Title: Where is the wisdom in removing wisdom teeth?

impacted wisdom tooth illustration

Most of my patients when asked “what was their worst experience in a dental chair?” say it was when they had their wisdom teeth taken out.

Okay, so if this is such a terrible event, why is it done?  And if it must be done, how can we make it any better?   And finally, how do I know if my dentist just wants to bill my insurance, whether they need to be removed or not?

The fact is that NOT ALL wisdom teeth need to be removed.  MANY do, but there is by no means any standard of care that says 100% of the time, removing them is the right call.  It’s a judgment call.

Now we are back to trusting your dentist to make the right call OR to place you in the hands of a proven surgeon who your dentist KNOWS and TRUSTS.   If you don’t have a dentist that you know and trust, you are in a difficult situation, BUT if your dentist has proven to you that they always have put YOUR NEEDS FIRST, you are in good shape.  Ask them logical questions.  If you get logical responses, then go back home and research those answers.

Bottom line here is that IT’S YOUR MOUTH.  You get to say what will and will not happen.  Give your dentist an opportunity to prove themselves, building your relationship with them.  GET a dentist who is YOUR advocate first and foremost!

I remember as a kid my dad telling me how his dentist put his knee on my dad’s chest to get his wisdom teeth out.  Then he kept having pain and was bleeding a long time afterward.  Sooooooooooo when I was 16 and it was my time to get my wisdom teeth out, he had me go to an expensive oral surgeon who sedated me.  I don’t remember a thing and my pain wasn’t too bad.  I didn’t even take the Tylenol Number Three.  My jaw didn’t hurt and my bleeding was manageable.  Was I just lucky?  Why was my experience easier?  How come so many people have a bad experience?

TIMING is everything with wisdom teeth.  The older you are, the greater the surgical risk.  As a teenager at about age 16, you have a much lower risk and much better healing potential.  Your bones are “greener” and less brittle.  PLUS the wisdom teeth don’t have long roots yet and are easier to get out with less pain and a smaller wound.

IF NECESSARY, the best time to get your wisdom teeth out is before the roots form and after they have started to erupt through the bone.  It’s easier, less traumatic and therefore leaves you with less pain, bleeding and leads to a shorter recovery period.

SO how do we get the timing right doc? Routine examinations make it easier for your dentist to time your wisdom tooth removal.  This includes panoramic x-rays from time to time.

So what makes it necessary or not?  I would say the likelihood of infection and pain due to wisdom teeth that don’t have room.

If I have room, can I keep them?  YES!  However, you must also be committed to keeping them clean, free of cavities and gum disease.  This means, again, routine examinations and cleanings.

Now I had braces and I want my wisdom teeth out so they won’t cause my crowding to come back, does that make sense?  Actually recent research has show that if crowding caused by wisdom teeth happens, it doesn’t do much for crowding your teeth.  You are best to get them out for OTHER reasons like lack of space.  ALSO WEAR YOUR RETAINERS.  That’s you best bet.  Replace them if lost or broken.  Your teeth will go back to a crowded state NATURALLY without any influence by your wisdom teeth.

When should I have my son’s or daughter’s wisdom teeth evaluated?  Most wisdom teeth are nearly ready to erupt anywhere from 16 to 21 years of age.  If your  teenager got their adult teeth early, then most likely they will be early with their wisdom teeth too.  It is best to have routine examinations throughout your lifetime and a dentist will start looking at the growth of the wisdom teeth by age 12.

I hope that you have enjoyed this short discussion on wisdom teeth and that it helps you.  Please ask questions related to this blog and I will answer them each week.

Blessings to you all!!

Dr. Philip Estes