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When Should Wisdom Teeth Be Removed?


There is still great debate among patients and even dentists as to whether or not wisdom teeth should be removed. What function do wisdom teeth play and why do we need these teeth? That question may be hard to answer but probably goes back thousands if not hundreds of thousands of years in our evolutionary development. The fact is that wisdom teeth are still around and we have to know how to treat them or not treat them. This should be part of every patient’s comprehensive treatment plan as to whether those teeth are going to be removed or just monitored.

Monitoring wisdom teeth are usually left for patients who do not have an active infection or bite problems related to the wisdom teeth. When evaluating the removal of wisdom teeth, the risk/benefit ratio needs to be determined. In many cases, wisdom teeth do not have adequate space to fully erupt in the mouth and remain stuck (impacted) below the gums and in the jaw bone. Additionally, the nerve in the lower jaw runs dangerously close to the roots of these teeth. Therein lays the risk of removal-damaging the nerve and causing partial or total numbness. This risk is greater after age 25. Therefore, patients who present with impacted teeth after age 25, without the presence of active infection, can usually get away without removing these teeth.

However, research has shown that the visible presence of third molars in adolescents and young adults was significantly associated with swollen gum disease of adjacent teeth. The position of these teeth in the mouth often affects the bite as well. Additionally, as these teeth attempt to erupt in the mouth, the adjacent teeth shift to make room for the wisdom teeth. This shifting of teeth can cause the front teeth to become crowded or the bite to change. For these main reasons, wisdom teeth are recommended to be removed between the ages of 15 to 21.

The earlier these teeth are removed the better. Usually at age 15, the teeth are not fully formed. The bone at this age is also much more malleable than in adults. Therefore, the removal is usually less traumatic and these adolescents heal quickly. Most patients can expect pain or discomfort for one to two days and swollen cheeks for three to five days. However, when the teeth have fully erupted in the mouth, the removal is usually much simpler and causes less post-treatment discomfort.

In summary, there are several factors that should be evaluated to determine whether third molars should be removed. However, the opinions of different doctors are still controversial. Therefore it is usually best to get second and third opinions. A consensus decision amongst doctors is usually best.

To schedule a consultation with Dr. Julio Hernandez in Miami, FL please call Biscayne Dental & Facial Aesthetics at (305) 224-1138. We are located on Biscayne Blvd. between NE 23rd & 24th Street at 350 NE 24 ST. Suite 105 Miami, FL 33137 (see map).