Dr. Greg Jorgensen
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Rio Rancho, NM 87124

The Jorgensen Orthodontics Blog

Do All Wisdom Teeth Need to Be Removed?

Posted by Dr. Jorgensen on April 5th, 2011

It seems that getting your wisdom teeth removed is just a “rite of passage.” But is it true that all wisdom teeth have to be removed?

Although some people are born without wisdom teeth (and some have extras), most of us have four. Officially known as “third molars,” wisdom teeth become visible in x-rays between 10 and 15 years of age and become a concern around the time we graduate from high school (17 or so). Some patients become aware of their wisdom teeth because they hurt, but most just find out they have them from their dentist as he (or she) evaluates their x-rays during a routine examination.

Today, around 90% of Americans have their wisdom teeth removed, but why? Is it because they make the other teeth crooked? That question was the topic of another article I authored entitled “Do Wisdom Teeth Make Your Teeth Crooked?” The take-home-message was that while wisdom teeth may be a factor, there are other things that are probably more to blame. So what are legitimate reasons to have your wisdom teeth removed?

The #1 reason that wisdom teeth need to be removed is that there just isn’t enough room. This usually causes them to remain fully or partially unerupted. If the wisdom teeth remain trapped deep in the bone, they are referred to as “impacted.” Your oral surgeon will discuss the pros and cons of going after teeth in this position. (There are important nerves in that area.) If they are visible in the mouth but don’t have enough room to come in all the way, they are classified as partially impacted. Partially impacted wisdom teeth almost always need to be removed. Because they cannot be cared for properly, they are more susceptible to decay and gum disease. Since they are closer to the surface than fully impacted wisdom teeth, they are easier to remove and there is less risk of damage to the underlying nerves.

The #2 reason that wisdom teeth are removed is because they are difficult to care for. If a patient has decay or gum disease associated with their wisdom teeth, the dentist will usually just recommend removing them. Not only are they hard for the patient to take care, they are equally hard for the dentist to fix. Removal of wisdom teeth in this condition is usually the best option even if there is sufficient space.

So when is it OK to keep your wisdom teeth? The answer is simple. You should keep them if they have plenty of room and are healthy. Even though most wisdom teeth DO end up needing to be removed, the reason usually has little to do with them causing the rest of your teeth to get crooked.

Dr. Greg Jorgensen is a board certified orthodontist providing braces and Invisalign to children, teenagers, and adults in Rio Rancho, New Mexico and Westside Albuquerque. He also lectures nationally on practice management, information technology, and current treatment techniques in orthodontics.

61 comments so far in response to “Do All Wisdom Teeth Need to Be Removed?”

  1. bonnie says:

    im 15 years old, i have an orthadontist appointment in about a month and its about getting my wisdome teeth removed because the dentist said they wont come through due to overcrowding and i need to get them removed before i get braces. how long is the process usually of getting them removed weeks, months ?

  2. Margehrita says:

    I’m 15 and starting ortho treatment but my orthodox want to remove my upper six year molars and my tiny extra wisdom tooth. To free up space to re align teeth and allow my wisdom teeth to stay in and not need removal. This sounds a little unconventional. How do you feel about this? My other option is getting four pre-molars removed. Btw I’m considered a class 2 and would be a class 1 after this procedure

    • The only time I would ever consider removing the upper first molars rather than bicuspids is if the upper molars have large fillings, root canals, or other damage that make their life expectancy questionable. Removing molars is very unconventional.

  3. leah says:

    I’ve had braces for 7 months to correct a severe overbite. I have had 5 teeth removed in total, only one being a wisdom tooth (bottom right). With my braces on I now have my top right wisdom which has came in, and my top left is just breaking through the gum. My ortho says he is leaving them in for anchors; how does this work?

    • For every action there is an equal an opposite reaction. If you need to move a front tooth back, you need to have something in the back to hook onto. If your orthodontist can connect to the wisdom tooth, he may be able to use it to help him move your front teeth back. I would ask him for a more specific explanation the next time you are in his office.

  4. Shandale says:

    Hi. My name is Shandale and I am 21 years old.I have an appointment on Monday June 9th with an Orthodontist to get my braces. But I have all four of my wisdom teeth and he said that I CAN still get braces before getting them removed. Is there a problem with that? Please let me know! Thank you!

  5. Esther says:

    I’m 37 and I’m getting braces put on in a couple weeks and I was told by my orthodontist that I need to have my 4 wisdom teeth pulled. I have never had any issues with them at all and my top 2 are impacted and bottom are partially exposed. Do I need to get them removed even though I haven’t had any issues with them. My orthodontist says my teeth are over crowded on the bottom but nothing mention about the top being overcrowded. I do have a major over bite and that is my main concern of correcting. Any advice will help me. Thanks

    • There are other reasons to remove wisdom teeth besides crowding. They can abscess, cause issues with adjacent 12-year molars, etc. This is a question more appropriate for an oral surgeon however.

  6. nana says:

    i’m 19 and i need braces because my front teeth are not even in the front. i have wisdom teeth that hurts but i have one in particular that is broken off in the back can i still get braces on my teeth or do i have to get that tooth pulled???

  7. Jennifer says:

    im 15 & i have an appointment to get 4 off my wisdom teeth out, but I’m only getting the bottom ones out tomorrow, I’ve had braces for 3 yrs & got them off this January, do i HAVE to take my wisdom teeth out? is it necessary? is it gonna cause problems with my teeth?

    • Most of us (85%) must have our wisdom teeth removed because they just don’t have room. Having them removed will not cause problems with your teeth, it will probably prevent future problems. Good luck!

  8. Geneva says:

    My son finished his orthodontic work in May. He was treated with Invisalign. Then, the orthodontist told us to have his wisdom teeth removed because they will be protruding against other teeth. He is currently wearing a retainer. I would like to know if it is necessary to do it right away. Looks like it is a complicated procedure and they have to cut through his bones. Thank you so much for your help!

    • Wisdom teeth are an issue, but not an emergency. There is no immediate requirement, but 85% of us need them out. Oral surgeons are now very good at getting these out.

  9. Ann says:

    Just had my top two wisdom teeth out yesterday. They said the others 2 dont need to be removed as there are no problems with them. Will there be a problem with the top not having other teeth ‘meeting’ them. I am also concerned about the permanent retainer I have on my bottom teeth. Is their information accurate? Thank you for your response.

    • It really depends upon your bite. If your lower wisdom teeth are still in occlusion with the second molars on the top, there will be no change. If there is no contact you may notice some movement of the lower ones.

  10. dang says:

    My son is scheduled for extraction of 2 upper premolars in preparation for his ortho treatment. he is only 14 years old. im wondering if it’s better for us to wait until the wisdom tooth are out and remove those instead than to sacrifice his 2 perfectly healthy premolars now?

    • The removal of wisdom teeth is not a substitution for the removal of bicuspids for orthodontic purposes. Generally bicuspids are removed because of their position in the mouth and their size. The wisdom teeth are nowhere close to the problems and don’t give the orthodontist any of the things he needs to help your son with his treatment. Sorry, waiting won’t help him at all.

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