Wisdom teeth: take them out or leave them
Wisdom teeth come through last, and there is not always enough room for them in the arch. As a result they may grow at an angle, erupt only partly or cause other problems. But not every wisdom tooth needs taking out: the dentist decides individually after an examination and an X-ray — taking into account the position of the tooth and the state of the neighbouring teeth and surrounding tissue.
Author: Albert Baranov, Implant surgeon When a wisdom tooth is better removed
- The tooth cannot come through fully and stays partly or entirely under the gum or in the bone.
- Inflammation of the gum keeps recurring around a partly erupted tooth — pericoronitis.
- The tooth sits at an angle and causes problems for its neighbour: it makes cleaning difficult, encourages caries or damages the tissue.
- The wisdom tooth itself has caries or another condition that cannot be treated properly.
- Other pathological changes have been found in the area of the tooth.
- Removal is required as part of another surgical or orthodontic treatment plan.
When the tooth can stay
If a wisdom tooth is healthy, causes no problems and its position allows you to keep it clean, there is no need to remove it simply because it is a wisdom tooth. The dentist may recommend keeping an eye on it at your preventive check-ups.
How the decision is made
To plan a removal the dentist assesses the tooth clinically and, where necessary, orders an X-ray. A panoramic scan shows the position of the tooth and its roots, while in more complex cases a 3D scan may be needed for a more precise view of the anatomy and of the structures nearby.
Based on the diagnostics the dentist decides whether removal is needed, how complex the procedure may be and which method suits best.
What to expect after removal
In the first days after a removal there may be pain, swelling, discomfort when chewing and limited opening of the mouth. These symptoms usually ease gradually as healing progresses.
For the first 24 hours it is important to follow your dentist's advice: do not rinse vigorously and do not disturb the socket, so that the blood clot stays in place. Avoid hot food and drinks, smoking and strenuous exercise. Soft food at a comfortable temperature is best.
If the pain and swelling do not ease but get worse, if an unpleasant taste or smell appears, if you develop a fever, feel generally unwell or the bleeding continues — contact your dentist.
This article is for information only and does not replace an examination. The decision to remove a tooth is made by the dentist on the basis of an examination and a scan; aftercare advice comes from the treating dentist.
Articles explain the general picture; the decision is always individual. Come in for a consultation — the dentist will examine you, take a scan and explain the options with an estimate.
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