Wisdom Teeth Removals: The Evidence
Important: Every mouth is different, and should be evaluated on a case-by-case basis. See your dentist for a consultation.
Summary:
if your wisdom teeth are already causing problems, remove them
if your wisdom teeth are very likely to cause problems, remove them
If your wisdom teeth are not causing AND NOT LIKELY TO CAUSE problems, the evidence is weak to justify removing them
wHAT PROBLEMS Could WISDOM TEETH cause?
Tooth decay (dental caries) - affects wisdom tooth itself, and puts adjacent tooth at risk of decay
Root resorption - shortening of roots of adjacent teeth
Gum disease (also called gingivitis or periodontal disease) - affects area surrounding wisdom tooth
Pericoronitis - when plaque causes an infection of the soft tissue that surrounds the tooth
Cellulitis - a bacterial infection in the cheek, tongue or throat
Abscess - a collection of pus in your wisdom teeth or the surrounding tissue as a result of a bacterial infection
Cysts and benign growths - a wisdom tooth that hasn't cut through the gum develops a cyst (a fluid-filled swelling)
If your wisdom teeth experiences any of the issues above, the advantages of removing the wisdom tooth outweighs the disadvantages. Where it gets tricky is evaluating the likelihood of problems when you're not experiencing any, particularly with impacted wisdom teeth.
Controversial issues and myths
Pressure of wisdom teeth causes crowding of front teeth - Not true and not enough evidence
Impacted wisdom teeth have a high chance of causing problems - 12% of impacted teeth have associated pathology (not counting pericoronitis)
Early removal of wisdom teeth is less traumatic - Complications are less likely to occur in persons aged 35 to 83 years than in those aged 12 to 24 years. The highest risk of complication is in persons aged 25 to 34 years
The risk of disease in impacted third molars increases with age - No significant increase in third-molar pathology with age
WHere you live could affect the decision
In the hospital setting, England removes wisdom teeth approximately five times less than France, and seven times less than Australia
The American Association of Oral and Maxillofacial Surgeons states that “about 85% of third molars will eventually need to be removed.”
Conclusion
If your wisdom teeth consistently causes issues, remove them. However, insufficient evidence is available to determine whether or not asymptomatic disease-free impacted wisdom teeth should be removed. Although asymptomatic disease-free impacted wisdom teeth may be associated with increased risk of periodontitis affecting adjacent second molars in the long term, the evidence is of very low quality.
These decisions should be made by qualified professionals on a case-by-case basis. Please see your dentist for a consultation.
