Wisdom teeth removal: When is it necessary?

Wisdom teeth — the third molars in the back of the mouth — may not need to be taken out if they are:

• Healthy.
• Grown in fully.
• In the right place and biting properly.
• Able to be cleaned daily.

But wisdom teeth often don’t have room to grow in properly, and they can cause problems. Wisdom teeth can grow in at various angles in the jaw, sometimes even horizontally.

Problems can include wisdom teeth that:

• Stay fully hidden within the gums. If they can’t grow in the usual way, wisdom teeth become trapped within the jaw. These are called impacted wisdom teeth. Sometimes this can lead to an infection or cause a cyst that can damage other teeth roots or bone support.
• Grow only partway through the gums. Because the back of the mouth is hard to see and clean, wisdom teeth that partly grow in can create a pathway for bacteria to get into the gums. This can cause gum disease and infection. Wisdom teeth that grow partway through the gums also can get cavities, which can’t be fixed with fillings and therefore must be removed.
• Crowd nearby teeth. If wisdom teeth don’t have enough room to grow in properly, they may crowd or damage nearby teeth.

Some dentists recommend removing wisdom teeth if they don’t fully grow in. In many instances, taking out wisdom teeth as a young adult — generally 15 to 22 years old — is safer, easier and requires less recovery than taking out wisdom teeth later in life. This is because the roots aren’t fully formed, the bone in the jaws is less dense and recovery from surgery generally is faster. This is why some young adults have their wisdom teeth pulled before the teeth cause problems.

According to the American Dental Association, you may need to have your wisdom teeth taken out if you have:

• Pain in or near your wisdom teeth.
• Repeated infection of soft tissue behind the lower last tooth.
• Fluid-filled sacs called cysts.
• Tumors.
• Damage to nearby teeth.
• Gum disease.
• Widespread tooth decay.

It isn’t always easy to decide if or when wisdom teeth should be taken out. Talk to your dentist or an oral surgeon about what’s best for you.