When is it Smart to Remove Wisdom Teeth?

Some dentists are rethinking automatically extracting wisdom teeth, but in some cases, keeping your wisdom teeth just isn't that wise.

When you are born, all your baby teeth are developed and waiting below the gum to start popping through when you are about six months old.

Wisdom teeth, however, don't start to develop until you are about seven. By the time you reach puberty, they are visible on an x-ray and continue to grow until they begin to erupt through the gums between the ages of 17-21.

While they are technically called your third molars, they have been nicknamed wisdom teeth because they develop later in your life when you are more mature and have more wisdom. 

Why do we have wisdom teeth?

Thousands of years ago, our diets were very different. Wisdom teeth are believed to have developed because our diets before the agricultural age needed a little extra chewing power to digest properly. They also would have come in at a time when your other teeth were starting to show signs of wear, and your third molars would have carried you through until your death at the ripe old age of about 30.

After we started growing our own plants and raising our own animals, our diets became softer and easier to chew. Over time, our jaws have become smaller, leaving less room for wisdom teeth.

It used to be common practice to extract your third molars as a preventive measure, but now many dentists opt to wait and see if they cause any problems before they are removed.

To extract or not to extract?

As your wisdom teeth begin to push through the gums, you might experience some pressure or discomfort, just like when you were younger. At each checkup, your dentist will look for signs that they are developing properly and occasionally take x-rays to make sure they are in the right position.

If they aren't, they may need to be extracted. Here are a few reasons why your third molars may need to come out:

They are Impacted – An impacted tooth is a tooth that is blocked from coming completely out of the gum. It can be lying on its side or too close to another tooth to erupt fully. An impacted tooth can damage its neighboring teeth and damage the roots of nearby teeth, causing bone loss.

Tooth Decay – Wisdom teeth are far back in your mouth, and it can be hard to clean them well, especially if they are only partially erupted. Food can get trapped and give bacteria a place to grow and create cavities.

Infection – If a tooth has only partially come out of the gum, bacteria can get trapped and seep down into the surrounding periodontal (gum) pocket. This can cause an infection that, if not treated, can lead to bone loss, periodontal disease, pain, swelling, and jaw stiffness.

Wisdom teeth are usually extracted under local anesthesia with mild sedation or general anesthesia, depending on the situation, and you will probably need a ride to and from the office. The procedure itself is relatively straightforward and generally doesn't take long.

After your procedure, you will be given post-op instructions. Sometimes an antibiotic or pain reliever may be prescribed. A softer diet may be recommended for a few days, and you'll want to avoid citrusy or spicy food and alcohol, which can delay healing.

Drinking with a straw, smoking, or rinsing vigorously with water or mouth rinse are also discouraged because the suction created can prevent a clot from forming or pull a clot out of the socket, causing a condition called dry socket.

Dry socket can affect up to 25% of people after wisdom teeth extractions. While we don't fully understand why a dry socket happens, it can cause extreme pain. If this happens, call the office immediately.

As we continue to evolve as a species, it's not uncommon for some people to only develop one or two wisdom teeth and, in rarer cases, none at all.

If you still have wisdom teeth, rest assured we will continue to watch their growth and position. If you have any questions about wisdom teeth or their development, give us a call. We're happy to answer all your questions!