Several years ago, the New York Times posted an article that questioned the efficacy and ‘wisdom’ of wisdom tooth removal. As it has been three years, and there appears to be little new evidence stating that wisdom tooth removal is superfluous, it is likely safe to say it is a decision that should be left to professional and patient discretion.

Wisdom teeth are an evolutionary leftover from ancestors that relied more on robust vegetation and rooty vegetables for their diets. As humans evolved and became more upright, our jaws and facial structure changed to the more crowded configuration we know today; which is why, more so than other animals, we require orthodontic adjustments and braces, as well as removal of impacted and problematic teeth. For many, wisdom teeth never present a problem and their removal is not required. Sometimes the surgery could be considered unnecessary at the time, but carried out anyway to prevent the attendant problems that frequently occur with wisdom teeth. The most common age to have wisdom teeth removed is between the ages of 17 and 21, when many young adults are beginning their careers, preparing for college, or getting ready to leave for military or civil service.

Because of the statistically significant and problematic nature of wisdom tooth impaction, this procedure is commonly recommended by dentists, orthodontists, and doctors, as well as covered by most major insurance plans, especially if the teeth are presenting a problem. However, there is a criticism of removing otherwise asymptomatic teeth in healthy adults.

Our streamlined jaws often do not have the space to accommodate wisdom teeth either, which, even if they come in flawlessly, can cause crowding and undo the work of a common adolescent and teenage rite of passage called braces. Due to the high level of importance placed on aesthetics and the attendant costs of straightening teeth, the removal of wisdom teeth may be recommended simply for preserving the current status and position of the teeth.

wisdom tooth extractionAnother major issue with wisdom teeth is hygiene. As our wisdom teeth are recessed deep in our mouths, we may be often remiss in cleaning them properly, which leaves them prone to cavities, infections, and other problems that can be very difficult to fix without extractions. This is why people who have otherwise healthy wisdom teeth and a complete set throughout much of their adult lives often have them removed either prior to or in early middle age.

My recommendation is generally that most patients will have to get them removed, simply due to the number of problems that can occur with them. However, I have also had a number of patients that are extraordinarily lucky and have had the blessing to keep all of their teeth throughout their entire lives. Still, this does not prevent memes and jokes about wisdom teeth from popping up now and again. The fate of your wisdom teeth is wholly up to circumstance.

The bottom line is that wisdom teeth generally result in more problems than benefit for most patients and the majority (at least 50%) will need to have them extracted in their lives, simply due to the nature of the wisdom tooth and its location in the mouth.

If you have impacted wisdom teeth and extraction is recommended, absolutely have them removed, as they can cause damage and even crack your other teeth, as well as displace your tooth. The procedure is very routine and common and quite safe.

I will never recommend wisdom tooth removal unless I feel it is necessary based on X-rays, examination, and the overall health of the patient’s mouth. There have been instances of complications from the procedure; however, these are rare. In most cases for removal, the case is made on the basis that any other extraction would be made, even if the tooth or teeth in question came in smoothly. Just as you would remove an incisor or other molar that was infected and damaged beyond repair, the same case goes for wisdom teeth.

If your wisdom teeth are giving you or your child significant pain or problems, please contact myself or your dentist immediately for an examination to ensure there is no impaction or other serious problem. Otherwise, enjoy and clean them as you would your other teeth, and hopefully you will enjoy them for a lifetime.