Why Do We Take Out Wisdom Teeth? (Third molars)

Published on August 26, 2014 by Joe Jankowski DMD

     Some people consider getting their 3rd molars or better known as wisdom teeth out as a right of passage going into adulthood.  Today we are finding out that may not always be the case and a multitude of factors go into a dentist and patient deciding to get their wisdom teeth removed.  A lot of us wonder why do people have so many problems with their wisdom teeth?  What other body part is routinely removed?  Maybe tonsils and the appendix but those are  not our specialty.

     Anthropologists have studied humans and due to evolution our jaws have gotten smaller and not all of us have the proper space for our 3rd set of molars.  This results in a variety of conditions that result from the lack of space.

     Wisdom teeth usually erupt in most people in their late teens to early twenties.  When we have adequate space, healthy gingiva and properly aligned teeth they can be a valuable asset. The problem is they usually don't have enough room which is referred to as impacted and usually require removal.  When the teeth are impacted this can lead to multiple complications such as: infection, damage to the adjacent teeth, formation of a cyst and most commonly pericoronitis.  When the teeth are partially erupted they are more difficult to keep clean resulting in decay on the tooth and the second molar also leading  to periodontal problems resulting in bone loss and ultimately infection/abscess.  Also when the teeth are fully impacted cysts can form around the root of the tooth leading to further bone loss and damage to the surrounding nerve and teeth.  Usually though when a wisdom tooth becomes partially erupted the flap of gingival tissue called an operculum can get food under it and it becomes inflamed and this condition is called pericoronitis and if it persists is the main acute condition that motivates people to get their wisdom teeth out.

Ultimately I feel if the wisdom teeth come in completely, straight, functional without pain and the patient is able to keep them clean they may not need to be taken out.  I also like to state that if things change later in life the condition can change and then they can give the patient problems leading to removal.  I feel its hard to criticize other dentists opinion whether a wisdom tooth will give the patient a problem later in life and need extraction. Sometimes the wisdom tooth may be appear that it may or may not give the patient a problem in the future but there are circumstances where it should be left alone due to its proximity to nerves or the sinus where the possible side effects outweigh the benefits.  That is why we have informed consent.  So that patients and their dentist can discuss these factors so patients can make the right decision. That is why most dentists caution on the safe side and get the teeth out at an early age when the roots haven't fully formed, the bone is softer, and the patient recovers quicker.  I welcome anyone with questions to contact us and we can evaluate your wisdom teeth and give you a recommendation!