Wisdom teeth do not necessarily have to be removed.
Some people have enough space in their jaw to let wisdom teeth come in and are able to clean them.
When wisdom teeth emerge, they can cause complications like tooth decay, pain, and infection.
The third molars - commonly known as wisdom teeth - usually emerge between the age of 17 and 21.
Sometimes, a dentist might recommend that wisdom teeth be removed, but financial barriers or fear of pain or surgery will keep someone from having the procedure, says John Luther, DDS, chief dental officer at Western Dental and Orthodontics.
Here's what happens if you don't get your wisdom teeth removed, plus the signs that you might need to have them taken out.
What happens if you don't get your wisdom teeth removed?
Choosing not to have your wisdom teeth removed can lead to complications, so it's best to follow a dentist's recommendation.
"Don't wait until pain, infection or swelling become severe," says Luther.
Common complications that can arise if you don't get your wisdom teeth removed include:
Pain. Wisdom teeth that don't have room to come and are stuck in the gums are often referred to as impacted. Impacted wisdom teeth can lead to pain, swelling, and discomfort.
Infection. If wisdom teeth emerge partially but don't have space to fully emerge, they may become prone to infections because food can get trapped, and they are more difficult to clean properly through flossing and brushing.
Tooth decay and cavities. If wisdom teeth can't erupt in line, they can make it difficult for the gums to seal around the other molars. Wisdom teeth may also come in crooked or too close to the other molars, which might cause difficulty when brushing or flossing them. This opens a doorway for bacteria, which is common in the mouth due to stuck-on food, to develop around the root of the other molars and potentially lead to decay.
A changed smile. Wisdom teeth can push your other teeth out of alignment, changing the appearance of your pearly whites. That isn't just aesthetically displeasing, but it can also lead to health complications like cysts and cavities. Plus, for teens who have had braces, their newly straight teeth could be threatened by wisdom teeth.
Cysts or tumors. Wisdom teeth that only partially emerge can lead to tumors or cysts in the gum. These can affect jaw and tooth health in other areas of the mouth.
"If you have pain, swelling, inability to clean, or if you have decay in the area of your wisdom teeth, it is best to consult with your dentist to determine if they should be removed," Luther says.
What to expect during wisdom teeth removal surgery
Wisdom tooth extraction is a routine procedure, but the details of the surgery will depend on your particular case.
"Wisdom tooth removal can range from simple to complex depending on tooth angulation, impaction, how close the roots are to the nerve in the jaw, or any infection," Luther says.
Before scheduling surgery, your dentist or orthodontist will evaluate each wisdom tooth individually to determine which, if any, is problematic. So, you may have only one or two wisdom teeth removed instead of all four.
The surgery is performed under local anesthesia, general anesthesia, or conscious sedation. Conscious sedation is more commonly used for wisdom teeth versus general anesthesia, as it is less dangerous. After your anesthesia takes effect, an oral surgeon will make an incision in your gums, tissue, and bone, if necessary, to reach your tooth and remove it. Oftentimes, they'll need to stitch the gums afterward to help the incision cut safely heal.
After a wisdom tooth extraction, most people experience a few days of pain, which can be managed with pain medications such as ibuprofen or Tylenol, as well as icing the outside of your cheek. In rare cases, people experience more severe complications like a broken jaw or opened sinus passage during the surgery.
How to know if you need your wisdom teeth removed
Although a third set of molars were helpful for our prehistoric ancestors, many modern humans don't have enough room in their jaws to accommodate a third set of molars, says Luther.
Your dentist or orthodontist might recommend having your wisdom teeth removed if they can tell, during the course of regular care, that you don't have room in your jaw for the teeth to emerge, Luther says.
Some sources say that up to 85% of people either don't have room for wisdom teeth in their mouths or have other reasons why they may need to have some or all of them removed. However, not everyone needs their wisdom teeth extracted.
Dentists only recommend that wisdom teeth are removed if they're going to cause problems, Luther says. Each tooth is evaluated separately. If you have room in your gums to accommodate another set of molars, a dentist will likely recommend leaving them in.
"Wisdom teeth do not necessarily have to be removed," Luther says. "Some people have enough space in the back part of their jaw to allow wisdom teeth to erupt in their proper position and are able to clean and floss them easily."
People can keep their wisdom teeth without complications if they have these characteristics, Luther says:
The teeth are growing in alignment with the other teeth and have space in the gum to emerge.
The teeth can be brushed and flossed.
The gums around the teeth are not puffy or red.
The wisdom teeth are not decayed.
Wisdom teeth are a vestige from when our ancestors needed extra chewing power. But since modern life - and readily-available food - has led to smaller jaws, wisdom teeth can lead to problems for many people.
When your wisdom teeth emerge, they can cause complications like tooth decay, pain, and infection. They may also cause your other teeth to move, possibly making them crooked. To prevent this, up to 85% of people have at least one wisdom tooth removed.
Luther recommends talking with your dentist or orthodontist to decide whether and when you should have your wisdom teeth extracted.
"It is important to review your specific situation with your dentist, review your x-rays and treatment plan and then decide on the best course of action for you," he says.
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