Wisdom Teeth - How do you know if they should be removed or not?

[TCB]

Took dd 16 to the dentist yesterday as one of her lower wisdom teeth had started coming through the gum. Dentist pretty immediately said she should have them removed. I have to confess to being a bit distrustful of dentists sometimes as I feel they are sometimes gung ho interventionalist minded. I think our dentist if pretty good but we usually only talk for a minute or two at appointments, and have not had to have anything other than cleaning done, so I don't know what he's like really. My opinion is probably colored by the fact that my dentist told me I would need my wisdom teeth out but they grew in fine. I had had 4 teeth removed as a younger child though, to relieve overcrowding, so that may be why mine were ok. This dd has not had any teeth removed and has not had any orthodontist treatment because her teeth are pretty straight etc, only one slightly crooked one, and she did not want to have braces, so we have left it so far.

I would love to hear other people's experience or wisdom on this!

[almondbutterandjelly]

So my family of origin did not believe much in dental care, and certainly never had us get our wisdom teeth out.  Fast forward to my late 30's, and I needed to get my wisdom teeth removed.  Worst pain of my life the next several days.  And that includes gall bladder attacks and labor pains (until the epidural).  So when my dd turned about 17ish and the dentist recommended getting them removed, I said heck yes.  Do it now when the recovery is much easier.  

So my vote is if the dentist recommends it, do it while you're young.

[Ellie]

4 minutes ago, TCB said:

Took dd 16 to the dentist yesterday as one of her lower wisdom teeth had started coming through the gum. Dentist pretty immediately said she should have them removed. I have to confess to being a bit distrustful of dentists sometimes as I feel they are sometimes gung ho interventionalist minded. I think our dentist if pretty good but we usually only talk for a minute or two at appointments, and have not had to have anything other than cleaning done, so I don't know what he's like really. My opinion is probably colored by the fact that my dentist told me I would need my wisdom teeth out but they grew in fine. I had had 4 teeth removed as a younger child though, to relieve overcrowding, so that may be why mine were ok. This dd has not had any teeth removed and has not had any orthodontist treatment because her teeth are pretty straight etc, only one slightly crooked one, and she did not want to have braces, so we have left it so far.

I would love to hear other people's experience or wisdom on this!

Mr. Ellie had beautifully, naturally straight teeth...until the wisdom teeth began to move around when he was in his 30s. And then the wisdom teeth began to get cavities and rot and he didn't even know it until it was an emergency and the teeth had to be extracted.

Only one of my wisdom teeth came in, and it came in sideways. The first dentist who noticed them said not to worry about it as long as it didn't bother me. And so seven years later I had to have it removed by an oral surgeon, with general anesthetic and everything, because it had moved such that it was causing nerve damage.

If your dd is amenable, I'd have that tooth removed now.

[TCB]

3 minutes ago, perkybunch said:

So my family of origin did not believe much in dental care, and certainly never had us get our wisdom teeth out.  Fast forward to my late 30's, and I needed to get my wisdom teeth removed.  Worst pain of my life the next several days.  And that includes gall bladder attacks and labor pains (until the epidural).  So when my dd turned about 17ish and the dentist recommended getting them removed, I said heck yes.  Do it now when the recovery is much easier.  

So my vote is if the dentist recommends it, do it while you're young.

Thanks! Good to get your perspective!

[TCB]

Just now, Ellie said:

Mr. Ellie had beautifully, naturally straight teeth...until the wisdom teeth began to move around when he was in his 30s. And then the wisdom teeth began to get cavities and rot and he didn't even know it until it was an emergency and the teeth had to be extracted.

Only one of my wisdom teeth came in, and it came in sideways. The first dentist who noticed them said not to worry about it as long as it didn't bother me. And so seven years later I had to have it removed by an oral surgeon, with general anesthetic and everything, because it had moved such that it was causing nerve damage.

If your dd is amenable, I'd have that tooth removed now.

Thanks! That is really helpful information!

[TCB]

Just now, happysmileylady said:

I didn't have my wisdom teeth out until they were causing problems for me.  And they eventually did, but that's partly my own fault as I haven't taken the best care of my teeth overall.  In addition to the wisdom teeth, I have had 4 other teeth removed.  The 4th wisdom tooth came out just this past January, I am 42.

Having said that, my lower wisdom teeth both developed dry socket after being pulled.  Women are more prone to dry socket than men, the older a woman is, the more likely it is, and the lower wisdom teeth are more prone to it than the upper wisdom teeth.  Also, because they tend to be bigger, wisdom teeth in general are more prone to dry socket than if other teeth are pulled.  In addition to developing dry socket, the socket later became infected and I needed antibiotics for it.  (though to be honest, I suspect that the infection had more to do with the office, and not necessarily the wisdom tooth extraction.  

So, she may not necessarily need them out and could maybe very well just leave them.  That's something I would get a second opinion about.  However, if they do need to come out, or might need to come out later.....I would say it's probably better to do it younger rather than older.  

Thanks! Great information for me!

[rebcoola]

I have great teeth.  1 wisdom tooth kept getting infection around the gum.  Now in my late 30's my wisdom teeth have decay. Its just really hard to keep them healthy.  The dentist wants them removed before something nasty happens.  Every person I've known with wisdom teeth as an adult has needed them removed for some reason.

[Arcadia]

My two wisdom teeth were on top so when they “dropped” since there was no “supporting“ lower molars when I was around 30, I had them extracted. My cousins still have their wisdom teeth and they are in their late 60s. DS15 has four wisdom teeth. We might get them sealed but not going to extract.

Edited June 4, 2020 by Arcadia
Typo

[Storygirl]

You can get a free consult with an oral surgeon. They will take x-rays, or the dentist can send over any recent x-rays that they have taken to the oral surgeon office.  You can ask the dentist for a recommendation for an oral surgeon in your area.

DD18 had hers out early, when she was about 14, because they were preventing her 12 year molars from being able to come in correctly. It wasn't fun, but I'm glad we did it. Both the dentist and the orthodontist said it was necessary, and then we got the oral surgeon consult, which agreed. We have not been advised anything yet about our younger three teens.

[Pawz4me]

Well, I see this is a familiar story -- DH didn't have his wisdom teeth removed until he was in his 30's. He started having issues and our dentist (the one I'd seen since I was 7 yo, and we trusted very much) said they needed to come out. He's not a wimp and it was a pretty bad experience. We knew we didn't want our boys to have to deal with that, so theirs came out as teens, as soon as the dentist recommended it.

[Jean in Newcastle]

Our dentist sent both my kids to an oral surgeon for panoramic x-rays and a consult.  He was much better able to predict which ones might get impacted, which ones were coming in sideways, which ones would cause crowding.  Both my kids had them out but he was able to give specific reasons why.  The same oral surgeon did the extractions and used the x-rays for that (so we didn't have to have others done as well). 

[Tap]

Both of my older kids had them removed in high school, before they went off to college. I like to have them removed when they are still growing and haven't got the roots intertwined yet.  Wisdom teeth are notorious for causing problems later on in life.  If your daughter has any crowding at all (twist tooth is a pretty good sign), then I would remove them ASAP, so they don't make the problem worse.

[TCB]

Thanks everyone for the information and advice! It definitely sounds like most often they need to come out. I do trust my oldest daughter's orthodontist as he was extremely concerned with saving all teeth possible, but I don't think he probably does consults about wisdom teeth. My dd says that if she has to have it done she just wants to get it over with as soon as possible, so I think we will probably go ahead with it.

I really appreciate everyone sharing their experiences!

[TCB]

14 minutes ago, WendyAndMilo said:

I have all of my teeth and all of my wisdom teeth.  No dental work of any kind, not even cavities.  Every time I go to the dentist they always ask me if I want to remove my wisdom teeth.  Every.single.time. they’ve (both dentists and hygienists) said that it would just make their job easier.  Sheesh.

I do have this underlying fear or assumption that much advice is given because of convenience and/or the least risk for the dentist. This may be completely unfair of me, and also very much not relevant to my dds wisdom teeth.

[Arcadia]

12 minutes ago, TCB said:

I do have this underlying fear or assumption that much advice is given because of convenience and/or the least risk for the dentist.

How is her X-rays of her teeth and jawline. My kids and I have “under crowded” teeth. My wisdom teeth were “tripod“ and not “quadruped” so they were easy to extract. My husband has no wisdom tooth and a generous jawline. 
DS14 had an overbite that diminishes as he grew older. So we tend to wait and see.

[hs03842]

-

Edited June 8, 2020 by JoyKM

[gardenmom5]

it's pretty standard.  most people's mouths aren't big enough to handle them without the rest of the teeth being affected at some point.  and they can cause other issues.

2dd (has a big mouth) was the only one of my kids who made it to adulthood with all wisdom teeth erupted and looking fine - then she was going to south America for 18 months and was told they'd have to come out. Because it's something easy to do here, and not there.  she had the easiest extraction.

I had mine out at 14 (not fun at all.) - but two of mine were sideways/impacted and they were already causing problems.

all of my kids had x-rays to show the position of the wisdom teeth before they were removed. it would be irresponsible not to do one - and I wouldn't use any dentist/maxiolfacial surgeon who doesn't.

[horsellian]

I have 6 wisdom teeth! Two on top, one below on each side.

The lower ones are slightly impacted, but none of them cause me any problems, and I can clean them just fine. My dentist is of the opinion that they can stay unless and until they cause a problem, no point yanking them out for the fun of it.

[TCB]

1 hour ago, Arcadia said:

How is her X-rays of her teeth and jawline. My kids and I have “under crowded” teeth. My wisdom teeth were “tripod“ and not “quadruped” so they were easy to extract. My husband has no wisdom tooth and a generous jawline. 
DS14 had an overbite that diminishes as he grew older. So we tend to wait and see.

They did an xray but I couldn't tell too much about how much room there is in her mouth. He said there probably wasn't room but he seemed to say that before he looked at the xray much at all, maybe even before he looked at it, it sort of seemed like a reflex reaction.

1 hour ago, JoyKM said:

Does your child have any pain associated with that area?  I had what were called “impacted” wisdom teeth. This meant that as they grew in they were pointing in such a way that they pushed into the molars that were in front of them. This caused pain for all four of the molars in front of the wisdom teeth. The teeth were never going to come in correctly so it was an obvious removal. See if you can have a consultation.  Stress that you need more information. An X-ray to see how it is growing may be helpful. I am not a dentist but think more talking to him would be a better way to feel better. 

She is having some pain and maybe swelling where the tooth is cutting through her gum but I think that is what you would expect. I feel kind of rushed as far as the decision goes, not necessarily rushed by the dentist, but if we need to get it done, it seems like now is a pretty good time pandemic wise because it is fairly quiet around here at the moment, and my dd wants to get it done and over with if she has to have it done at all.

[KungFuPanda]

Mine never bothered me so I kept them in my head. They’re choosing NOW to act up so, at 48 and during a pandemic, I have to deal with this.  Ugh. 

[TCB]

31 minutes ago, horsellian said:

I have 6 wisdom teeth! Two on top, one below on each side.

The lower ones are slightly impacted, but none of them cause me any problems, and I can clean them just fine. My dentist is of the opinion that they can stay unless and until they cause a problem, no point yanking them out for the fun of it.

On the xray it looked like they were all pointing in the right direction. The front part of the tooth has erupted through her gum and that looks like the right orientation etc, but not sure about room for the back of it to come through properly. I guess I'm asking myself if it's any big deal to just go ahead and get them removed, even if it proves to be not absolutely necessary, but that just goes against how I usually like to proceed. I prefer to only do invasive things that are absolutely necessary.

[TCB]

3 minutes ago, KungFuPanda said:

Mine never bothered me so I kept them in my head. They’re choosing NOW to act up so, at 48 and during a pandemic, I have to deal with this.  Ugh. 

This is the sort of thing that goes on the getting them out and done now side of the balance. How are they acting up? Did yours come all the way through?

[Arcadia]

38 minutes ago, TCB said:

. I guess I'm asking myself if it's any big deal to just go ahead and get them removed, even if it proves to be not absolutely necessary, but that just goes against how I usually like to proceed. I prefer to only do invasive things that are absolutely necessary.

Would it be local anesthesia or general anesthesia? Is it only one tooth? 

I would usually wait for the entire wisdom tooth to have emerged instead of just coming out because it’s easier to extract. However, if your daughter wants it done ASAP, and you trust your dentist’s skills, I’ll let her have her tooth extracted. 

[TCB]

1 hour ago, Arcadia said:

Would it be local anesthesia or general anesthesia? Is it only one tooth? 

I would usually wait for the entire wisdom tooth to have emerged instead of just coming out because it’s easier to extract. However, if your daughter wants it done ASAP, and you trust your dentist’s skills, I’ll let her have her tooth extracted. 

It would be having all of them taken out and would be IV sedation. She would have to go to an oral surgeon to have it done. She doesn't want to have to worry about it for ages before having to have it done. I'm a bit nervous that I might not be allowed to go in with her, because of the virus issues, so I'm waiting to find out that and see if that makes a difference to her wanting to get it done now and over with.

I wish I could know that it is definitely necessary! Not sure how to accomplish that though, because I feel like it's the easy safe thing to recommend so that is what any dentist is going to recommend. I feel like my questions at these times(to dentists etc) are somehow taken as questioning them in a bad way, I try not to be aggressive or anything, but what I really want is a frank and free discussion of the pros and cons. That seems to be really hard to get. I'm probably overthinking it.

[KungFuPanda]

On 6/4/2020 at 4:35 PM, TCB said:

This is the sort of thing that goes on the getting them out and done now side of the balance. How are they acting up? Did yours come all the way through?

They didn’t come all the way in. They just decided to move a little, like glaciers, just enough for one to push into another tooth and another to get infected because they can shift in such a way that they’re impossible to clean at home.  Good times. 

[Suzanne in ABQ]

Well, since it will be an oral surgeon who does the extraction, make an appointment, and let that be your second opinion.

I would never have a regular dentist do an extraction on a child or young person. It is a very traumatic procedure, and may make your daughter afraid of dentists forever after. (ETA: I wish I had taken my son to an oral surgeon for his extractions.)

 

Edited June 7, 2020 by Suzanne in ABQ

[Terabith]

My kids’ orthodontist told me they needed to come out.  I trusted them.  The fact that the military takes them out for everyone makes me think it’s probably a risk to leave in. And teens heal easily.  

5 hours ago, Suzanne in ABQ said:

Well, since it will be an oral surgeon who does the extraction, make an appointment, and let that be your second opinion.

I would never have a regular dentist do an extraction on a child or young person. It is a very traumatic procedure, and may make your daughter afraid of dentists forever after. (ETA: I wish I had taken my son to an oral surgeon for his extractions.)

 

I would never have a regular dentist do an extraction on anyone of any age.  There is a reason people go for extra training to be an oral surgeon.  Dentists are rarely equipped and trained for complications that can occur with the operation or the sedation.  Plus, oral surgeons do it all the time.  I would want the best with the most experience, not the dentist who thinks he can do it.

10 minutes ago, Terabith said:

My kids’ orthodontist told me they needed to come out.  I trusted them.  The fact that the military takes them out for everyone makes me think it’s probably a risk to leave in. And teens heal easily.  

I don’t know that I would base my decision on whether the military does it across the board.  The United States seems to have a general policy to remove just in case,  it I was reading about it a couple of years ago and it sounded like there was little evidence that it improved outcomes enough to justify the procedure.  The thing it has done is hugely increase teen addiction to opioids.  Hopefully, that is getting better, but be careful and do some research on pain management so you are prepared.
 

FYI - My brother, my parents and I have all our wisdom teeth, my sister had hers removed as a teen.

[Bambam]

Our doctor showed up on the x-rays why he thought the kid's wisdom teeth should come out. He referred us to an oral surgeon.
Oral surgeon also showed us the potential problems on the xray (maybe a new one? I can't remember). One had teeth coming in sideways vs. straight up which would push those nicely corrected teeth out of order. The other had nerves that were close to the root and he said that would cause issues later. I did not verify this though. We've had other dealings with them as have many other friends, and I felt no reason to distrust what they said. I may have gotten more info than some because I definitely asked why they needed to come out vs. being left alone. 

[mmasc]

I think the oral surgeon consult is what you’re needing to feel good about this and get the answers you need. The dentist should have put in a referral so you can actually talk to the person who would be removing them. If I were you, I’d get that appointment and take it from there. You just don’t have the information you need to make this decision, imo. 
 

Just an anecdotal side, my parents had my wisdom teeth removed when I was around 19/20 and in college because 1) the dentist recommended it and 2) my dad was about to change jobs and lose our dental insurance. I chose to do it over spring break so I wouldn’t miss classes (fun, fun). I don’t remember it being that bad really and had no problems, but as an adult, I’m SUPER thankful my parents did it because I would be absolutely PANICKED if I had to do it now. I don’t even have teeth problems or horror stories, but I would be so, so, so nervous to do it now. Maybe that’s silly, but I’m pretty confident I handled it better as a young adult than I would now.

[teachermom2834]

With our dc we have opted to have them out before they leave for college. I just didn’t want them causing a problem while they were away or couldn’t take time off to recover or have a mom to fuss over them. 
 

Dh had his out when he was 34. He wasn’t having issues but his dentist had been telling him for years that once he passes 35 the recovery is much more difficult so he did it then. I don’t have them at all so it wasn’t an issue for me.

My sister had an issue and had to have them removed when she had just had her second baby. It was terrible dealing with that as an emergency situation post partum with a newborn and toddler at home. 
 

We’ve opted to have them out when we could do it preventatively and schedule it when convenient. 

[katilac]

My kids did not go to a dentist who recommended removing wisdom teeth in all young people, and apparently never saw anything alarming on their x-rays. I did not ask about it, because I had decided against doing it routinely based on my experience and research. A couple of my friends had dentists who were like, okay, 16, let's get these wisdom teeth removed as a precaution, and I wasn't comfortable with that viewpoint. I don't take going under anesthesia lightly at all (but did agree to let a dd at 4 get adenoids removed, so I can be convinced).

I did have to have mine removed in my late 20s, but I was the only one of 4 siblings who had to get it done and my parents and tons of extended never had it done. So, my personal experience was that it wasn't always inevitable or required. My dentist was actually really happy that I had my wisdom teeth, as he was hoping to get one to come down and replace a tooth that was extracted (didn't work, sadly). I did some reading on both sides, and decided that routine extraction was not for us. I would want detailed explanations, verbally and in writing, and definitely a second opinion. I'd possibly consider the first oral surgeon to be the first opinion, and go to a second oral surgeon for the second opinion. I'm Team Specialist for this kind of thing. 

I think that hearing stories about adults who have problems with their wisdom teeth is like anything else - you usually hear only the horror stories, because most people don't go around saying, let me tell you about the time my wisdom teeth were fine and stayed that way 😄

It's very possible that your dd has valid reasons to get them extracted, but I would want a second opinion for sure. I'd make it clear before going into that second opinion that I was going for a consult for whether to have them removed, not when. I would ask around and try to find a doctor who is not 100% for removal in every single case. 

I"m not a 'just in case' person for sure; like this article says, everyone is at risk for appendicitis, but do we remove everyone's appendix? 

On 6/4/2020 at 1:01 PM, TCB said:

I do trust my oldest daughter's orthodontist as he was extremely concerned with saving all teeth possible, but I don't think he probably does consults about wisdom teeth 

I would ask him - he will certainly have as much knowledge as the regular dentist, and you could make it clear that you will speak with an oral surgeon as well. It sounds like his opinion would be meaningful. 

On 6/4/2020 at 3:30 PM, TCB said:

He said there probably wasn't room but he seemed to say that before he looked at the xray much at all, maybe even before he looked at it, it sort of seemed like a reflex reaction.

Yeah, it is a reflex reaction for many of them, and I have found dentists to be a much more mixed bag than doctors regarding taking everything into consideration. I once saw a new dentist at our group practice who suggested a procedure that made it clear she had not read my chart at all. 

Don't delay on gathering information and seeking additional opinions, but also don't feel so rushed that you just go ahead and schedule it before you are comfortable with the decision. If she does get it done, it's a very quick recovery for most young people, so no reason to be eek, gotta do it right now! Google with some competing search terms, like "the case for not removing wisdom teeth" vs "why have wisdom teeth removed" and you should find reputable articles on each side. 

[Kassia]

23 minutes ago, OKBud said:

 

Does it hurt more to have them out when you are older, or is it just more of a nuisance to deal with when no one is taking care of you?

 

I had mine out as an adult and had no problems.  Two of my sons had them out in their early 20s and were also fine.

[Arcadia]

41 minutes ago, OKBud said:

 

Does it hurt more to have them out when you are older, or is it just more of a nuisance to deal with when no one is taking care of you?

It’s a nuisance if you have a nasty boss. My former employer accepts two days paid leave for minor extraction of wisdom teeth (local anesthesia), five days for major extraction of wisdom teeth. They also cover the full cost. Many of the engineers in my dept went and have theirs extracted only when it’s impacted. They were pampered by their wives 🤣 and went on a liquid diet for the first few days. 

 

Psychologically it might feel more scary as we get older even though it would feel scary for DS14 at any age. Since my engineers only extracted their impacted tooth and not all their wisdom teeth, they said it was annoying when the impacted tooth hurts and the recovery period because of keeping the wound clean while it heals. Mine was a minor extraction, similar in pain level to the baby set of molars falling out during elementary school.

[KungFuPanda]

50 minutes ago, OKBud said:

 

Does it hurt more to have them out when you are older, or is it just more of a nuisance to deal with when no one is taking care of you?

I think it’s that, in general, teens and twenties heal quicker and easier than those in middle age. Also, fewer problems have had a chance to develop over time. I’m a little concerned about this since I’m facing this at 48, but my dentist told me that is much less of an issue with the top wisdom teeth.  
 

Quicker healing aside, this would have been much easier logistically when I was young enough to only be responsible for myself. It’s harder to fit this in when other people are depending on you. 

[itsheresomewhere]

I have had two of mine removed in my thirties. They were starting to give me trouble and were pulled out.  No issues and I don’t regret waiting.  My bottom ones are still there and totally impacted but can not be removed as they are wrapped around the nerves in the face.  The chances of part of my face becoming paralyzed or severe nerve issues are great.  

[Kassia]

Oh, one thing I forgot to mention earlier.  

I assume this is rare, but one of my sons had his wisdom teeth removed in his twenties.  He wasn't having problems, but he was told he might as well have them out before problems developed because he had good insurance.  He had them removed and his other top teeth ended up shifting back, which caused a gap between some of his molars that were causing problems.  A dentist ended up filling in part of the gap by creating a "filling" there, but there is still a small gap there that causes him problems and pain when he eats certain foods because things get caught in there easily.  He has to have floss with him at all times and regrets having the surgery now.