Should I have my wisdom teeth extracted?

September 3, 2013 8:30 PM

All of my wisdom teeth are impacted. I only have one that's even slightly erupted, but the rest never erupted at all. My old dentist used to recommend having them pulled, and now my new dentist also recommended extraction after I had problems with my slightly erupted wisdom tooth, i.e. gum swelling and pain due to a food particle getting stuck in the gums.

The dentist recommended an oral surgeon who recommended that I have all 4 pulled just in case I have future problems. The problem is that I'm 34 and nervous about complications now from the extractions; I've read that risks go up after the early 20s. Aside from the usual complications such as dry socket, I have the risk of nerve injury due to the position of my lower wisdom teeth relative to the nerve. He doesn't think it's likely, but he warned of it. The upper teeth extractions carry the risk of perforating the sinuses, which is also not likely, but doesn't sound pleasant. Then there's the cost. Even with insurance, it's a hefty price tag. I'm having a hard time deciding whether or not I should go ahead with getting them yanked, getting only the wisdom tooth that actually bothers me occasionally pulled, or doing nothing.

posted by hazel79 to Health & Fitness (30 answers total)

You've had the recommendations of both your dentist and an oral surgeon to have them extracted. I doubt any better advice can be forthcoming from AskMe, because we're not privy to your X-rays, or other clinical information.

But if it helps you decide, on the strength of two professional recommendations to extract, I, an otherwise anonymous Internet guy who is not a dentist, but who had 3 wisdom teeth extracted 20 years ago, and still carries one fully impacted lower wisdom tooth that has never appeared above the gum line, and still gets Xray'ed once a year, just in case of decay or infection, recommend you pull them, before they cause you real problems, like the 3 I had pulled were causing me, and unlike the one that hasn't ever caused me a moments thought, other than at annual Xray time, ever has.
posted by paulsc at 8:43 PM on September 3, 2013 [6 favorites]

I only ever grew 2 wisdom teeth (both that grew were impacted), and they never caused a problem. Until they did when I was 32. The root of one decided to wrap around a facial nerve, causing gum/lip numbness. I was told by the oral surgeon that it would only get worse and harder to deal with the longer I waited, since they seemed to be shifting around. I had them removed and never had another problem. YMMV.
posted by Cloudberry Sky at 8:49 PM on September 3, 2013

I would trust the recommendations of both your dentist and oral surgeon- the professionals who have actually examined you.

If it helps, my husband had had zero trouble with his wisdom teeth and did not have them out, against the recommendation of every dentist he ever saw and felt very satisfied with his decision...until they actually started giving him trouble in his mid-40s. A *lot* of trouble, like, he was miserable for a couple weeks until he could get in to see an oral surgeon. His experience would suggest that it might be in your best interest to do it now, if you are already hassling with having to get one done.
posted by charmedimsure at 8:50 PM on September 3, 2013 [1 favorite]

I would follow the dentists' suggested advice and get the pulled. It does get harder as you get older, but you don't want to wait longer if you don't have to.

Also, they have to warn you about the nerve canal and damage. The majority of lower wisdom teeth run into the nerve canal (as far as I know, anyway.) In fact you have to sign a standard waiver for the possibility of nerve damage. I had to sign and was told the same thing, but have no nerve damage. It's just one of the risks of extractions. (Along with the sinus problems.)

As far as cost, there are options such as Care Credit or payment plans. I had to finance mine through Care Credit.

In addition, I can testify to the fact that they can seem fine, then all of a sudden become the worst pain ever. Two of my top ones started to cut through the gums and I was getting small headaches. My dentist recommended that I get them pulled, but I simply didn't have the money. Then a few months after that, they were so impacted and put so much pressure on the roots of the back molars that I had a 6 day straight, excruciating, migraine level, all-hell-broke-loose headache that was 100% incapacitating. I got Care Credit and got them pulled basically on and emergency level basis.

You don't want to wait and get to the point where they hurt so bad that you can't even sit up in bed without your head pounding. Nor do you want to have them cause such problems and rotting or infections. Follow your dentists' advice and get them pulled.
posted by Crystalinne at 8:54 PM on September 3, 2013 [2 favorites]

A friend was in a similar position - don't know if his wisdom teeth were impacted but he had all four and was in his 30s and didn't know what to do. His dentist said, look, maybe they'll be fine but maybe they'll get infected while you're traveling and you're miles away from a dentist and it'll ruin your trip. I think he got them taken out.

I wouldn't worry too much about complications because they are what they are and there isn't much you can do about them. That said, I feel like most people I know have had their wisdom teeth taken out and I only know one person who got the dreaded dry socket.

Can you have the problematic one taken care of and then decide what to do about the others? I'd say have them out one at a time to spread out the cost but after having one out, you might want to just get the others done all at once.

As for my experience, I had one that got infected and made me miserable for a weekend, then saw the dentist that Monday. Because of the infection, I had to do a course of antibiotics before they could take it out.
posted by kat518 at 8:59 PM on September 3, 2013

I had all four out at age 39, no complications, went totally under for it and felt fine a couple days later, fully back to normal food in a week.

I was supposed to do it at age 25, put it off for 15 years and regret it because my teeth got way messed up to the point I'm wearing braces now to fix it. I was fearful of the pain but going under was like magic and painkillers are amazing. I just chilled on the couch for a couple days watching movies and was back working after that.
posted by mathowie at 9:13 PM on September 3, 2013

Yes. Like everyone is saying, it will only get worse. I had a summer job in an oral surgeon's office. It gets MUCH worse. (I will never again have or smell bad breath without thinking, "Maybe it's an abcess?" That's a possible consequence of not getting them out. You don't want that.)

Teenage wisdom teeth are super simple. The simplicity goes down with age, but it's still a lot simpler than a lot of things they do. And the twilight drugs and painkillers are great.
posted by supercres at 9:20 PM on September 3, 2013 [1 favorite]

I am 37 and had all four taken out this past January. I was out completely and the pain wasn't too bad and drugs were really only needed to help sleep. I had the procedure done on a Friday and I was at work on Monday mostly eating normally and I was certainly back to eating without thinking in a week.
posted by mmascolino at 9:32 PM on September 3, 2013

They will keep nagging you until you get them out. Period.
posted by jenfullmoon at 10:01 PM on September 3, 2013

I'm guessing that the increase in complications as you get older is because you're more likely to be getting them out due to some concrete problem rather than as a precautionary measure, as most younger people do. So I wouldn't necessarily make too much of the higher rate of complications. That said, I am not any sort of doctor, so take this advice for what it's worth.
posted by matildatakesovertheworld at 10:23 PM on September 3, 2013

I got my two impacted wisdom teeth out in my early 30's, although without the elevated risk of nerve damage (I had the two non-impacted ones pulled in my twenties). I have a very low pain threshold, and I was fine with just Novocaine (asked for nitrous, but I didn't like it at all and told them to make it stop.) The teeth were sometimes painful and I could tell before that the area around them was often weird-smelling; now it's all healthy and normal, so I'm really glad I had it done.
posted by Ralston McTodd at 10:38 PM on September 3, 2013

I only just had all 4 of mine out after one erupted one got a cavity and started hurting. I'm 30. Nobody seemed to give a shit that only that one was a problem and the dentist and oral surgeon both insisted they all come out. I felt uneasy about it to be honest but I went through with it. It took me 2 weeks to recover and all the while I regretted deciding to mess with healthy teeth.
But I suppose now it's all done I'm not at risk of future problems and my dentist will get off my back about it.
I'd say go with your gut, but keep in mind that it's annoying at best getting them out, so doing it all in one fell swoop is the cheapest, and most practical solution.
Good luck!
Ps IV sedation is worth the cost.
posted by Youremyworld at 10:46 PM on September 3, 2013

Follow the advice of your doctors. These things tend to not improve with time.
posted by quince at 10:53 PM on September 3, 2013

Yes, you should have the teeth removed.

I had three done at the same time in my late 20s. (For some reason the fourth one never came in).

Recovery took a couple of weeks, which is longer than normal. I think that is because my teeth were totally impacted and had grown the wrong way for several years. The dentist had to cut deeper than the usually do. Your case is likely not as severe as mine was.

My jaw was tight for a while and I couldn't open my mouth very wide. I also found chewing unpleasant so I stuck to liquids and soft foods as much as possible. I didn't have any socket problems but I did notice the empty spaces and scars for a while. I got used to it pretty quickly.

I have used both Care Credit and Chase Health Advance to finance procedures like this. Your dentist will likely have a relationship with one of these two companies. They will usually offer one year interest free if the amount is high enough. The trick is to do whatever it takes to pay it off within that one year. If there is even $1 left on the account at the end of the year they will charge you interest on the total amount financed.
posted by Gringos Without Borders at 11:25 PM on September 3, 2013

They are legally required to warn you about the risks. However, the risks are very unlikely. You were warned about the exact same risks as I was (and likely everyone else as well.)

The advantage of doing it now is that you do not have to wait weeks when they start causing you trouble in the future, which is painful - in addition to no change in the risks at that point compared to now.

You aren't trouble free at the moment. Hell, you sound like you're having more trouble from your tooth right now than I did from the entire surgery and recovery.
posted by Ashlyth at 12:32 AM on September 4, 2013

Get them pulled. I agree, if one is starting to be a problem, the others probably will eventually. The body heals better when it is younger. I had all 4 of mine done when I was in my early 20s and the worst thing that happened is that I realized that I really like Vicodin.

If you really want a third opinion, you might visit an orthodontist and have them tell you what trouble the impacted teeth can cause.
posted by gjc at 1:57 AM on September 4, 2013

I would be wary of pulling the non problem causing teeth "just in case". I would have a talk with the dentist and ask how big the risk of further problems is, and if bi-yearly checkups would be enough to identify a problem in time, and have them pulled then. If a wait-and-see approach is responsible I would do that.
posted by blub at 2:12 AM on September 4, 2013

I am also 34 and have two partially erupted wisdom teeth that are going to be removed later this month, after I've waited years through my dentist telling me to do something about them. The oral surgeon was totally cool with me saying I just wanted to do the problem two now due to cost concerns. Getting two done soon seems like a reasonable compromise to take care of what is obviously a problem for you while balancing costs and fears of complications. Any chance your work might be changing dental insurers next year? I had not-great dental insurance for a few years, but this year they changed our insurer and suddenly the cost for this procedure is hundreds of dollars cheaper for me.
posted by banjo_and_the_pork at 2:34 AM on September 4, 2013

I ignored my dentist about my 3 wisdom teeth from age 21 to 33, when one got infected. Of course, it got infected and exploded in pain the day before I had an important trip (job wooing) in SF. I live in DC. The dentist, knowing I was traveling, refused to prescribe me anything good for the pain, and suggested that I instead rotate Tylenol and Advil, which helped some. So I flew cross country in pain, was wined and dined by a start up all weekend that wanted to hire me, the took the red-eye home Sunday night, went straight to work Monday morning from the airport, and had the wisdom teeth extracted on Tuesday.

I was miserable all weekend.

I didn't take the job, which turned out to be a very good move.

There were no complications at all with my teeth and I only took one dose of the Tylenol 3 they gave me. I went to work the next day and felt pretty much normal.

If one has to come out now go ahead and do them all.
posted by COD at 4:30 AM on September 4, 2013

I had all 4 extracted last year after they started causing me pain suddenly at 34. I do not regret this decision one bit. I had ignored the problem for close to a year, and it was not improving.
posted by Nimmie Amee at 6:28 AM on September 4, 2013

I got all four out at age 33 or 34. No problems, and I'm much happier without them, since before extraction I was getting infections from them every couple of years.
posted by BlahLaLa at 6:51 AM on September 4, 2013

My husband waited until his early 30s to have his wisdom teeth removed, and like most people have said, the surgery itself wasn't bad, with a few days to a week of recovery. Waiting for so long to have his removed did have one unpleasant consequence though--one of the lower wisdom teeth had erupted and was resting sideways against his back molar for years. This ended up causing a cavity in the molar which had to be fixed with several more trips to an endodontist for some awful-sounding procedures like bone scraping and a root canal, followed up of course with a crown. So, keep in mind the unintended consequences of leaving those teeth in might mean more (expensive and time-consuming) procedures down the road.
posted by Jemstar at 6:58 AM on September 4, 2013

I'll just add that if you're going to get the one pulled, go ahead and get them all pulled, if you can find a way to swing the cost. As someone who had all four impacted wisdom teeth removed, I promise you're not going to want to go through that again years down the road when another one shifts and causes problems.
posted by carolinecrane at 7:15 AM on September 4, 2013

You've got two professional recommendations to have them extracted. So, have them extracted.
posted by tckma at 7:43 AM on September 4, 2013

I'm one of those people whose wisdom teeth got infected while not in close proximity to a dentist. My infection traveled down through my lymph nodes and into my lungs - luckily not my brain - and I had a nice hospital stay and IV antibiotics. I could have died. Don't die. Get 'em extracted.
posted by juniperesque at 7:48 AM on September 4, 2013

I had one extracted from well within my jaw when I was a teenager because it was heading towards other teeth. The other two that I had seemed to be OK and came in about half way. I basically asked my dentist if that was a problem and he kept saying...they need to come out, but no, there is no actual problem. So, I decided that I would wait until one had a problem and then have them both removed. The problem came in the form of a cavity on one of them.

Basically, I waited until one had a problem and then had them both pulled.

Are they damaging other teeth or your jaw? Are they going to get infected inside your jaw? I would take the advice of the professionals, but be sure to ask what exactly the problem is and what is the risk from waiting.
posted by BearClaw6 at 8:06 AM on September 4, 2013

Two of my wisdom teeth were impacted, and a third was growing partially in my sinus (the fourth never came in) -- got all three pulled at once, when I was 20. Since they had to go into my sinus during the surgery, they knocked me out completely for the actually "pulling" and I was on Vicodin and an antibiotic afterwards.

The Vicodin seemed to do nothing for the pain, I had to use these syringe-type things to squirt food out of the empty sockets for what seemed like forever, and I couldn't even eat solid food for a week. The recovery time total for me was about a month to a month and a half, in that it took that long for me to feel comfortable and to eat normally.

It was a pretty horrible (and gross) healing process. On the other hand, that healing process would have been exactly the same *at best* if I had had to get them pulled later because of an emergency. I don't really think it's a question of *if* you'll have to have them pulled, but when -- so I would go with the dentists' recommendations and get them pulled while you're feeling good otherwise and can plan to take a few days off, rather than wait until you're an uncomfortable and possibly infected mess with a jammed schedule.

I would also follow other people's on-thread advice and get them all pulled at once. You'll dread taking out the others after pulling the first one or two teeth, and you'll have to go through healing and squirting out food and not being able to eat property all over again instead of getting it over with at once. Even if that means having to get a Care Credit (though I would also ask the dentist if there's any way to lower the price, because why not?).
posted by rue72 at 9:18 AM on September 4, 2013

For what it's worth, I had the same situation and out of parsimony and fear of pain deferred extraction for decades. When the time came, it was much more complicated and expensive--and painful--than it could have been, and was accompanied by far more hassle. I should have done it at your age and still wish I had. Do it if you can.
posted by fivesavagepalms at 10:51 AM on September 4, 2013

Response by poster: Thanks to everyone. All of your stories really helped. I think I'm going to have to get these suckers out, so I don't have to deal with any problems later on.
posted by hazel79 at 3:59 PM on September 4, 2013

I would have an oral surgeon, not a dentist, do it. All four of my wisdom teeth were impacted and had to be cut out. My dentist strongly recommended an oral surgeon. It was much less horrible than I was anticipating. Got all 4 removed at once. The top two never hurt. The bottom two were sore for about 3 days but not terribly so. I too was worried about nerve damage but it went off without a hitch.
posted by GlowWyrm at 11:57 PM on September 5, 2013