I have a general philosophy on removal of wisdom teeth. Basically, do it if they have ever given the slightest trouble and you are under 25 and the risks seem minimal. Reasons for removal are varied:
Wsidom teeth are the hardest to clean and often decay early- filling them can be virtually impossible due to space and access. If they can’t be filled or cleaned, they will eventually decay to the point where they cause major pain and problems – this is not the best time to remove wisdom teeth. Bacteria impacts under the gum causing decay or nasty infections – this can be life threatening, but usually is just a pain. It also puts the adjacent teeth at risk – see the photo! The older you get, the harder the bone is and the more difficult to remove the teeth, and the worse result on healing. If you are likely to keep your wisdom teeth for life then that is fine – but I have had to remove wisdom teeth from a 90 year old and that is a serious risk. As you age you may be on medications or have health issues that complicate surgery. Some medications such as bisphosphonates for osteoporosis and bone diseases can be related to post surgery wounds that never heal and are acutely painful (see www.nundahdental.com or http://www.ada.org.au/newsroom/article,documentid,109063.aspx for more info. If your dentist suggests removal of wisdom teeth it is usually in your best interests in the long run.
What are the risks of wisdom teeth removal? – the nerve supplying sensation to the lower lip and tongue can be damaged resulting in permanent numbness of these areas. This risk is usually very small and your dentist can judge the risk better by looking at your X-ray -(usually an OPG X-ray). If the risks are great they may advise against removal – but if the tooth is decayed or infected you may have no choice – again, the earlier these teeth are removed, the less the risk of problems.
I am happy to supply more info if anyone is interested.
March 11, 2008 at 11:48 pm |
I am 41 year old female with all 4 wisdom teeth fully erupted. I have no problems with them at this time. My dentist did a probe and I had a number 5 on the molar next to the lower left wisdom, the rest of the mouth probed normal. They scaled it and put in antibiotic. Then my dentist suggested that I have them all removed, so I scheduled it for next week. He says he feels the risk of gum disease from not being able to reach them properly could cause a problem later. I do not want to endure unneccesary surgery (nothing to fool with), but I also don’t want to wait for something worse to happen. What do you think . I’ve already had 4 teeth pulled when I was a tween-two at the top and two at the bottom, they told my mom I had too many teeth for my mouth.
March 14, 2008 at 2:59 pm |
I don’t know if you have already had your wisdoms out yet or not.
I can’t give an exact opinion without an X-ray but an educated guess. I have had gum specialists advise me to remove wisdom teeth on certain patients to make cleaning of the teeth more reliable and therefore preserve the other teeth. If you have difficulty cleaning the wisdom teeth (in the opinion of your dentist when they look in the mouth) or you already have fillings in the wsidom teeth, and now there is a gum disease risk, then I say take them out. It will give you less heartache when you are older and you can maintain your remaining teeth better
BUT
If you have few fillings and good hygiene and see a dentist regularly, and generally you can maintain the teeth and good overall health – I would say a probing of 5 is perhaps a little premature to remove the wisdom teeth. Perhaps a periodontist can keep cleaning and maintain the gums at this hieght.
Secondly, if the Xray shows your wisdom teeth to be risky to remove and there are high risks of damage to the nerve in your jaw, then maybe it would be ok to monitor the gum disease and only remove the tooth when the gum disease has lossened the tooth (if your teeth are erupted I expect this option is unlikely)
I hope this gives you some info – my advice would be to just ask your dentist again if there is more reason than just the 5 probing depth to base theit decision on. (I still think if they are already gone, it is probably for the best)
Good Luck – Marc
April 8, 2008 at 4:27 am |
Do not get your wisdom teeth out for more info please visit http://www.teethremoval.com.
May 18, 2008 at 7:03 am |
Hi..I m 21 years old male and today i saw a small cavity in one of my wisdom teeth by chance.I have no pain,no trouble …just seen the cavity by chance.My wisdom teeth had appeared just 8 months ago.I went to dentist and he told for filling..had clean it today..havn’t said or even advised for removal..anything happen if i would leave my teeth as such without filling coz i have no problem with it.
should i get my wisdom teeth out without any problem or should i go for filling?
May 18, 2008 at 9:18 am |
Hi Ashish. If your wisdom teeth are coming through straight, and there is room for you to clean them, and room for the dentist to do a filling, then there is no reason to remove them. If they are hard to reach and clean, or crooked like the above photos, then it is worth discussing the options with your dentist after they get an Xray of it. By all means get a second opinion if still unsure.
The important thing to remember with all decay is that it doen’t hurt until it is too late. Don’t wait for pain!
If you need a small filling now it is easy and will last for years, if you wait it will cost more and probably fail earlier, and if you have a toothache you will spend a lot of money on root treatments or have to have a tooth removed.
If you need an extraction and the tooth is solid it is easier to remove, if you wait until you have pain it may be harder to numb up, or the tooth may crumble and be harder to extract meaning more time,expense,and pain, or worst case you may end up with a nasty infection and be worse off.
Whether you have pain or not, you should always be proactive and seek to look after your body and look at what’s best for the long term. A stich in time saves nine as they say. Hope this helps somewhat
May 18, 2008 at 4:46 pm |
Thanks for the help …
The teeth are straight so I will go to the dentist for filling but i think the cotton he had put in the cavity after cleaning it yesterday goes inside my stomach and he told me not to remove of your own and it won’t go anywhere.
Can i wait for 2,3 days?
May 18, 2008 at 7:25 pm |
If the tooth was dressed with cotton wool already it sounds as if the cavity was already very large. I would seriously ask the dentist if this tooth is worth filling, or what the expected lifespan of this filling would be. It seems like removing the tooth may be a better option.
If the tooth is fillable, then 2,3 days is probably not going to be a problems. If it becomes painful it was probably way to big a hole to start with.
August 20, 2008 at 5:01 am |
I have felt my wisdom teeth break through my gums, but have not had any pain associated with them at all. Is it okay to just let them keep coming in or should I get them checked out? I am currently pregnant, so having them removed now wouldnt be the best idea. Any opinions? Thanks~
August 21, 2008 at 9:36 pm |
Hi Shanna – if your wisdoms have just broken through and aren’t sore they are unlikely to be a major problem while you are pregnant. It is impossible to tell the long term options until an X-ray is taken and most dentists would avoid this during pregnancy if at all possible. The most likely problem would simply be gum inflammation/infection usually fixed by brushing the area thoroughly, and possibly rubbing the area with salt and using a mouthwash.
You should still have your teeth checked by a dentist during pregnancy. We would prefer to do nothing other than general cleaning, but if there is a large cavity or problem then the last thing you want is a nasty infection or pain in the later stages of pregnancy and intervention is the lesser of the 2 evils.
I suggest a general check-up and clean just to be sure, and keep up good oral hygiene. Most likely your wisdom teeth are fine for now. Hope this helps
Marc
August 22, 2008 at 2:13 am |
I just went to the dentist recently, and I have small cavities in all of my wisdom teeth. The dentist said they aren’t deep enough to bother me, but having my wisdom teeth removed is necessary. My gums are a little swollen in the back, but my teeth have never given me any problems coming in. They are all in and straight but a couple do have a little gum still over the corner of the tooth. While I trust a dentist, I am wondering if this is just him not wanting to bother removing the cavities because they have the attitude that everyone should just get them removed. Is it worth maybe getting a second opinion on the removal of my teeth?
August 22, 2008 at 5:11 pm |
While he may not want to bother filling the teeth the reasons are likely to be in your best interest. A second opinion is always valuable although be cautious of trying to wait until you hear the answer you want not be the best in the long term. I see 2 scenarios.
If the teeth are likely to not cause gum infection, and they can be accessed, then they should be filled. The reason is that if they are easy to access, they are easy to keep clean, and refill in the future – just like any other tooth in your mouth.
More often the wisdom teeth are very difficult to reach, and so the dentist may have difficulty actually doing a filling that will last very long. Many fillings need good visibility and a dry accurately drilled tooth and although the cavity may be small it may be impossible to fill the tooth if there is no room to manouver. The thought of charging money trying to fill teeth that you as a dentist know may only last a few years before extraction is necessary is not ideal. The dentist is probably thinking that if the decay is small, then it will be some time – maybe a year or more before any pain is likely – why not use this time to save up, organise time off, and remove these teeth once and for all.
I had my wisdom teeth removed at 22 and am glad they will never be an issue for the rest of my life.
September 23, 2008 at 1:57 am |
Hi..I went to the dentist because my upper teeths are somewhat outside.
short upper lip, malocclusion,
overjet>10mm
he advised for 4/4 extractions and fixed orthodontic therapy.
Is there any other new advance technology present so that it will get possible without my 2 teeths extraction.
I don’t want to get my 2 teeths out.
September 23, 2008 at 6:32 pm |
Ashish some orthodontists never extract teeth and prefer to expand the jaw. It looks fine on some people, but on others looks like a big wide straight denture and can relapse back easily. Not all people are the same. Some people can have the teeth straightened without removing any and all the teeth ‘fit’ into the mouth space. Some people have so little room in their mouth, that by straightening the teeth they will stick out even further and extraction is clearly the best course. Imagine a piano keyboard and you make it narrower by 6 inches. Now imagine you want to keep all the same number of keys – they will either have to overlap, or be squeezed into a big bow shape and you wont be able to close the lid!
Orthodontists rarely like teeth removed unless necessary – and only after thorough measurements and calculations to see which option will look best at the end. I have had patients where the orthodontist tried to avoid extracting teeth, and then after 12 months the patient and orthodontist decided extractions were the only way to get a good looking result.
You can always get a second opinion before going ahead. Good Luck
December 22, 2008 at 4:20 am |
hi
I am 25 and had filling done on my upper widsom tooth instead of removal about 2 months ago now the filling has come out causing me severe pain in my ear tooth etc.
Is wisdom tooth extraction like filling and is it painful procedure
Please advise me
Abbey
December 22, 2008 at 5:19 pm |
Hi Abbey,
As I mentioned sometimes it is hard to place a filling in such a hard to reach place and get much success. regarding extraction an upper wisdom tooth is USUALLY quite easy and shouldn’t be a painful procedure. Any pain experienced after is usually well controlled with medications such a Panadeine or Nurefen Plus, but your dentist will probably prescribe a back-up stronger painkiller if needed. It is impossible to predict how your extraction would go without seeing you or the Xray but many patients have a top wisdom tooth out and go back to work the next day. My dental assistant had her’s out at a previous place of employment in the morning and kept working for the rest of the day (but I thinks that’s overkill)
I would suggest do it before a weekend, plan to relax for the next day, and be done with the tooth once and for all.
Good Luck,
Marc
January 3, 2009 at 1:39 am |
I just turned 23 and for about the last year my top left wisdom has been coming in. Half of the tooth is out of the gums and the other half has just now broke through the gums. I have had a headache at least once a day since I was about 16 and I’m now realizing it’s all because of my teeth. But now at the same time I think my bottom left wisdom tooth is coming in because my bottom row of teeth are being pushed together. And the corner of my left jaw inside my mouth has become very very sore. Is this a sign that I need my wisdom teeth taken out?
January 5, 2009 at 10:12 am |
I am 48 and have all my wisdom teeth. They are the strongest teeth I have.
I have had no infections from them and not one cavity any of the four.
I think it is a mistake to have them out. It would be better to straighten them when they come in, my other adult teeth are 20 years older then my wisdom teeth. I think it is mostly a racket run by the dental community to generate more opportunity to make money and that most people should keep their wisdom teeth.
January 5, 2009 at 7:20 pm |
Just because one person has room for teeth doesn’t mean everybody is the same. Look at the pictures of the Xrays I posted and you will se one wisdom tooth that has caused such a decay trap that the tooth in front will need to be removed – everybody is different. Some teeth come through with more than enough room for hygiene and chewing, some people have horizontally impacted teeth that become infected and cystic, some people have no room to even see the wisdom teeth. I had one patient about 15 years ago with 22 extra teeth (including 9 wisdom teeth). Randy has had no infections or cavities – great. Samantha is getting pain and sorness. They may or may not come through, and an Xray and check with a dentist is adviseable. If it is decided that they should go, you will get less healing complications if they are removed before the age of 25.
January 21, 2009 at 10:20 am |
Every time I go to the dentist, they notice that I still have my wisdom teeth and remark that I should have them removed. However, all four teeth are straight and none are impacted. At my last dental probing, the gum around my wisdom teeth numbered 4 or 5s. They told me since the wisdom teeth are hard to clean, they are affecting the gum surrounding the adjacent teeth. I am 27 years old and don’t have any pain from my wisdom teeth so I’m reluctant to have them taken out. But I also don’t want to acquire gum disease or lose other teeth. Would an electrical toothbrush and water pik enable me to keep my wisdom teeth clean? Or would you recommend removal?
February 3, 2009 at 10:41 pm |
After the age of 25 if your wisdom teeth are through and straight and not decayed, then I would probably hang on to them at this stage. You are right that a water pik may improve cleaning in the gum area. I would tend to not see gum disease as a big enough reason to remove wisdom teeth without associated pain / decay risk / impaction issues.
January 22, 2009 at 11:41 am |
Hi,
I am 30 years old and I have two cracked teeth. One is at the very back of my mouth (top left, possibly my 2nd molar) the other is maybe my #11 or #12 on the top right with only the inner side of the tooth remaining.
My regular dentist was away, so I looked up an old childhood dentist. After doing some x-rays, he told me that I have very weak teeth but he could work with me in saving them. He then proceed to tell me that in normal cases he would extract the top right but because I had no insurance for a cosmetic replacement he would try to just fill it. The back one he said he can save but it would need a root canal because the filling would be sitting on the nerve. Then he said the last tooth on the bottom right also needs a filling because there was a small hole on it.
I wanted to get a second opinion about my root canal and my regular dentist had returned, he said that the top left was an extraction because the decay was under the tooth and even if he did a root canal with a filling it would not last long. With the top right (#11 or #12) he was confused as to how the other dentist could offer to fill it with only one side of the tooth remaining. After some thought he said, he could try to fill it with a post and a crown but if the tooth could not support the post then it would be an extraction. For the bottom right he said that it is an extraction because there is no sense in saving it since it is a wisdom tooth and he believes that the nerve is dead (but I never experienced pain with the tooth) or I could just leave it was is and allow it to decay further.
It’s a huge difference of opinion and I’m confused as to who to trust. Even though my teeth are weak, I would like to keep them as long as possible. I should also mention that both dentists have 30+ years experience.
Thanks in advance for any advice!
February 3, 2009 at 11:03 am |
Hi,
Sorry for taking so long to reply. It sounds like the main reason you don’t know who to trust is that there is not ideal communication explaining to you what the problem is with the teeth, and what options there are to fix the problems. Here is me guess at what is being said.
The top right has only a shell of tooth left above the gum on the inside. If a tooth loses %50 or more due to decay or cracks, then a filling may hang on but likely the whole thing will split or break apart while you are chewing. The more tooth lost, the greater the risk. This is when we recommend a crown (like a helmet over the remaining tooth). If there is even more tooth missing, even the crown may fail. If the decay reaches close to the nerve then bacteria can get in and kill this tissue causing an infection (abscess). An abscess can occur even after you have filled or crowned the tooth and needs root canal treatment to fix. If the tooth is really decayed or broken down, even with a root canal and crown the tooth may be so weak it will just fall apart.
It sound like the upper right is likely to fail in the mind of both dentists and eventually it will be extracted. As this will leave a gap and the tooth isn’t hurting at present, the dentist is suggesting try to fill it (not as expensive as root treatment/crowns) but be aware it may break or get sore at any time – at least you gambled to keep the tooth a bit longer but didn’t spend lots of money on it – otherwise just pull it out now.
The upper left sounds like a better prognosis and they would suggest a root treatment and crown to give the tooth the best chance of long term success. Although it is not causing pain at present, removing the decay and doing a filling is likely to be the straw that broke the camels back – that is you pay for a big filling and soon after the tooth gets sore, needs root canal and a crown.
The difference of opinion depends on each dentist believing what they can achieve long term. The first dentist may be over optimistic wanting to save the upper left, or just very confident and giving you the right option. You original dentist may be realistic thinking that both teeth are beyond repair, or just not confident in their skills to get a good result. I am conserned with the comment of root-treatment and a post and if it holds then crown – that sounds like a tooth doomed to eventual loss with a far amount of cash outlay.
My opinion, for what it is worth (remember free advice is worthless), would be to seek a third opinion from a dentist recommended to you by friends or family. I can’t give better advice without seeing the tooth or X-ray, preferably both. I would ask the dentist for explainations why for each tooth they have a certyain opinion. The teeth may be untreatable, or may be but try to find out what is the prognosis. I can treat any tooth with a root treatment / crown – but do I expect it to last 6 days or 16 years? What is the best option value for money. Hope this gives some help.
February 21, 2009 at 1:29 pm |
I’m a 25 year old male who has been advised to have my wisdom teeth removed.
My lower jaw wisdom teeth are badly impacted and one has already badly decayed so I am quite happy to get these 2 teeth out.
My top jaw teeth are fine, well clear of the gum and I can clean them easily with a normal tooth brush.
Should I get all 4 removed? The cost is a significant factor (especially in these tough times). My dentist was originally planning on removing the teeth in her surgery but after seeing the x-rays of the lower jaw referred me to a surgeon.
He was keen to remove all four but I wasn’t comfortable taking his advice on this matter given the financial gain for him (he stands to make double if I get 4 teeth removed).
If the top 2 teeth remain I understand they won’t do anything as they won’t have anything to bite down on. Will this cause them to grow out further and potentially cause problems?
Thanks very much for your advice.
February 22, 2009 at 7:19 pm |
Hi Dave,
If you are nervous in the dental chair and going to have a general anaesthetic, then getting all four removed at the same time helps to avoid going through the extra costs at a later date for the uppers. Otherwise, if you want to save some money leaving the upper wisdom teeth for now is probably not such a big deal. Eventually because they are not biting on anything they will probably drift down toward the lower gum. This makes a food trap between them and the tooth in front, and because they are not in function bacteria and plaque often grows on the biting surface causing decay. They become less self cleansing. Having said this, that outcome may be many years away and top wisdom teeth are often the easiest to remove. For a financial gain, and if your happy removing them at a later date, then leaving them for now should be fine
Regards,
Marc
April 29, 2009 at 5:58 am |
I’m a 26 year old male, with all wisdom teeth in and straight. My dentist has said that I have enough room to keep the teeth. Two years ago I was told that all 4 teeth had cavities and needed to be filled. I had my right wisdom teeth (top and bottom) filled, however because of the pain and overall disdain of the dentist I put off getting the other two wisdom teeth filled.
Two years later I have not had any direct problems with the unfilled wisdom teeth. However, the left side of my jaw has been hurting for several weeks. I do not know if this is related to the wisdom teeth. The jaw hurts at the joint when I clench my teeth and when I open my mouth wide. The teeth do not directly hurt when I chew on that side or push on the teeth. Do you believe the pain to be a direct result of the wisdom teeth?
Also, one of my right wisdom teeth that was filled has cracked and broken off. Because of the overall work to be done and the (direct/indirect) pain, I have scheduled a consult with an oral surgeon. Based on what I’ve told you, do you believe I should go ahead and have all the wisdom teeth removed. Your opinion is much appreciated.
Thanks.
May 3, 2009 at 6:39 pm |
As you may have seen in some of my other comments, filling wisdom teeth may be easy in one person, and impossible access in another. I have had patients where the drill and handpiece literally doesn’t fit even to their fourth back tooth when they open as wide as they can, so what hope do I have of filling their wisdom tooth? When you have the wisdom teeth through straight, the decay they get is usually in the deep grooves on the biting surface of the teeth. Sometimes dentists watch these deep grooves and can’t see that the grooves have been leaking bacteria deep into the tooth. We don’t want to be seen as doing fillings unnecessarily “my dentist said I need 4 fillings and they haven’t been hurting”. By the time the tooth is drilled into it is already deeply hollowed and compromised. Deep large fillings mean 2 things – risks that the nerve tissue in the tooth will become infected (possibly your pain cause) or the tooth has been hollowed so much that when you bite on the tooth a piece breaks off from the filling (as you describe). If the other two teeth aren’t hurting it is because the decay is yet to hit the nerve – but after 2 years of decay the chances are that trying to fill the teeth would be the last straw on the camels back. You are 26 years old. Even if a great filling could be done and it lasts 10, or even 20 years – it sounds like your wisdoms are at risk of decaying again. I would put my money towards a permanent solution (ie removal by the surgeon). An X-ray will give the surgeon a better idea of how much decay may be in the left side teeth, but if you have all your other teeth in good shape and you are going to remove wisdoms on one side, I’d suggest remove the others and save going through the dilemma again at a later date. I am so glad I had all my four wisdoms removed at 22 because they no longer hang over my head (pardon the pun!). I have just referred my brother at 55 to get his last wisdom tooth removed because it is partially under the gum and it has decayed and is causing pain. A 55 year old will heal much slower and with potentially more complications than a 20 year old.
Good Luck,
Marc
May 20, 2009 at 6:14 am |
I am 35 years old and my dentist told me my left wisdom tooth is impacted. It has never bother me, so I am not sure if I should remove it. It is not bothering me now. My dentist says there are benefits to removing and keeping, but he is not making a recommendation for either or. Should I remove it?
May 22, 2009 at 5:18 pm |
I can’t answer this case without seeing an X-ray. If the impacted tooth is under the bone and has never caused problems it is probably best to leave it. If it is exposed to the mouth then it may eventually decay and it may be best to remove it early. If it is deeply impacted and there are high risks of damaging the nerve then it may be best to leave it until it causes problems and there is no choice but remove it. I would ask your dentist to be more specific and recommend one way or the other based on their findings – or get a second opinion from another dentist.
August 27, 2009 at 12:57 am |
Hey,
I’m a 24 yr old male. I’ve been depressed lately coz on Monday (24th August 2009), i got 3 wisdom’s out (i only had 3). The bottom one definitely needed to come out, so i’m ok with that. But it’s the top two which i feel maybe i shouldve left in, coz they weren’t causing any issues. The tops were a soft-tissue impaction. The surgeon, dentist and my orthodontist all recommended taking the tops out coz they said when the roots grow more, they will touch my sinus cavity. But i’ve heard that wisdom’s stop growing at 24? They also said i had no opposing bottom wisdom’s anyway. One of the tops had grown on a slight angle towards my check as well. So based on this info, have i made the right decision to remove them now? Or should i have waited until later on? I just find it odd to suffer in pain now for basically no reason – e.g only as a precautionary IF the tops were to cause trouble. Please let me know what ur thoughts are. Corry
September 6, 2009 at 3:07 pm |
Hi Corry,
Sorry I took so long to reply as I changed emails and didn’t get to check the site. Your top wisdom teeth are unlikely to affect the sinus but they should have come out. They are generally less bother than bottom ones but over time they have no bottom tooth to bite on so the drift down (almost an ‘over-eruption’) and eventually start to bite on the bootom gum. They also drag the bone around them so you end up with an uncleanable area between this tooth and the one in front. Often it takes years – even decades, but when you get decay the damage is in the second back tooth! Without the wisdom tooth there, the second back tooth is now more cleanable by brushing and at lower risk of problems.
Also the wisdom teeth on the top often grow angled outwards towards the cheek, and the side of the tooth rots as the cheek holds food here and stops you brushing effectively – end result a rotten tooth and pain!
You’re probably healed now and will never think about the loss of those top wisdoms again but thought I should reply.
Regards,
Marc