Why Are Wisdom Teeth Removed? Understanding the Necessity

Wisdom teeth, also known as third molars, are the last teeth to emerge, typically in your late teens or early twenties. It’s a common question, especially when they’re not causing any immediate discomfort: Why Are Wisdom Teeth Removed? While some individuals may keep their wisdom teeth without issues, for many, extraction becomes a necessary step in maintaining oral health. This article will delve into the reasons behind wisdom teeth removal, helping you understand why your dentist might recommend this procedure.

What are Wisdom Teeth and When Are They Okay?

Wisdom teeth are essentially the third set of molars located at the very back of your mouth. In some fortunate cases, wisdom teeth can erupt fully and function just like any other tooth. Dentists generally consider keeping wisdom teeth if they meet several criteria:

They are healthy: Free from decay and disease.
Grown in fully (erupted): They have emerged completely through the gum line.
In the right position and properly aligned (biting correctly): They don’t interfere with your bite or other teeth.
Maintainable with daily cleaning: You can effectively brush and floss them as part of your regular oral hygiene routine.

If your wisdom teeth meet these conditions, and you can easily access and clean them, removal may not be necessary. However, this scenario is becoming increasingly rare due to the evolution of the human jaw, which often doesn’t provide enough space for these latecomers.

Common Problems Caused by Wisdom Teeth

More often than not, wisdom teeth encounter obstacles during their eruption. These difficulties can lead to a variety of dental problems, making removal the most prudent course of action.

Impaction: Hidden Threats Beneath the Gums

When wisdom teeth lack sufficient space to erupt fully, they become impacted, meaning they are trapped beneath the gum line and jawbone. Impacted wisdom teeth can present several risks:

Infection: The area around an impacted wisdom tooth can become a breeding ground for bacteria, leading to painful infections.
Cyst Formation: A fluid-filled sac (cyst) can develop around the impacted tooth. Cysts can damage the roots of nearby teeth and even erode the jawbone.
Damage to Adjacent Teeth: As impacted wisdom teeth try to erupt, they can push against the roots of the second molars, causing damage, misalignment, and even resorption of the roots of adjacent teeth.

Partial Eruption: A Pathway for Bacteria

Wisdom teeth that only partially emerge through the gums create a perfect trap for bacteria. This is because:

Difficult to Clean: The location at the back of the mouth and the flap of gum tissue often covering a partially erupted wisdom tooth make thorough cleaning incredibly challenging.
Gum Disease (Pericoronitis): Food particles and bacteria can become trapped under the gum flap, leading to an infection of the surrounding gum tissue known as pericoronitis. This condition can cause pain, swelling, and difficulty opening your mouth.
Tooth Decay: Partially erupted wisdom teeth are also more susceptible to cavities. Due to their difficult-to-reach location and the gum flap, brushing and flossing effectively becomes nearly impossible, increasing the risk of decay, which often cannot be adequately treated with fillings.

Crowding: Disrupting Your Smile

Even if wisdom teeth do erupt partially or fully, they can still cause problems if there isn’t enough room in your jaw.

Pressure and Misalignment: Wisdom teeth can exert pressure on adjacent teeth, leading to crowding and shifting of your existing teeth. This can undo years of orthodontic treatment or create new alignment issues.
Damage to Nearby Teeth: The pressure from erupting wisdom teeth can damage the roots of neighboring molars.

Why Early Removal is Often Recommended

Dentists frequently recommend removing wisdom teeth in young adulthood, typically between the ages of 15 and 22, even if problems aren’t currently apparent. There are several compelling reasons for this proactive approach:

Easier Procedure and Faster Recovery: In younger patients, the roots of wisdom teeth are not yet fully formed, and the surrounding bone is less dense. This makes extraction surgery less complex and generally leads to a quicker and smoother recovery.
Prevention is Key: Removing wisdom teeth before they cause problems can prevent future pain, infection, and damage to other teeth. It’s often easier and less costly to remove them proactively than to deal with complications later in life.

Signs You Might Need Wisdom Teeth Removal

While preventative removal is common, certain symptoms clearly indicate the need for wisdom teeth extraction:

Pain in or near your wisdom teeth: This can be a sign of impaction, infection, or pressure on other teeth.
Repeated infection of soft tissue behind the lower last tooth: Recurrent pericoronitis is a strong indicator for removal.
Fluid-filled sacs (cysts): Cysts detected through dental X-rays necessitate removal to prevent further damage.
Tumors: Although rare, tumors can develop in the wisdom teeth area.
Damage to nearby teeth: Evidence of wisdom teeth harming adjacent molars.
Gum disease: Periodontal issues related to wisdom teeth.
Extensive tooth decay: Cavities in wisdom teeth that are not treatable with fillings.

Deciding whether or not to remove wisdom teeth is a personalized decision that should be made in consultation with your dentist or an oral surgeon. They can assess your specific situation, evaluate X-rays, and recommend the best course of action for your long-term oral health.

References:

Wisdom teeth. American Dental Association. http://www.mouthhealthy.org/en/az-topics/w/wisdom-teeth. Accessed Oct. 30, 2023.
Wisdom teeth management. American Association of Oral and Maxillofacial Surgeons. https://www.aaoms.org/images/uploads/pdfs/Ebook_Wisdom_Teeth_R.pdf. Accessed Oct. 30, 2023.
Management of third molar teeth. American Association of Oral and Maxillofacial Surgeons. https://www.aaoms.org/docs/govt_affairs/advocacy_white_papers/management_third_molar_white_paper.pdf. Accessed Oct. 30, 2023.
Ghaeminia H, et al. Surgical removal versus retention for the management of asymptomatic disease‐free impacted wisdom teeth. Cochrane Database of Systematic Reviews. 2020; doi:10.1002/14651858.CD003879.pub5. Accessed Oct. 30, 2023.
Should you have your wisdom teeth removed? National Library of Medicine. https://www.ncbi.nlm.nih.gov/books/NBK279590/. Accessed Oct. 30, 2023.
Ettinger KS (expert opinion). Mayo Clinic. Nov. 17, 2023.