Wisdom Teeth: When Is It Wise to Remove Them?

Wisdom teeth, the third molars, are the hindmost positioned teeth. They usually erupt between 17-25 years — but can also erupt later in life or fail to erupt. For some, wisdom teeth can be healthy, while for others, they are a nuisance. Dentists remove 80% of lower wisdom teeth due to complications. Read on why you might consider removing wisdom teeth.

Key takeaways:
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    Wisdom teeth are the third molars that erupt between 17-25 years.
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    Wisdom teeth can cause complications related to space and position in the gums. They can remain partially erupted (impaction) in many.
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    While healthy wisdom teeth can help you chew, impacted wisdom teeth must be professionally monitored and extracted if necessary. A dentist is the best person to guide you on this.

Can you keep your wisdom teeth?

Some people can keep their wisdom teeth . You can retain the wisdom teeth if they are:

  • Completely healthy.
  • Fully erupted.
  • Correctly positioned and functional (biting with opposing teeth).
  • Helping with chewing foods (you have healthy and complimentary upper wisdom teeth).
  • Adequately cleanable, your toothbrush can reach the nooks and corners of the tooth.

Stanford researchers have pointed out that the human jaws are gradually shrinking in size — known as the “jaw epidemic.” Interestingly, they have highlighted that the jaw epidemic, rooted in soft diets and refined food habits, is a significant cause of increasing incidences of impacted and malaligned wisdom teeth.

Wisdom teeth complications

A tooth is said to be "impacted" if not fully erupted. As wisdom teeth are last to erupt, problems often arise due to a lack of space in the jawbone, leading to impaction-related complications.

Due to lack of space, wisdom teeth can emerge from the jaw at various angles, including horizontally. Such varying angles can impede eruption due to the overlapping root positions of the adjacent molars and lead to partially erupted wisdom teeth.

These teeth sometimes lack the force to erupt and remain beneath the gums. This leads to gum swelling, discomfort, and pain. Eighty-one percent of 20–29-year-olds suffer from pericoronitis — swelling and/or infection of the wisdom teeth.

When wisdom teeth become locked (impacted) within your jaw, they start to damage the roots of neighboring teeth. This can lead to infection and cyst formation and ultimately cause irreversible damage to the adjacent teeth, jawbone, and nerves. Once the infection spreads to the adjacent teeth, both teeth often need removal.

When a wisdom tooth has partially erupted, it is not functional. Instead, it creates an environment for germs, bacteria, and food particles to accumulate, causing a foul smell. Subsequently, poor oral hygiene follows.

A severe infection can lead to a swollen face, lymph node involvement (lymphadenopathy), and difficulty in mouth opening (trismus).

Studies show that oral bacteria from the infection site can enter the blood and cause systemic infections and diseases affecting the heart, kidneys, and other organs.

When is it necessary to pull out wisdom teeth?

Dentists often advise removing locked wisdom teeth to avoid further complications. The American Dental Association states that the removal is wisdom teeth is required if the person experiences specific changes in the region of the teeth, including:

  • Pain, continuous or intermittent.
  • Harm to adjacent teeth. The most common danger is if wisdom teeth push and misalign adjacent teeth.
  • A significantly decayed wisdom teeth (due to caries/cavity).
  • Gum swelling and pus discharge — a recurring soft tissue infection beneath the wisdom tooth can cause this.
  • Development of cysts (sacs packed with fluid) and tumors.

Most dentists recommend removing wisdom teeth if they have not fully erupted or if they have stopped erupting. Studies have affirmed these partially erupted teeth often lead to potential complications if left as it is in the mouth.

Things to consider before you take a decision:

Wisdom teeth can come with or without complications. It's best to visit a dental surgeon and discuss the prognosis of your erupting wisdom teeth to understand the appropriate treatment plan. Before making any decision, your dentist will examine your mouth and take an X-ray to diagnose any associated complications. A dentist will also guide you on whether you are the right candidate to undergo a wisdom teeth extraction.

Recommendation
If you experience any symptoms, check with a dentist. Professional cleaning, annual check-ups, and periodic X-rays can reduce your chances of suffering from a painful situation. Even if your wisdom teeth appear healthy, keeping them under constant professional monitoring is good.

Is wisdom teeth removal a complicated procedure?

Since wisdom teeth are frequently locked in bone, a surgical extraction is needed. Oral and maxillofacial surgeons (OMFS) are best equipped to do this. Dull pain and swelling can follow. Your dentist may prescribe antibiotics and painkillers to get over the discomfort.

If you get your wisdom teeth removed, follow the dentist's post-operative instructions religiously. They will help you heal faster.

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