Oral Care

Wisdom teeth: Is it time to remove them?


March 8, 2023

The trouble with wisdom teeth and why and when they typically need to come out

Wisdom teeth are the third set of molars to grow in. They get their common name from being the last set of our adult teeth to erupt. Since we get them much later than our other teeth, we’re seemingly wiser when they arrive. Despite the name’s suggestion, wisdom teeth typically aren’t a good thing, since they can cause trouble with oral health. That’s why they’re generally removed when we are adolescents or young adults.

“There are very few people who can accommodate those four teeth,” said Dr. Samuel McKenna, a surgeon with Vanderbilt Oral and Maxillofacial Surgery. “There just isn’t room for them. And that, in large part, is a basis for us often removing the wisdom teeth.”

The timing of wisdom teeth removal

Ideally, wisdom teeth should be removed before the complete development of the tooth. “We try to remove wisdom teeth before they become symptomatic,” McKenna explained.

Not everyone’s wisdom teeth will fully erupt. Instead, they may partially come in. “But when they’re partially erupted,” McKenna added, “they’re more prone to being symptomatic and problematic.”

Despite this, McKenna does not advise a wait-and-see approach. “It also turns out that it’s safer to remove wisdom teeth at an earlier stage than to let them run their course and see what’s going to happen,” he said.

“It also turns out that it’s safer to remove wisdom teeth at an earlier stage than to let them run their course and see what’s going to happen.”

A nerve runs close to the roots of wisdom teeth. “We like to get them out before the root is fully formed and closely associated with that nerve,” McKenna added. “It’s also easier on the patient when we take the teeth out at an earlier stage of development, which equates to an earlier age.”

Additionally, a wisdom tooth can often be very close to the adjacent tooth, putting that adjacent tooth at risk for decay. Removing wisdom teeth, even if they’re not causing symptoms, can help preserve the health and integrity of these nearby molars.

When removal is most common

Age itself isn’t the predictor of when removal is appropriate. Instead, it’s the appearance of the wisdom teeth on X-ray. However, wisdom teeth often begin to develop or erupt when patients are in their mid-teens. Some people may be in their early or late teens as well. And some people may not experience wisdom-teeth development until their early 20s. Rarely, wisdom teeth will be congenitally missing, meaning someone won’t get them at all.

“The recommendation for removal usually comes from the family dentist,” McKenna explains. “Or, if the child is under orthodontic care, the orthodontist may recommend that their wisdom teeth be removed.” For this reason and for overall oral health, regular dental checkups and routine X-rays are vital.

Young woman laughs with a friend.

Help when you need it

Vanderbilt’s oral and maxillofacial surgeons care for people with complex injuries, diseases or deformities of the jaws and face. The team has the expertise to manage or repair a wide variety of problems, with a goal of reducing pain and providing better quality of life. For an appointment, call 615-322-2377.

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