Dr. Greg Jorgensen
(505) 891-9440
1401 Barbara Loop SE
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.

NOTE: The author, Dr. Greg Jorgensen, is a board-certified orthodontist who is in the private practice of orthodontics in Rio Rancho, New Mexico (a suburb on the westside of Albuquerque). He was trained at BYU, Washington University in St. Louis, and the University of Iowa in the United States. Dr. Jorgensen’s 25 years of specialty practice and 10,000 finished cases qualify him an expert in two-phase treatment, extraction and non-extraction therapy, functional orthodontics, clear aligners (Invisalign), and multiple bracket systems (including conventional braces, Damon and other self-ligating brackets, Suresmile, and lingual braces). This blog for informational purposes only and is designed to help consumers understand currently accepted orthodontic concepts. It is not a venue for debating alternative treatment theories. Dr. Jorgensen is licensed to diagnose and treat patients only in the state of New Mexico. He cannot diagnose cases described in comments nor can he select treatment plans for readers. Because he has over 25,000 readers each month, it is impossible for him respond to all questions. Please read all of the comments associated with each article as most of the questions he receives each week have been asked and answered previously. The opinions expressed here are protected by copyright laws and can only be used with written permission from the author.

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

  1. Julia says:

    Hi there,

    I am getting invisalign done and i was sent to a specialist to see if I need my wisdom teeth removed. My wisdom teeth are not coming through at all, and are very deep. By the look of the x ray, the bottom wisdom teeth seem to be mesial. The specialist told me I need all 4 removed, is there any rush to get them removed if they are not hurting or coming through? I am not covered by dental insurance and this is a steep payment to make on top of invisalign. Will i risk my teeth becoming more crooked or crooked again after i go through invisalign if I do not get them taken out?

    Thanks so much for your advice in advance!

  2. Rebecca Blum says:

    Are there any orthodontic procedures that will can salvage a crooked wisdom tooth descending where the neighboring molar was removed? Is is worth an evaluation anyway?

    • The amount of time and expense needed to move a wisdom tooth into the position of a lost second molar is not worth it to me. It is the same as extracting two bicuspids on the same side and by the time you get the wisdom tooth forward, there may not be much bone around it. I would opt for an implant if your dentist feels you even need to replace the second molar at all.

  3. Samantha N says:

    My dentist recommended that I remove my bottom two wisdom teeth but my surgeon says to remove all four. The top four are fully grown and the bottom two are stuck in the bone. The top ones seem fine to me; they don’t look impacted. And I can brush them fine I think. Do you think I should remove all four?

    • I would discuss this with your dentist. I think that he’s less biased than the oral surgeon. Oral surgeons make money pulling wisdom teeth. If your uppers are healthy, have room, and have something to bite on in the lower, I don’t see why you can’t keep them

  4. Janette o says:

    Is it bad to have both your bottom bilateral wisdom teeth out at the same time?
    Or should it be done one at a time?

  5. lenol says:

    I had my top two wisdom teeth removed last year, I feel like my last two remaining molars have moved as I can feel the space when I flick my tonque between them, also there are already larged bits of food stuck in between this space everytime I eat pork and chicken. I am concerned that this space might be a reason to get a tooth decay and its so annoying to have food stuck in between every meal, should I be getting a retainers or braces? my dentist said no need but she didn’t even bother to look at them.

    • It is very rare to have the molars move backwards after wisdom tooth removal, but I guess it could happen. If you were my patient and I found that it was the case, I would probably recommend a short series of clear aligners to re-close the gaps that have formed.

  6. Ain says:

    do I have to extract all my 4 wisdom tooth before doing braces? my Dentist told me to extract all 4 although they are not painful and they are impacted.

    • This is a decision between you and your orthodontist. Unless he is planning on pushing all of the teeth back into the positions currently occupied by the wisdom teeth, I see no need to remove them prior to treatment.

  7. Crystyna Da Costa says:

    Hello Dr.,
    I would really appreciate if you can answer my question… This upcoming Friday I am to get all four wisdom teeth removed but I am a bit hesitant to remove the top ones as they seem that they have grown in fine. Both bottom molars need to be removed. At my school dental clinic where they also have oral surgeons told me that because I am removing the bottom wisdom teeth I need to remove the top . Their reasoning behind it was that they said my top wisdom teeth will drop and grow plaque and they said my top teeth need to have a partner teeth ( which would be the bottom ones that I am removing ).
    Thanks so much in advance for your time.

    • Depending upon your bite, you may need all four removed. If the upper ones are “unopposed,” they can continue to grow until they cause problems with the tissues in the lower arch. Good luck on Friday!

  8. Amir dyjuan says:

    Is it important to have a decayed tooth pulled before braces even tho it doesn’t bother you or give you pain?

    • I would recommend that your mouth be completely healthy before you consider braces. If you have anything wrong with your teeth or gums, you should not have orthodontics until those things are fixed.

Leave a Comment

Back to Top

Your account login
Your rewards
Schedule an appointment with our talented orthodontist online