Should I Always Remove My Wisdom Teeth

Some people think that the removal of wisdom teeth is a complete waste of time and money. Others believe that all wisdom teeth are a source of trouble and they must be removed. So, who is right? The simple answer is that not all wisdom teeth require removal; only those wisdom teeth which may cause problems in the future should be extracted.

Wisdom teeth are the final set of molars that most people get in their late teens or early twenties. These teeth can be beneficial when healthy and properly aligned, but more often than not, they require removal due to various issues.

When to get a wisdom tooth removed?

Now, we come to the next question. In what situations should wisdom teeth be removed? According to the National Health Service (NHS), wisdom teeth should be removed in case of the following clinical situations.

• Impacted Wisdom Teeth – A tooth is said to have become impacted if it is unable to erupt completely into the oral cavity. Wisdom teeth are among the most commonly impacted permanent teeth. When a wisdom tooth becomes impacted, oral hygiene maintenance in the region becomes difficult and there are higher chances of the development of cavities and gum infection problems.
  
  
• Tooth Decay – Poor position of the wisdom tooth can cause food to get stuck between the wisdom tooth and the tooth in front of it. Over time, this causes gum pain and bleeding gums as well as tooth decay that affects the adjacent tooth. If it progresses into the dental nerve of the tooth, it will require a root canal or even tooth extraction of the previously healthy and functional tooth.
  
  
• Tooth Crowding – In some cases, there is insufficient space in the jaws to ensure optimal alignment of all teeth in a jaw. As a result, when the wisdom teeth erupt, they may exert pressure on the existing teeth, resulting in teeth movement and local crowding. In these cases, wisdom teeth should be removed.
  
  
• Pericoronitis – This is a condition in which the soft tissues surrounding a partially impacted wisdom tooth become inflamed. This condition is characterised by severe pain and swelling of the affected tooth, which can persist for a few days. In severe cases, this follows with limited mouth opening and foul odour. Pericoronitis can resolve by itself, and recur over and over again. The permanent solution for this condition is to remove the impacted wisdom tooth.
  
  
• Cysts – Cysts are fluid-filled cavities which can sometimes form around the teeth and can damage the crowns or roots. Similarly, if a cyst develops around a wisdom tooth, it must be removed to prevent damage to the bone as well as the adjacent teeth.
  
  
• Cellulitis – This is a potentially serious and life-threatening condition in which infection from an impacted wisdom tooth can travel into the soft tissues of the cheeks, throat or tongue. It can cause blockage of the airways. If you have any sign of breathing difficulty while experiencing a swollen gum associated with the wisdom tooth, do contact your dentist or doctor immediately as it can be life-threatening.
  
  

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When a wisdom tooth extraction may not be necessary?

Removal of a wisdom tooth is not necessary, if:

• It is not impacted and does not cause food to get stuck around it,
• Is properly aligned and is incomplete occlusion with the opposing tooth
• It can be easily cleaned
• Healthy wisdom teeth, fully erupted and positioned correctly

What happens if you avoid wisdom tooth removal?

If your dentist has recommended the removal of one of your wisdom teeth and you continue to avoid it, then there are higher chances of development of the following problems:

• Teeth Cavities – Optimal teeth cleaning often becomes difficult around impacted or partially impacted teeth. As a result, there are higher chances of the development of teeth cavities, not only around the impacted tooth but also in the neighbouring teeth as well, which can cause long term serious problems.
  
  
• Gum Problems – As a result of the difficulty in maintaining oral hygiene around wisdom teeth, there are higher chances of the development of gum and periodontal problems. If the wisdom tooth is not removed in time, the infection can spread to the other teeth as well. Also, impacted or infected wisdom teeth can cause headaches due to the pressure they create and the inflammation they cause.
  
  
• Pericoronitis – The soft tissue surrounding the wisdom tooth may frequently get inflamed, leading to severe pain and discomfort. When this happens, the affected tooth must be removed as soon as possible.
  
  
• Tooth Crowding – In some cases, the eruption of wisdom teeth exerts pressure on the existing teeth, leading to crowding and misalignment. This situation is corrected by removing wisdom teeth and creating space for re-alignment through orthodontic treatment.

The Final Word

Not all wisdom teeth need to be removed. Instead, the decision to remove a wisdom tooth should be made after your dentist has examined the wisdom tooth position and X-rays. However, if your dentist has recommended that you remove one of your wisdom teeth, you should do so as soon as possible. Otherwise, it can lead to serious problems and complications.

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References:

1. Friedman JW. The prophylactic extraction of third molars: a public health hazard. Am J Public Health. 2007 Sep;97(9):1554-9. doi: 10.2105/AJPH.2006.100271. Epub 2007 Jul 31. PMID: 17666691; PMCID: PMC1963310.
2. Coulthard P, Bailey E, Esposito M, Furness S, Renton TF, Worthington HV. Surgical techniques for the removal of mandibular wisdom teeth. Cochrane Database of Systematic Reviews 2014, Issue 7. Art. No.: CD004345. DOI: 10.1002/14651858.CD004345.pub2. Accessed 15 July 2024.