Question

The dentist of our sons (18 and 21) has recommended that all wisdom teeth should be extracted, as there is a risk of infection with increasing age and it becomes more difficult to remove the wisdom teeth afterwards. We are very unsure about this. Can this preventive measure be recommended without reservation? H. C. in I. 

Short answer

Not every wisdom tooth needs to be extracted. If the wisdom tooth has enough space and can fit into the row of teeth normally, it does not need to be removed. There are situations in which you should not wait until an acute emergency situation arises. In this case, the wisdom teeth should be removed beforehand. If at all, the wisdom teeth should be removed before the age of 25. If the roots are not yet fully grown, the tooth is easier to remove.

The removal of wisdom teeth is a dental surgical procedure for which a justification (indication) is required. Not every wisdom tooth needs to be extracted: If the wisdom tooth has enough space and can fit into the row of teeth normally, it does not need to be removed. 

However, if it does not manage to break through completely because it cannot find a place or grows in the wrong direction, it remains partially covered by the gum halfway through. Gum pockets form along the hidden part of the tooth crown, which represent permanent bacterial deposits. As it is not possible to clean the teeth properly, the bacteria growing there can cause infections and recurring painful inflammation. In the worst case, a local abscess with pus can develop. The neighboring tooth can also be damaged by the accumulation of bacteria and the poor cleaning possibilities. In such situations, it is advisable not to wait until an acute emergency situation has arisen, but to remove the wisdom teeth beforehand. 

Complications very rare 

As with any surgical procedure, the extraction of a wisdom tooth is not without risk. To assess the risk, the dentist always takes an X-ray beforehand. Complications are very rare if the surgical technique is correct and a precise diagnosis is made (prior examination and clarification). 

A recent study by the University of Basel shows that nerve injuries, for example, are very rare when wisdom teeth are removed: In 2384 extractions, injury to the mandibular nerve occurred in 17 cases. In all patients, the temporary numbness or loss of sensation returned to normal. 

Remove before the age of 25 

Many other studies also show that the risk of nerve injury is lowest between the ages of 17 and 24. It is therefore advisable, if necessary, to remove the wisdom teeth before the age of 25. If the roots are not yet fully grown, the tooth is easier to remove. 

Author: Dr. med. dent. Jürg Eppenberger
Published in: Neue Luzerner Zeitung on March 14, 2007