Wisdom teeth — Must I get them removed?

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,

It's true that there are plenty of people who never have problems with their wisdom teeth, but for some people, emerging wisdom teeth can lead to dental complications. Your wisdom teeth are the last teeth to emerge — they typically come in when we are in our 20s. At that point, there's often not enough room in our mouths for them, especially if you have a smaller mouth or jaw. With limited space, they may become impacted, which could cause a number of concerns with oral health, including gum disease, decay, cysts, and crowding. 

So, what does this mean? Without space to emerge, wisdom teeth can become impacted, or trapped below the jaw. However, even wisdom teeth that erupted normally can be a challenge. Some people find their position makes it difficult to keep them clean, which can also lead to tooth decay. 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. 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, the dentist will determine whether or not your wisdom teeth are impacted or might become impacted.

You say that everyone is trying to convince you to get your wisdom teeth removed. Has a dentist suggested that you get your wisdom teeth removed? Removal is recommended on a case-to-case basis, so the experience of those around you may not be applicable to your situation. Keep in mind that impacted teeth may or may not lead to complications and that dentists vary in their recommendations. For instance, some dentists take a preventive approach 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 them to be in a particular position or 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 an array of options when it comes to those third molars. 

About your concerns regarding complications of tooth extraction — it might help you to know that the risk of having complications after wisdom tooth removal is not very high — especially if you follow the dentist's or oral surgeon's directions for aftercare. However, knowing about these complications will allow you to be prepared if you find yourself in this situation. Some problems that may arise include dry socket, a condition that occurs when the blood clot needed for healing falls off too early, bacterial infections, or an abscess, which can be drained by your dentist. Though these complications may sound scary, they are rare outcomes that can be easily treated by your dentist with a course of antibiotics. 

It's great that you are taking charge 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.

Last updated Sep 23, 2022
Originally published Aug 22, 2008

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