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There is one burning question when it comes to your wisdom teeth: to pull or not to pull? There isn’t a blanket answer. Each person’s mouth is different, and each dentist may have a different philosophy regarding wisdom teeth removal.
The answer isn’t black and white in some situations, so we’ve taken a deep dive here to help you make the best decision possible. Always consult your dentist or oral surgeon to go over your options.
What Are Wisdom Teeth?
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Wisdom teeth are the upper and lower third molars, located at the very back of your mouth. They are also the last teeth to surface in the mouth. They were originally called wisdom teeth because they come in so late when the person is “wiser” they were as a child. Generally, they show up between 17 and 25 years of age.
Some lucky folks never get all four of these extra molars and don’t have to think about wisdom teeth removal. It is thought that there may be between 10-40% of Americans (depending on the origin of descent) that are missing at least one wisdom tooth naturally. Some people had none of their wisdom teeth grow in at all. It’s an ancient mutation that showed up thousands of years ago. At least 90% of you have at least one wisdom tooth and need to know your options for removal.
Is Wisdom Teeth Removal Necessary?
Some people have their wisdom teeth for their entire lives without ever having an issue. For others, it’s not such smooth sailing. About 85% of Americans get one or more wisdom teeth pulled at some point in their lives, typically before the age of 30. So, while wisdom teeth removal isn’t always necessary, they can cause enough problems for most people to have them removed. When it comes to protecting your oral health, regular dental cleaning and check-ups will prevent many issues and catch other problems early. X-rays are the best way to see how your wisdom teeth are doing on their way to the surface of your mouth. Your dentist will understand their trajectory and how, or if, they’ll fit into the grand scheme of your mouth.
- Wisdom teeth removal won’t be necessary if the teeth:
- Are healthy
- Grow in completely with no complications
- Positioned correctly to allow for a proper bite alignment
- Able to be cleaned fully in your daily routine and bi-yearly visits with your dentist
When Should I Have My Wisdom Teeth Removed?
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Unfortunately, the majority of people will have some sort of issue with their wisdom teeth. There are definite scenarios that will warrant a removal conversation with your dentist. Some dentists pull teeth themselves while others will refer their patient to an oral surgeon for their wisdom teeth removal cases.
Impacted Wisdom Teeth
When your wisdom teeth remain completely hidden within the gums, your dentist needs to determine if they are impacted. Impacted simply means that they are trapped within your jaw. If this happens, it can sometimes lead to infection or a cyst that can damage other teeth roots or even bone support. Impaction can also be extremely painful.
Some oral surgeons and dentists think it’s best to take impacted teeth out before the patient is 20, if possible, because it’s easier to remove them while the roots and bones of your teeth are not fully formed and therefore softer. The older we get, the bones around our teeth grow and get harder, making extraction more difficult. Recovery is also generally faster and easier when we’re young.
Partially Emerged Wisdom Teeth
Another big reason for wisdom teeth removal is if they become partially emerged. They peek through the gums but don’t fully make their way to the surface. This makes the teeth impossible to see and clean thoroughly. This scenario can make a passageway that becomes a magnet for bacteria and may lead to gum disease and oral infection. This can take a dangerous toll on your surrounding gums and be extremely painful.
Some people have a perfect amount of space in their mouth for all their teeth… until their wisdom teeth show up and there simply will not be enough room. This can crowd other teeth and lead to misalignment or even damage to other, healthy teeth. If there isn’t enough room, the wisdom teeth may erupt from the mouth at various angles, even horizontally.
Given the late arrival of wisdom teeth, many people have already had braces and are enjoying straight teeth. Crowding wisdom teeth can ruin a perfect and expensive smile and almost always leads to wisdom teeth removal.
Because wisdom teeth are positioned so far back in the mouth, they can be difficult to thoroughly brush and floss. This makes these molars very susceptible to decay. When there is significant tooth decay or gum disease around the teeth, an extraction conversation is warranted.
It’s important to pay attention to any changes in your mouth. Talk to your dentist about wisdom teeth removal if you or he find any of the following:
- Repeated infection of gums behind the lower last tooth
- Damage to nearby teeth
- Gum disease
- Extensive tooth decay
These could all be signs it might be time for your wisdom teeth to come out.
What To Expect
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Talk to your doctor about what to expect for your wisdom teeth removal appointment. You’ll want to decide on what, if any, anesthesia will be used. You may need to do pre-surgery bloodwork or tests.
There will be a specific protocol for when you have to start fasting the night before and what medications or supplements to avoid taking in the days and hours leading up to your extraction appointment. You’ll want to make sure you have someone to drive you home after your procedure.
Most procedures last about 45 minutes. Usually, your doctor will either numb your mouth or give you medication that lets you sleep during the procedure. Next, your doctor will open the gums at the desired location and remove the teeth then close the gums with stitches, if needed. After a few days, your stitches will be removed or dissolve. Most people recover in just a few days, and life goes on as normal.
You should plan for a few days off work or school just to be on the safe side. You won’t want to do a lot of talking right after, and it’s always best to rest to allow your body to heal quickly and successfully. You’ll need soft food and lots of liquids. Your doctor may prescribe pain medications above and beyond what you can get over the counter.
Sometimes the decision for wisdom teeth removal isn’t clear. It’s important to talk to your dentist or oral surgeon about the pros and cons of moving forward. The benefits associated with having your wisdom teeth extracted typically far outweigh the risks involved. Avoiding damage to your other teeth, staving off pain and infection and preventing cavities and gum disease in the back of your mouth are enough to make wisdom teeth removal appealing.
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As with anything, it’s important to know of the risks and side effects associated with the procedure. The most common side effects of wisdom teeth removal are:
- Dry socket
Dry socket happens to only 2%-5% of patients, but when it happens, it’s very uncomfortable. Luckily, it’s also easily treatable. The socket is the hole in the bone where the removed tooth used to be. After the tooth is pulled, a blood clot forms in the socket to protect the nerves and bone. Sometimes that clot can dissolve or loosen a day or two after the extraction.
When that happens, the bone and nerve underneath become exposed to food, air, and fluid. Sometimes this leads to infection and that kind of pain can last up to a week. At the first sign of pain, check your wound site.
If you see exposed bone or have unusually bad breath, call your dentist immediately. Your doctor will clean the tooth socket and fill the socket with a special dressing or paste to promote healing. Be sure to follow your doctor’s instructions to the letter to avoid dry sockets.
There are risks involved in any medical procedure that must be discussed even though the likelihood of these happening is very low. The very rare risks for wisdom teeth removal are:
- Numbness in your mouth and lips that never goes away
- An opening in your sinus cavity where the wisdom tooth was removed
The Final Decision
It’s important to make the choice you will be happiest and most comfortable with. The decision to remove wisdom teeth isn’t always clear, but we’ve given you a solid blueprint that should open the door to a conversation with your doctor.
Talk to your dentist or an oral surgeon about the position and health of your wisdom teeth and what’s best for your situation; your mouth will thank you!