Dr. Greg Jorgensen
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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.

129 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.

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