Do Wisdom Teeth Always Need to Be Removed?

A common question with no single answer

If you're asking yourself 'do I need to get my wisdom teeth removed?', you're not alone. Wisdom teeth are the last molars to arrive, one in each back corner of the mouth. They usually show up between the late teens and early twenties, if they show up at all. Some people never develop them. Others have one, two, three or four.

For years, many people had them taken out as a matter of routine. Today, dental groups in Canada, the United States and the United Kingdom take a more case-by-case view. If a wisdom tooth is healthy, useful and easy to clean, there is often no need to remove it. If it is causing trouble, or is very likely to, removal is usually the better choice.

Do wisdom teeth need to be removed if they don't hurt?

Not necessarily. Lack of pain on its own doesn't mean a tooth is fine, and it doesn't mean the tooth must come out. Some wisdom teeth sit fully under the bone for life without causing harm. Others look quiet but are slowly causing decay on the back of the tooth in front of them, which you can't feel until it is deep.

That is why your dentist looks at more than symptoms. A clinical exam and an X-ray show the angle of the tooth, how much room there is, how close the roots are to nerves and sinuses, and whether the teeth around it are healthy.

Reasons a dentist may recommend removal

• Repeated infection of the gum flap over a partly erupted tooth, called pericoronitis, with swelling, a bad taste or pain on biting
• Decay in the wisdom tooth that can't reasonably be filled
• Decay or gum damage on the back of the neighbouring molar
• A cyst or other change around the tooth seen on an X-ray
• Food trapping and gum disease that keep coming back because the area can't be cleaned
• A tooth that is needed out of the way for other planned treatment, such as orthodontics

When keeping them is reasonable

Your dentist may suggest leaving wisdom teeth in place when they have come in fully, line up with the opposite tooth, have healthy gum around them and can be reached with a brush and floss. Teeth that are deep in the bone with no signs of disease may also be watched instead of removed, especially in older adults, where surgery can be harder.

Watching does not mean ignoring. Teeth you keep still need regular checkups, and an X-ray from time to time, because problems can start later in life.

Do I need to get my wisdom teeth removed? Signs to watch for

If you're asking yourself this, these are the signs that mean it's time to book an exam:

• Sore, puffy or bleeding gum at the very back of the mouth
• A bad taste or smell from that area that keeps returning
• Pain when you bite on your back teeth, or pain that spreads to the ear
• Trouble opening your mouth fully
• Food that always gets stuck behind your last molar

Do wisdom teeth make other teeth crooked?

Many people believe wisdom teeth push the front teeth out of line. The evidence for this is weak. Front teeth can shift slowly with age for many reasons, including normal changes in the jaw and not wearing a retainer after braces. Removing wisdom teeth only to prevent crowding is not usually advised. If straight teeth matter to you, a retainer does more to keep them in place.

Is age a factor?

Yes, in a practical way. In teens and young adults, the roots are often not fully formed and the bone is softer, so removal tends to be simpler and healing quicker. That doesn't mean everyone should have healthy teeth out early. It means that if a tooth is clearly heading for trouble, your dentist may suggest acting sooner rather than later. Each case is judged on its own.

How the decision is made

At an exam, your dentist checks the gums and teeth, takes an X-ray, and explains what they see. If removal is recommended, they will go over the reasons, the risks, what recovery looks like and other choices, including leaving the tooth for now. You'll get a written estimate before any treatment.

Simple and surgical extractions are both done at our Aurora clinic, and sedation options are available for some treatments. Complex cases may be referred, and we'll explain why. If you're in Aurora or nearby and want a second look at your wisdom teeth, call Aurora Gateway Dental Care at 289-475-5497.

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