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?

Most people have four wisdom teeth
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 (age 17). Some patients become aware of their wisdom teeth because they hurt, but most find out they have them from their dentist as he (or she) evaluates their x-rays during a routine examination.

Research shows that wisdom teeth don't really make teeth crooked
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 of that articles 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?

9 out of 10 patients just don't have room for their wisdom teeth
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.

Even with room, wisdom teeth are almost impossible to care for
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 restore. Removal of wisdom teeth in this condition is usually the best option even if there is sufficient space.

You may be able to keep your wisdom teeth if you have room and they are healthy
So when is it OK to keep your wisdom teeth? The answer is simple. You can 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 should not be that they are 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 nearly 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 is 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. Please understand that because he has tens of thousands of readers each month, IT IS IMPOSSIBLE FOR HIM TO RESPOND TO EVERY QUESTION. 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.