The other day I was reading through Quora. It was bewildering. Do you know what one of the top questions questions for wisdom teeth was? Get ready for it: Why do experts now say not to remove your wisdom teeth?

You can’t make that stuff up. You can even read about it here.  Someone asked quite a leading question. And when first read it, it makes you think, wow I guess experts are now saying not to remove your wisdom teeth now. But do they really?

When I read that question, it got me thinking. It seems most people are mystified by wisdom teeth. Many people don’t know when do their wisdom teeth come in, let alone, why they even have to have their wisdom teeth out.

In this article we’ll discuss the benefits, the risks, and the hard facts of wisdom teeth removal. We’ll also discuss what happens if you never get your wisdom teeth removed, and hopefully, shed some light to make you a mini-expert of when wisdom teeth should be removed.

Why Do We Have Wisdom Teeth?

human evolution's role in why we have wisdom teeth

Who hasn’t heard of wisdom teeth when they are growing up right? Most people know what the are, but wonder why do we have wisdom teeth.

The story is believed to go back to our ancestors. Wisdom teeth are what are known as vestigial organs, they were once important for function, but are now obsolete in the modern human. Think in terms of the appendix or tail bone in humans. They don’t really serve a benefit and you only really think of them when they cause a problem. Wisdom teeth are, unfortunately, part of that group.

Wisdom teeth once were important for function when humans chewed raw meat, nuts, roots, and other hard and fibrous foods to survive. As the early humans evolved, they began to stand more upright. The jaws became more vertical and less horizontal. And ultimately, humans were able to create tools that enabled a softer diet. That’s when the wisdom teeth became vestigial organs.

Does Everyone have Wisdom Teeth?

When teenagers are growing up they often hear that a friend is having their wisdom teeth out over summer break. What do you think they go home and google? You guessed it, “does everyone have wisdom teeth?”

The good news is some of us get lucky. Not everyone gets wisdom teeth, and actually less do each generation. In fact, wisdom teeth are the most common teeth to not develop. Studies show that 11%-40% of wisdom teeth don’t develop. However, for the rest of us, most of us will expect to develop 4 wisdom teeth at some point in our teen years.

What happens if you keep your Wisdom Teeth?

Have you ever heard that old quote about prevention? Something about an ounce of prevention is worth a pound of cure? Trust me, I know, it’s a great quote, but severely overused. That’s why I didn’t quote it verbatim. Anyway, prevention is the best philosophy with wisdom teeth. Let me explain.

Wisdom teeth commonly cause problems. The good thing about them are, it’s pretty obvious if a wisdom tooth is going to cause a problem. When a dentist sees the signs of a wisdom tooth in a poor position, or erupting in another tooth’s space, its clear that problems will multiply with time. So why would we let a patient continue going down a path to more problems? We recommend to have wisdom teeth out to prevent further problems. That’s the goal, and that’s why wisdom teeth are so commonly removed early in life.

Now you will notice a different philosophy regarding wisdom teeth depending on geography. In the United States, dentists are trained with prevention in mind for wisdom teeth. Since studies show complications from a tooth extraction increase with age, dentists and oral surgeons in the United States recommend extraction early in life to reduce complications later in life.

In some other countries, noteably in eastern Europe or Russia, the dentists are of more of a reactive philosophy. Many patients from these countries keep their wisdom teeth longer than in the United States, but the trade off is increased risk of wisdom tooth emergencies, and increased risk of surgical complications, if a wisdom tooth extraction is required later in life.

What are Problems that Wisdom Teeth Cause if They are Not Removed

What are Problems that Wisdom Teeth Cause if They are Not RemovedIf it ain’t broke don’t fix it, right? The reality is that most wisdom teeth are defective goods from the start. They’re the “get your return label and ship them back” type of teeth.

Wisdom teeth come in about 5 years after all the other teeth have already formed their alignment. That in itself is one of the biggest factors of why wisdom teeth cause problems. By the time the wisdom teeth erupt, there is no space left for them. The wisdom teeth are notorious for squeezing up through the gums in awkward angles, often partially covered by gums, and into the space of another tooth. Those facts cause the following, all too common, wisdom teeth complications:

  • Impaction (this means they are wedged against another tooth or wedged against the bone)
  • Infection of the gums
  • Cysts forming around the wisdom teeth (the body’s version of socially distancing the wisdom teeth)
  • Sinus issues
  • Inflammation of the gums and jaw.
  • Cavities of the wisdom tooth or the tooth it is impacted against
  • Lack of room can cause potential shifting of the other teeth

Why are Wisdom Teeth the Last Teeth to Develop?

From a dental perspective, we’re all following roughing the same biological clock. The first set of permanet molars erupt around age 6 and the last permanent tooth erupts around 12, except the wisdom teeth. Wisdom teeth begin forming around the age of 10 but do not erupt until you reach the age of 17.

Why wisdom teeth are 5 years late to the party really makes no sense. Wisdom teeth are the last to form for no particular reason, and that is the biggest reason wisdom teeth create issues during their eruption. Not only are all the other teeth already occupying space, but the average teenager has already completed orthodontics. The other teeth have had the help of an orthodontist when establishing their alignment, but the wisdom teeth are left to figure it out on their own.

What Happens if you Don’t Get Your Wisdom Teeth Removed?

Most people are hoping to avoid extracting their wisdom teeth, and rightfully so. Who would prefer to have a surgery and go through a healing process? But here’s the deal, you have to weigh the pros and cons.

Yes wisdom teeth surgery is no picnic, but the alternative can be worse. If the wisdom teeth stick around too long and cause the problems we talked about above, the situation becomes not only a matter of extracting the wisdom teeth, but also correcting what the wisdom teeth caused.

So we talked about the problems wisdom teeth cause like impaction, decay, crowding of the teeth, and infection, but what does all that mean? It means the wisdom teeth still need to be extracted, and in addition, the problems create additional treatment that is needed.

For patients who have wisdom teeth in poor positioning, its usually best to extract your wisdom teeth before they cause those above problems. So what are other treatments that commonly are recommended from wisdom teeth that aren’t extracted soon enough?

Orthodontics

The primary reason why most wisdom teeth need to be removed is that there’s not enough room to fit them into alignment. This situation is obvious when a dentist looks at your x-rays. It’s like looking at Shaqulle O’Neal and knowing right away he won’t be driving a Mini Cooper anytime soon. If the wisdom teeth are erupting into insufficient space, what do they do? They start to crowd and inadvertantly push the other teeth out of the way. Even if you had braces or Invisalign in the past, the wisdom teeth can cause shifting that destroys your ROI on your investment in braces. Wisdom teeth are one of the most common reasons why people have to have braces or Invisalign a second time in life.

TMJ Treatment (Temporomandibular Joint Disorder)

tmj pain and temporomandibular joint disorder can be caused by wisdom teeth illustration

The wisdom teeth erupt an unconventional angles. Sometimes the wisdom teeth erupt sideways, backwards, and even into another tooth. What it boils down to is that wisdom teeth are a disrupter. By erupting at odd angles, the wisdom teeth can affect how the top and bottom jaw close together and they can also place pressure on the joints of the jaw. The reality failure to extract wisdom teeth at the right time are a risk factor for TMJ pain and temporomandibular joint dysfunction.

Composite Fillings for Tooth Decay (aka Cavities)

When I talk about wisdom teeth and cavities, I have to preface the topic by saying it is two-fold. Wisdom teeth are far in the back of the mouth which makes them difficult to brush. The position of wisdom teeth makes them the most likely teeth to develop a cavity; but its more than that. When a wisdom tooth is impacted or wedged against the tooth in front of it, it makes cleaning that area difficult as well. This is why wisdom teeth indirectly cause cavities on the adjacent teeth.

Emergency Visits

I don’t know about you, but I rather not have a wisdom tooth begin hurting while I’m on vacation at a beach somewhere. People who delay addressing their wisdom teeth for too long often find that the wisdom teeth have a way of flaring up at the most inconvienent times. It’s not actually true, but it just seems that way. It’s usually better to schedule to extract your wisdom teeth on your terms instead of having the tooth decide when.

How to Tell If You Need Your Wisdom Teeth Removed

Whenever your wisdom teeth are erupting into a space without enough room, there’s a good chance the wisdom tooth will be a problem. Partially erupted wisdom teeth are the most likely orientations to need to be removed. What this means is the tooth is half-in and half-out. It’s tried to make it into the mouth but is blocked by the tooth in front or the jaw bone. It’s a bit of a stalemate. The gums flap over the tooth which trap food, the tooth can’t really function for chewing, and it has nowhere to go. This is the most common type of wisdom tooth that requires extraction because it clearly serves all risk and no benefit.

Often times a dentist can see when a tooth is headed for problematic eruption position before it gets to that point. We call that situation fully impacted. It means that the tooth hasn’t moved toward the surface yet, but its blocked in some way. Extracting a tooth early is better, ideally before they have a chance to cause any other complications like we discussed about.

Now, not everyone has impacted wisdom teeth, and not everyone needs impacted wisdom teeth removed. It’s all about the trajectory of the wisdom tooth’s eruption. A dentist experienced with wisdom teeth or an oral surgeon can evaluate an x-ray and determine the path of the wisdom teeth.

But what if you’re already having issues with, what your think is, your wisdom teeth. The question becomes, “Should I get my wisdom teeth removed?” If you’re experiencing any of the following symptoms, the answer to that question might be yes:

  • Tenderness and/or pain in the back of your mouth close to your gums
  • Lower jaw pain that radiates to your ear
  • Reddening and inflammation around your wisdom tooth
  • Internal or external swelling of your jaw
  • A bad taste or odor in your mouth
  • Red, tender, swollen, and/or bleeding gums

Wrapping Up: What Happens if you Never get your Wisdom Teeth Pulled Out

Should You Remove your Wisdom Teeth

With all that being said, you now have the tools to make an informed decision with moving forward with wisdom teeth extraction. Hopefully it’s easier to hear a recommendation of wisdom teeth extraction now that you understand how things can snowball if you never get your wisdom teeth pulled out, when they are recommended to be.

If you have been dreading getting your wisdom teeth out for a while, just by understanding the long term benefits and risks of not removing your wisdom teeth can make the decision easier. Weigh the pros vs the cons of your particular situation and discuss any questions openly with your wisdom teeth specialist.