Do you have to get your wisdom teeth removed? If you are skeptical of this common practice, let’s see what the research studies have to say.
Having your wisdom teeth removed can be one of the most painful experiences of your life. Do you have to get your wisdom teeth removed? Is it really necessary to have them taken out? Some natural dentists are going against conventional wisdom–excuse the pun–and not highly encouraging their young adult patients (or their parents) to have their wisdom teeth removed….
What are wisdom teeth and why do they usually get removed?
Wisdom teeth are the third and last group of molars to grow. They are the furthest back in your mouth and usually don’t start growing until the pre-teen or early teen years.
The aging process can be cruel. For men, it involves losing hair where they want to have lots of it, and gaining it where they want none; for women of a certain age, it’s a decline in libido. But teens don’t have it any easier….
By the early- to mid-teens—when the jaw has stopped growing and the mouth already is crowded with teeth—third molars are formed. Almost everybody has what are called ‘impacted’ third molars. It’s estimated that 9 out of 10 people will develop at least one impacted wisdom tooth. This results when there’s not enough room in the mouth for the tooth to fully “erupt” out of the gums. Impacted is the term used in dental and orthodontic lingo.
By the late teens if the wisdom teeth have not been extracted, they may either be semi-impacted (or fully impacted). When impacted, do you have to get your wisdom teeth removed? Let’s see why leaving them in could be bad.
Why are impacted wisdom teeth bad?
If the wisdom teeth don’t erupt above the gum line, then they are impacted, or semi-impacted. If they are not extracted, the third molars may form horizontally. This may press against the adjacent teeth and cause problems (see below).
If you’re going to have your wisdom teeth removed, conventional wisdom (there we go again) says to have it done earlier when tooth roots aren’t fully formed, the adjacent tooth nerves aren’t as impacted (yet another pun; a more accurate term would be ‘affected’).
Up until recently it was thought that impacted wisdom teeth (again, almost everybody will grow at least one) led to overcrowding, especially the anterior (front) of the mouth. That line of thinking is increasingly being questioned. But we’ll get to that soon; there are still several potential serious health risks or negative outcomes that may arise from impacted or semi-impacted wisdom teeth:
- Overlapping roots
- Bacterial infection
- Nerve damage of adjacent teeth
- Eventual high risk of decay for impacted third molars
- Gum disease/gingivitis
Do you have to get your wisdom teeth removed? Even if there isn’t a problem?
Instead of suggesting that everybody get their wisdom teeth removed as a preventative measure, some dentists are saying that many third molar extractions are unnecessary. Wisdom tooth/teeth extraction is a serious oral surgery that may cause the same complications it’s trying to prevent. Botched surgical procedures can cause nerve damage and infection, for example.
On the flip side, traditionally-minded dentists argue that almost every wisdom tooth that’s not extracted is a ticking time bomb for serious problems down the road, such as those mentioned above.
So, do you have to get your wisdom teeth removed? Let’s see what the research says.
What does research say about wisdom teeth extraction?
Some studies have found that the preventative benefits of wisdom teeth extractions are inconclusive at best. A review of third molar extractions in The Scientific World Journal examined 12 clinical studies. The authors allege a high risk of bias was found in most of the articles, “either because the relative items assessed were inadequate or because they were unclearly described.”
One of the benefits of wisdom teeth removal, according to many advocates of the extraction process is relieving tooth crowding. (Remember, by the time the wisdom teeth come in the mouth is already on the verge of being overcrowded, much like an intro level college philosophy course.)
But the authors of the 12 clinical studies review concluded, “The third molars were not correlated with more severe anterior tooth crowding in most of the studies … third molar extraction to prevent anterior tooth crowding or post-orthodontic relapse is not justified.”
In other words, the mouth is already over-crowded so don’t blame it on the wisdom teeth and don’t yank ‘em out just to relieve overcrowding.
A Cochrane Review of third molar extractions also looked at the prophylactic (preventative) removal of impacted wisdom teeth that did not show any symptoms (pain, inflamed gums, infection, etc.) The authors noted that impacted wisdom teeth have been associated with pathological changes, such as inflammation of the gums around the tooth, root resorption, gum and bone disease, damage of the adjacent teeth, as well as the development of cysts and tumors.
With all these possible horrible health outcomes, you would think the researchers would be on board with wisdom tooth extraction, even if no symptoms are present….
But as the authors write in the review, “wisdom teeth do not always fulfill a functional role in the mouth.” And when surgical removal is carried out in older patients, “the risk of more postoperative complications, pain and discomfort increases.”
The authors claim that the number of surgical procedures could be reduced by 60% or more.
This of course is true if wisdom teeth don’t present any symptoms, in which case, the authors recommend “watchful monitoring.” The authors of the Cochrane Review of wisdom teeth removal concluded, “No evidence was found to support … removal of asymptomatic impacted wisdom teeth in adults….”
Are you a young adult researching whether or not you should have your wisdom teeth removed (or the parent of one)? If your wisdom teeth haven’t given you any problems, they might not need to be taken out. This is true even if they are at risk for fully forming horizontally instead of vertically like all your other teeth.
Unnecessarily removing wisdom teeth can lead to cavitations (abscesses) and other problems already mentioned above. If the wisdom teeth are asymptomatic go to a dentist that has the latest state of the art equipment such as radiography. Regular, outdated X-rays may not show the total picture of what’s going on below the already crowded surface. Though it may be pricey without dental insurance, make sure you go regularly to the dentist for continued monitoring of your wisdom teeth.
If your wisdom teeth, though, are causing you pain, it may be wise (last pun) to visit a holistic dentist anyway. They may be able to refer you to an oral surgeon who is skilled at preventing infection from the extraction process.
Do you have to get your wisdom teeth removed? The answer to this question really depends on your specific situation.