Should Wisdom Teeth Be Removed?

I. Introduction: Basic Understanding of Wisdom Teeth and Common Issues

Wisdom teeth (third molars) are the last teeth to emerge in the human mouth, typically between ages 16-25. Due to smaller jaw sizes in modern humans, wisdom teeth often become impacted or misaligned due to lack of space, leading to pain, infection, and damage to adjacent teeth.

Key Statistics:

In China, about 54% of people aged 16-25 have wisdom teeth erupt, with 44% experiencing impaction or misalignment.

Lower wisdom teeth are 2.5 times more likely to become impacted than upper ones, increasing risks of pericoronitis and cavities.

Core Questions:

"Should pain-free wisdom teeth be removed?"

"Which wisdom teeth must be extracted? Which can stay?"

"What's the best timing and risks for extraction?"

This article provides science-based, objective guidance to help readers decide whether wisdom tooth removal is necessary.

II. Which Wisdom Teeth Must Be Removed? 5 Cases Requiring Extraction

1. Impacted Wisdom Teeth (Most Common Issue)

Symptoms: Grow horizontally or at an angle, pressing against adjacent teeth, causing crowding, decay, or root damage to second molars.

Risk: Long-term pressure may loosen neighboring teeth, eventually requiring removal of both.

2. Recurrent Inflammation (Pericoronitis)

Symptoms: Swollen, painful gums, difficulty opening mouth; severe cases may lead to facial infection or sepsis.

Solution: Treat acute infection first, then extract to prevent recurrence.

3. Severe Cavities or Untreatable Decay

Cause: Hard-to-clean positioning makes wisdom teeth prone to cavities. Deep decay (especially between teeth) often warrants extraction.

4. No Opposing Tooth (Affects Bite)

Issue: If upper/lower wisdom teeth lack counterparts, they may over-erupt, disrupting chewing and jaw joint function.

5. Orthodontic or Prosthetic Needs

Braces: Removal may be needed if wisdom teeth interfere with alignment.

Dental Work: Sometimes kept as "backup teeth" if adjacent molars are missing.

III. Which Wisdom Teeth Can Stay? 3 Cases Where Removal Isn't Necessary

1. Properly Erupted and Functional

Criteria: Fully emerged, with good bite alignment to opposing teeth, no pain or decay.

2. Fully Impacted Without Complications

Signs: Completely buried in bone, no pressure on nearby teeth or cyst formation—monitor via X-rays.

3. Useful as "Replacement Teeth"

When: If first/second molars are missing, wisdom teeth can sometimes be orthodontically repositioned.

IV. Best Timing and Risks of Wisdom Tooth Removal

1. Ideal Age for Extraction: 13-30 Years

Teens (13-18): Roots not fully formed; easier removal, faster healing.

Adults (18-30): Bone still adaptable; fewer complications.

After 40: Higher bone density increases surgical difficulty and recovery time.

2. When to Delay Extraction?

Active infection (treat first)

Menstruation/pregnancy (bleeding risk/fetal concerns)

Systemic diseases (e.g., uncontrolled hypertension, diabetes, bleeding disorders).

3. Common Post-Op Risks

Short-term: Swelling, pain, minor bleeding (manageable with ice packs for 24 hrs).

Long-term: Dry socket (infection), lip numbness (usually temporary nerve irritation)

V. Professional Advice: How to Decide?

Imaging: Panoramic X-rays or CBCT scans to assess tooth position, nerve proximity.

Choose an Experienced Surgeon: Complex cases require oral specialists to minimize nerve injury risks.

Pre-Pregnancy Check: Hormonal changes increase infection risk; remove problematic teeth beforehand.

Post-Op Care:

Avoid brushing/rinsing for 24 hours

Stick to soft foods

Take prescribed antibiotics if needed.

VI. Conclusion: To Remove or Not? Key Takeaways

✅ Remove If: Impacted, recurrent infections, decayed, no opposing tooth, or orthodontic need.
❌ Keep If: Properly erupted, fully impacted without issues, or usable as replacement teeth.
⏳ Best Timing: Ages 13-30; avoid during pregnancy or active infection.

Final Recommendation: Even asymptomatic wisdom teeth should be monitored—early intervention prevents complex issues later.