If you are in your late teenage years or are in your twenties, there’s a decent chance you’ve already had the talk with your dentist about your wisdom teeth. They may have advised you to keep an eye on them or have recommended you visit an oral surgeon. For something so common, the whole topic can feel surprisingly confusing.
Not everyone needs their wisdom teeth removed. Some have enough room in their mouths, and these third molars come in just fine. But for a lot of us, these extra teeth cause real problems. And when they do, removal usually becomes necessary rather than optional.
So, to have a better idea, here’s when and why wisdom teeth removal is needed.
When There Just Isn’t Enough Room
This is most likely one of the most prevalent reasons that people wind up having their wisdom teeth extracted. Your mouth is full of teeth, and then these additional teeth try to fit in the back. Very often, there is just nowhere for them to go.
The teeth then become lodged. It can be trapped under the gum tissue, growing partially through the gum, or growing at unlikely angles due to being obstructed.
Dentists call these impacted wisdom teeth. These teeth remain lodged in the jaw. They may make an appearance through the gum tissue. And sometimes they grow almost sideways, pushing right into the tooth next to them.
The thing is, impacted teeth don’t just stay put. They keep trying to come in, and that creates pressure. It’s putting pressure on everything else in your jaw, and eventually, all those teeth are getting shifted around. The roots of your second molars can even be damaged.
When your dentist spots impacted wisdom teeth on an X-ray. Getting them removed by experts from Malmquist Oral and Maxillofacial Surgery before they damage your other teeth could be the best decision. The surgical procedure might seem intimidating, but it’s routine work for oral surgeons who do this every day.
When Infections Keep Coming Back
Partially erupted wisdom teeth are an infection nightmare. When a tooth only breaks partway through your gum, you are left with this pocket of gum on top of part of the root. That pocket traps food, so bacteria accumulate there, even with brushing.
Maybe you will get infected, take some antibiotics, and feel better. Then a few months later, it comes back. Infection compromises your gums as well as the bone around the mouth of the said teeth. Each time it happens, you’re losing a little more tissue, putting you at risk of the infection spreading to the mouth.
There are some people who try to keep ahead of it through careful cleaning, possibly using antibacterial mouthwash. But if you continue to have infections in addition to all that maintenance, the only solution is extraction.
When Decay Sets in, Where You Can’t Fix It
Sometimes a wisdom tooth gets a cavity, but it’s positioned so poorly that your dentist can’t fix it. Maybe it’s only halfway erupted, or it’s angled so far back that there’s no good way to get in there with a drill.
Unlike your other teeth, wisdom teeth aren’t worth saving because your other molars do all the chewing work just fine. So, when tooth decay hits a wisdom tooth that can’t be properly treated, the answer is to pull it.
Same thing if a wisdom tooth needs a root canal or some other major work. Most oral surgeons would just recommend taking it out instead of going through all that trouble for a tooth that doesn’t really matter.
When Cysts or Other Complications Develop
Sometimes cysts form around impacted wisdom teeth. These are fluid-filled sacs in your jawbone around the tooth. As they get bigger, they damage your jawbone, mess with nearby teeth, and occasionally damage nerves.
The wisdom tooth and the cyst both need to come out before you’re looking at really serious damage that could need facial and jaw reconstruction. Tumors can develop around impacted wisdom teeth, too, though that’s rare. But when it happens, there’s no question about removal.
When They’re Threatening Your Other Teeth
Your wisdom teeth might not hurt at all, but your dentist sees on an X-ray that they’re going to damage your other teeth if they stay.
Maybe the wisdom tooth is angled in a way that’s putting pressure on the roots of your second molar. Maybe it’s creating a tight spot where plaque builds up between the two teeth, setting both up for decay. Maybe the pressure is already affecting the bone around your second molars.
When that’s the case, you remove the wisdom teeth to protect the teeth you need. If they get damaged badly enough, you could lose them or need dental implants, which is a whole expensive ordeal.
When Gum Disease Takes Hold
If you develop a case of gum disease around your wisdom teeth and the normal treatment isn’t having any effect, then your dentist will usually recommend extraction as the best option. That’s because gum diseases burn away bones, and in the process, you can lose teeth. In fact, there’s even research that links it to heart problems and other health issues.
The problem with gum disease around wisdom teeth is the location. Those teeth are so far back that treating gum disease around them is tough. Deep cleanings, better brushing and flossing, and antibiotics would work great for teeth you can reach. If you can’t clean the area around your wisdom teeth well enough to stop the disease from getting worse, removing them could be the fix.
The Bottom Line
Wisdom teeth must be removed when keeping them creates more problems than removing them. If the dentist or oral surgeon recommends that the tooth be extracted, then ask them to tell you exactly what they see and what their reason is behind it. Once the reason is identified, it really isn’t that hard a decision.