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.

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.

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

  1. Dagher says:

    My first lower molar on both side have a big cavity, but both are still alive. my orthodontist suggested to extract the first molar and put braces and move the 2nd molar and 3rd molar (wisdom teeth) and fill the gap of the removed first molar. my wisdom teeth is out and little crowded at the end, but not causing problems (till now). based on the Xray, the wisdom teeth is healthy with 4 roots and no cavities.
    Other doctors suggested to remove the wisdom teeth and keep the first molar since it is nearly impossible to move the 2nd and 3rd molars and fill the gap of the extracted first molar.
    what would you suggest

  2. Hannah says:

    All four of my unerupted wisdom teeth are impacted. Is it possible that by extracting my upper and lower 2nd premolars followed by braces, my wisdom teeth will proceed to grow normally? Thank you.

    • All I can do is give you statistics since I’m not your doctor and have never seen your mouth. 85% of Americans do not have room for their wisdom teeth if they have all of their bicuspids. If four bicuspids are removed, that number drops to 50%. So your odds increase, but 1 out of 2 still need the wisdom teeth removed anyways.

  3. Elsie Elma says:

    Hi, Would you extract a bottom right wisdom tooth ONLY so it wouldn’t cause problems for final invisalign results & alignment in the future for a 61 yr. old woman? It never got pulled like my other 3 wisdom teeth when I was younger since it worked with my bite. But my bite will be changing and my dentist says the tooth (which is out of alignment but never caused any problems in the past) may cause problems in the future. I’m very worried especially about permanent paresthesia? Thank you. Appreciate any advise.

    • I cannot diagnose your case online, but it is not uncommon to remove a single third molar if it has different circumstances than the other three. Only your local doctor has all of the facts necessary to make that call.

  4. frustrated patient says:

    Hello..ı recently got my four wısdom teeth extracted but ı am not really happy the way my face looks. my mouth seems to have protuded and my upper teeth are over my lower ones ın such a way that they dont meet at all. my maxılla also seems protruded and pronouncıng S or Z causes my teeth to knock over. my lips and nose also appear bigger than before. i really dont understand this and it has done a huge number on my self esteem. i have never needed braces before and i only had 2 impacted lower teeth but the dentist advised me to get all four removed after seeing my xray film. is this a normal thing? do i need to get braces? does tooth extraction really change your facial structure? please reply/ thanks

    • I have never seen any studies where removing wisdom teeth has been linked to changes in facial structure. I think there must have been something else occurring at the same time. I’ve have over 10,000 patients and never heard this complaint with any of them.

  5. Mike says:

    My lower wisdom teeth are impacted, and like the above commenter my dentist is advising the top molars to be removed as well even though they are perfectly healthy. He claims the top molars will rest on nothing because the lower molars will be removed and the top molars will dig into my gums. I don’t feel comfortable removing healthy teeth. Can you shed some light on this issue? Thank you so much for answering our questions!

    • Your orthodontist (or dentist or oral surgeon) is correct in this case. There is no reason to keep the upper wisdom teeth and eventually they will probably need to come out anyway. It is up to you, but 99% of patients just have them all out at one time to get it over with.

  6. Uri says:

    All 4 of my wisdom teeth are fully erupted. I suffered from nocturnal reflux for a few years and needed a filling on the posterior of one but otherwise they and the gums around them are healthy. Due to an anterior open bite, I have naturally intruded them over the years to the point that they are now mal-aligned with the other molars (which are also somewhat intruded) and like my other molars, they have been ground down to a point that they need crowns. Now that I’m pursuing orthognathic surgery, I’m being asked to have them removed. I’m hesitant because I have space for them and, while they’re damaged, it’s not due to inability to maintain them (I take impeccable care of my teeth). I’m having an MMA so am going to gain a lot of space back there, which, after wisdom tooth removal is going to be even bigger. I’m concerned that having a large amount of gummy surface may interfere with eating. What do you think I should do?

    • The reason you’ll need the teeth removed is because the incisions and bone cuts that will be made during the surgical procedure are in the area where the wisdom teeth are currently located. They must go so the surgeon can do his job.

  7. Leah Marie says:

    i was thinking about getting Invisalign. My bottom teeth are very crowded but my top teeth are pretty straight except that one of tooth sits kinda on top of another. Should I get my wisdom teeth removed or do you think my teeth could still straighten out with my wisdom teeth still in?

    • The wisdom teeth are not a factor at all. In my practice however, I have not been successful correcting VERY CROWDED lower incisors with plastic aligners. I’m just saying…

  8. Missy says:


    I have chipped and broken my top left wisdom tooth and it needs to be pulled. I am 31 and have had all of my wisdom teeth since I was 16 with absolutely no crowding issues. I was told by my dentist that I will need the left lower wisdom tooth removed also even though there is no damage and I am having no problems. I have a scheduled consultation with an oral surgeon next week, but when I made the appt, they are already talking about pulling the lower one as well as “No one keeps their wisdom teeth their whole life”! I do not want to get any healthy teeth pulled. Is it necessary to have the bottom pulled just because the top is being pulled? It seems the only answers I get from the dentist are things like “everyone gets them pulled” but that is simply not answering anything.

    • In many cases the lower wisdom tooth is removed at the same time as the top one because they occlude or bite together. If you only have one removed, the opposing one can move and cause you problems.

  9. Ionia says:

    Hello from Chicago
    My top and bottom teeth aligned perfectly. The only error I have is a gap in between my 2 front teeth. My 4 wisdom are impacted and they do not bother me. I had 2 consultations in the last 6 months and both suggested I get my wisdom teeth removed before braces.
    I honestly do not see the problem with allowing my wisdom teeth to remain in my mouth, I’ve never experienced pain, my dentist say my oral upkeep is superb and I don’t want to go through the oral surgery because I negotiate for work
    Is it possible to get braces without having any of the wisdom teeth removed that are impacted?


    • Closing a space between the front teeth and having impacted wisdom teeth are completely unrelated. You should be able to deal with your wisdom teeth before, during, or after treatment unless they are unhealthy and causing a problem.

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