Should Wisdom Teeth Be Removed?
As a dentist, I love helping my patients make informed decisions about their dental health. One of the most common questions I hear, especially from teenagers, young adults, and their parents are about wisdom teeth. Many people wonder if their wisdom teeth really need to be removed or if it’s OK to leave them alone.
It’s a great question and one that’s up for some debate in the dental community. In today’s post, I’ll help you understand what wisdom teeth are, as well as share my opinions on whether it’s OK to have your wisdom teeth removed.
What are Wisdom Teeth?
After you finish losing all of your baby teeth, you’ll likely have 28 teeth, including 8 adult molars, 4 on each side of your mouth. However, as you enter your teens or early adulthood, you’ll probably start to notice the appearance of 4 more molars at the very back of your mouth. These are your wisdom teeth. Their name comes from the fact that they start to appear as you leave childhood and become “wiser”.
Wisdom teeth aren’t like other teeth. You’ll only have one set of them for your entire life! This is because many thousands of years ago, early humans were very likely to lose teeth during their lives-- either from decay or injury. So having a backup set of molars that appeared a bit later on in life was very useful.
Today, thanks to advances in modern health care and dental technology, wisdom teeth aren’t really necessary. Plus today, our diets include less tough, fibrous vegetables and meat, meaning our teeth don’t wear as fast as our ancestors’ teeth did. Additionally, early humans had much larger skulls than we have today. This means that many people simply don’t have room in their mouth for these extra teeth!
Did you know that as many as 25% of all Americans don’t have wisdom teeth at all? It’s a genetic quirk and one that might give us a glimpse into the future of human evolution!
Should Your Wisdom Teeth Be Removed?
Like many health questions, the answer is: “maybe.” Every person is different and there’s no one size fits all answer for everyone when it comes to wisdom teeth.
Children & Teens
I begin monitoring my patients’ wisdom teeth as they begin to enter their teenage years. I use x-rays to visualize the wisdom teeth before they actually begin to erupt through the gums. Here’s what I look for and the questions I ask myself:
Does the patient have good brushing habits? If a patient doesn’t have great oral hygiene or is developing many cavities, I will usually recommend removing the wisdom teeth, simply to prevent unnecessary decay on a few more, hard-to-clean teeth, which can lead to more serious problems further down the road.
Is the wisdom tooth developing to come in a normal direction? If not, it’s better to have the tooth removed to prevent problems with the tooth or the gums.
Will the wisdom teeth cause crowding in the jaw? If so, they should be removed as they can change the alignment and structure of the rest of the teeth in the mouth!
Many people don’t realize this, but there’s a great reason to have wisdom teeth removed when you’re younger: it’s just plain easier and less complicated.
Often, the hardest part about removing wisdom teeth is working with the curved roots of the tooth. In teenagers, the wisdom tooth root is not fully formed, so it’s much shorter and straighter than it will be when it’s fully developed. This makes removing the tooth that much easier. Plus most teenagers are healthy, and tend to heal quickly with very few complications!
When I see a new adult patient and they still have their wisdom teeth, I evaluate their need for wisdom tooth extraction on a case-by-case basis. Are the gums surrounding the teeth healthy? Are the teeth easily accessible for brushing and flossing? Are there cavities present? Does the tooth contribute to chewing ability?
Another consideration for the adult patient is their overall health. Generally speaking, as we get older we tend to have more health problems, which can affect how quickly we heal from an extraction if a tooth does need to be removed. This can affect the decisions we make with regards to our health and the medical procedures we choose.
For example, people with diabetes do not heal as well and are more prone to infection following the removal of their wisdom teeth. People with certain cardiac problems may need sedation for extractions to minimize the stress associated with this procedure, as stressful situations could exacerbate their heart conditions. Individuals on blood thinners might need special coordination with their physician prior to a procedure like an extraction. Removing a wisdom tooth might be the right decision for patients with these health conditions, but taking health into consideration is extremely important so appropriate precautions are taken when planning the procedure, and for post-operative care.
So if you’re an adult who never had your wisdom teeth removed, don’t rush into making a decision, but seriously think about it if you are still in good health - you never know what the future holds health-wise! Work with your dentist and make sure he or she understands your health history and all of your current medications. Together you can make an informed decision that will minimize complications and help you to achieve a healthy, happy mouth!
What About Impacted Wisdom Teeth?
You may have heard about impacted wisdom teeth. These are teeth that form but remain “stuck” in the jawbone and never grow into your mouth. It used to be that many dentists would leave impacted wisdom teeth in place, believing that they didn’t cause any harm.
However, this isn’t necessarily true. Impacted wisdom teeth, especially lower ones, can cause serious problems! These impacted wisdom teeth often affect the health and alignment of the neighboring healthy molars. Your otherwise healthy teeth might end up requiring extensive treatment (or even complete removal) that could’ve been avoided if you’d just had your wisdom teeth taken out.
Above: You can see how an impacted wisdom tooth is crowding and contributing to decay on the neighboring molar.
Plus, impacted wisdom teeth can also cause pretty serious gum infections and cysts - they can even develop cavities!
Is Wisdom Tooth Removal a Big Deal?
For most healthy teens and adults, wisdom tooth extraction is a relatively simple procedure with very few complications. Modern anesthesia and sedation techniques have essentially eliminated the painful extractions that were common as recently as 20-30 years ago. In most cases, if you have your wisdom teeth removed you might have a day or two of discomfort then you’ll be back to normal!
Do you still have your wisdom teeth? No matter your age, I’d love to help you make the decision that’s right for you and your health. Call my office at (540) 298-6696 or contact us online to schedule an appointment where we can talk about the advantages of wisdom tooth removal and review any concerns you might have.