I get them removed?

Originally Published: August 22, 2008
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Dear Alice,

Do my wisdom theeth really need to be removed? Please explain situations in which they must be to avoid health risks. The standard operation I was told about seemed to include more "temporary" damage than what it is supposed to prevent. My parents have not had their wisdom teeth removed. They are both fine and have not had any problems. How much of a risk do I have from not have them removed and becoming one of those "crazy convicing" stories? I am 90% unconvinced. I need proof, not "off the top of doc's head" stories.

Dear Reader,

You are correct in thinking that there are plenty of people who never have problems with their wisdom teeth. Yet, these third molars are often connected with miserable dental complications. Keep in mind, wisdom teeth are the last teeth to emerge — they come in when we are in our 20s. At that point, there's often not enough room in our mouths for them.

Without space to emerge, they can become impacted or trapped below the jaw — especially among people with smaller jaws or mouths. It's when they become impacted that they can cause the most trouble. Impacted wisdom teeth are associated with gum disease, crowding, decay, and cysts. While it's hard to know if this would happen to you and there aren't exact statistics to base your decision on, the best way to get a sense of your personal risk would be to consult with a dentist or two. A dentist would perform a dental exam and x-ray. They'll ask you about your family and personal dental history as well. Through this process, dentists determine whether or not wisdom teeth are impacted or might become impacted.

Keep in mind that impacted teeth may or may not lead to complications and dentists vary in their recommendations. For instance, some dentists take a preventive tack and recommend surgically extracting wisdom teeth before they get a chance to cause any damage. Others prefer to watch the x-rays and wait for symptoms to arise before recommending surgical extraction. Some dentists will even work with patients to treat symptoms with mouthwashes, pain relievers, etc. Then, if these remedies don't work, the dentist might recommend surgical extraction as a last resort. As you can see, there's a bit of variation out there.

About your concerns regarding complications of tooth extraction… it might help you to know that the relative risk of experiencing terrible complications of extraction is not very high — especially if you follow the dentist's or oral surgeon's directions for aftercare.

You say that everyone is trying to convince you to get your wisdom teeth removed. Since some sources are more credible than others, it's important to base decisions like these on professional opinions. Has a dentist advised you to get them removed? Keep in mind you can always get a second opinion from another dentist. If you're in the market for a dentist and you're a Columbia student, you might consider looking at the Health Services website for information about some options for dental care.

It's great that you are taking active control of your dental health. Hopefully you'll be able to get more specialized advice from a trusted dentist (or two). Then, you'll be best equipped to make a solid decision.
Alice