When is it wise to remove wisdom teeth? These ‘third molars’ at the very back of the gums might erupt completely in perfect position—but it’s not likely. More often than not, wisdom teeth become stuck, or impacted, only erupting partially or emerging in any number of incorrect positions. When this happens, the wisdom teeth often become difficult to clean properly, causing tooth decay, discomfort and infection.
You can wait until that happens to have your wisdom teeth removed, but oral surgeons recommend removal before things get to that point. “The majority of patients should have their wisdom teeth removed, although there are exceptions,” says Dr. Michael Barbick, an oral surgeon with Oral Facial Surgery Institute and Implant Center.
Barbick suggests that teenagers be assessed by their dentist and then referred to an oral surgeon to determine whether wisdom teeth are likely to become impacted or improperly erupt. By examining dental X-rays to see how the wisdom teeth are positioned, experts can predict whether they will be problematic.
“When we see younger patients, from about 14 to 17, the wisdom teeth are only about half the size they will be when they’re completely formed,” Barbick says. “The wisdom tooth is the last tooth to develop in the mouth, and they tend to complete development on average about age 19. When they’re only about halfway developed, they can be removed more easily with fewer complications.”
Many people opt for intravenous sedation during wisdom tooth removal. Using a mild sedative that doesn’t require hospitalization, oral surgeons typically perform the extractions quickly, often in no more than 30 minutes. When the IV is removed, patients awake with no memory of the procedure.
“In most cases, recovery is just a day or two of relaxing at home, taking medications as needed,” Barbick says. He often removes wisdom teeth on Fridays so the patients are back to work or school by Monday.
“They can expect to stay on a soft diet for at least three days, have soreness when opening their mouth, discomfort in the area where the teeth were removed, and the main complaint is that they are hungry,” adds Dr. John Boain, a dentist with Boain Dental Care. “We recommend stocking up on instant breakfast drinks (for vitamins and minerals), jello, soups, pasta, mashed potatoes, pudding, etc.”
Complications from wisdom tooth extraction are rare, but “a ‘dry socket’ is a complication that no one wants to have,” Boain notes. “This is where the blood clot (that forms in the cavity where the tooth was extracted) becomes dislodged or dissolves too soon and the bone and nerves are exposed, causing intense pain. Thankfully, this only happens in 2 to 5 percent of patients, and we can treat them and keep them comfortable.” Adults are more likely to experience complications than are teenagers.
Barbick says that potential problems caused by wisdom teeth can become serious, and many people decide to have the teeth removed to prevent any future issues. “All you have to do is spend a few days with us (oral surgeons) in the operating room, in the hospital and in our office to see the problems these teeth can create, especially as people age, and you’d understand,” he says. “So many people say they wish they’d had it done sooner.”