You probably hear it from oral surgeons all the time: “get your wisdom teeth out!” “Wisdom teeth will cause problems down the line like pain, infection, and damage to other teeth.” When you hear these sentiments from your dental professional, do you ask yourself, “is it really necessary?” Does every wisdom tooth HAVE to be removed? Are there situations where wisdom tooth removal is not necessary or, moreover, not recommended?
First, it is important to note that the claims made by dental professionals about wisdom teeth, oral surgeons included, are absolutely true. When left to their own devices, wisdom teeth have the potential to cause major problems in the mouth even if they are not actively causing symptoms at first (1). These issues include everything from simple discomfort, to debilitating pain, to infections, cysts, impaction, and even damage to adjacent teeth (1). Often, the size of the patients mouth and space available for wisdom teeth to erupt though the gums in the proper fashion contribute heavily to these complications, though this is not the only factor leading to the decision to remove wisdom teeth. How wisdom teeth develop can be a key factor for oral surgeons in making the decision to remove them as well.
When wisdom teeth are coming in sideways, or are potentially impacted, they need to be removed to avoid complications such as those mentioned above. To determine this, oral surgeons like Dr. Polyakov will often use a combination of traditional xrays and advanced imaging such as computerized tomography, or CT scans, to get a clear picture of exactly what is going on below the gum line. By putting years of expertise and modern technology into practice, oral surgeons can make the best possible clinical decision when it comes to the long term health of your smile.
Though these practices are best in determining to remove wisdom teeth, the question remains, “should we just go ahead and remove all wisdom teeth?” The answer is “not necessarily.” Current literature actually indicates that there is not enough evidence to warrant removal of every wisdom teeth that is not experiencing symptoms (2). In some cases, it is better to allow the wisdom teeth to develop naturally without going through the inherent risks of a surgical procedure. Decisions should be based not around just the existence of wisdom teeth themselves, but on data points such as clinical findings, risk factors associated with each individual patient, and the expertise of the oral surgeon (2).
As mentioned earlier, when evaluating the wisdom teeth during your consultation, Dr. Polyakov will use a combination of imaging, symptom history, and clinical expertise to determine if removal is warranted. Many times, if the teeth appear to be coming in straight and there is ample room for development and eruption through the gum line, there is no pain present, and there does not appear to be any crowding, shifting, or risk of damage to adjacent teeth, Dr. Polyakov will make the decision to monitor the progress of your wisdom teeth as opposed to removal, avoiding unnecessary risks associated with surgical procedures.
Though the majority of wisdom teeth ARE removed, mostly in the late teens to early twenties, it is not always necessary to undergo surgery to fix a problem that is not there. When the body naturally provides ample room in the mouth for development of the teeth, symptoms are not present, and there is little risk of infection or further damage to teeth near the third molars, there is little to no reason to remove them. Ultimately, patients should defer to the expertise and judgement of their oral surgeon to make the best decision for not just their short-term comfort, but their long-term oral health as well.
To see if you are a candidate for wisdom tooth removal, give us a call today and schedule your consultation. Dr. Polyakov and our expert team would love to evaluate your smile and get you on the path to success!
- Nunn ME, Fish MD, Garcia RI, et al. Retained asymptomatic third molars and risk for second molar pathology. J Dent Res. 2013;92(12):1095-1099.
- Ghaeminia H, Nienhuijs MEL, Toedtling V, et al. Surgical removal versus retention for the management of asymptomatic disease-free impacted wisdom teeth. Cochrane Database Syst Rev. 2020;5(5):CD003879. doi:10.1002/14651858.CD003879.pub5.
Frequently Asked Questions About Wisdom Teeth
1. Do all wisdom teeth need to be removed?
No. Not every wisdom tooth requires removal. If the teeth are developing normally, there is enough space in the mouth, and they are not causing pain or damage to surrounding teeth, your oral surgeon may recommend monitoring them rather than removing them.
2. Why do oral surgeons often recommend wisdom tooth removal?
Wisdom teeth can lead to a variety of problems, including pain, infection, impaction, cyst formation, and damage to neighboring teeth. Removing problematic wisdom teeth before complications develop can help protect your long-term oral health.
3. How does an oral surgeon determine whether wisdom teeth should be removed?
Your oral surgeon will evaluate your wisdom teeth using a combination of clinical examination, dental imaging, symptom history, and professional expertise. This comprehensive evaluation helps determine whether removal or continued observation is the best course of action.
4. What happens if wisdom teeth come in sideways?
Wisdom teeth that erupt sideways or become impacted can place pressure on nearby teeth and increase the risk of infection, pain, and other complications. In many cases, surgical removal is recommended to prevent future problems.
5. What imaging is used to evaluate wisdom teeth?
Oral surgeons often use traditional dental X-rays along with advanced imaging, such as CT scans, to obtain a detailed view of the wisdom teeth and surrounding structures before recommending treatment.
6. Can wisdom teeth stay if they are not causing pain?
Yes. If wisdom teeth are healthy, erupting properly, and not creating problems for adjacent teeth or surrounding tissues, they may simply be monitored over time with routine dental evaluations.
7. What factors make wisdom tooth removal more likely?
Removal is often recommended when wisdom teeth are impacted, growing at an improper angle, causing pain or infection, crowding other teeth, or creating a risk of damage to nearby structures.
8. At what age are wisdom teeth usually removed?
Most wisdom teeth that require extraction are removed during the late teenage years or early twenties, although treatment recommendations depend on each patient’s individual situation rather than age alone.
9. Is it better to remove wisdom teeth before they cause problems?
For many patients, removing wisdom teeth before significant complications develop can reduce the risk of pain, infection, and damage to adjacent teeth. However, every case should be evaluated individually by an oral surgeon.
10. How can I find out if I need my wisdom teeth removed?
The best way to determine whether wisdom tooth removal is necessary is to schedule a consultation with an oral surgeon. Through a thorough examination and appropriate imaging, your surgeon can recommend the treatment option that best supports your long-term oral health.
