why should i have my wisdom teeth removed?
July 30, 2006 9:04 AM   Subscribe

is it important to have your wisdom teeth removed? why? they really don't bother me at all.
posted by brandz to Health & Fitness (43 answers total) 5 users marked this as a favorite
Because many humans have mouths too small to accomodate wisdom teeth, which can then become infected. You don't seem to have that problem, so until and unless you do, you don't need them removed.
posted by orthogonality at 9:08 AM on July 30, 2006

If your wisdom teeth will eventually hit, or impact your molars, you will be in for some serious pain.

They can also make it more difficult to clean your back teeth, leading to infection and worse if you're not fastidious about dental hygiene.
posted by Blazecock Pileon at 9:08 AM on July 30, 2006

The reason wisdom teeth often need to be removed is because they impact the other teeth when they come in. When I had my wisdom teeth removed, one of them was basically coming down right on top of another tooth. I've heard of cases where grown-in wisdom teeth also cause infections and have to be taken out for that reason.

Generally, though, I don't think your wisdom teeth need to be removed unless and until your dentist tells you that they're causing a problem.
posted by magodesky at 9:11 AM on July 30, 2006 [1 favorite]

I dunno... when I was in the military they persuaded lots of people to have it done, pre-emptively, to aovid problems later. I took a raincheck though as I don't take any kind of surgery lightly. I'm 37 now and haven't had the slightest trouble with them. I only hope I don't regret it later, as I could have had it done for free back then.
posted by rolypolyman at 9:11 AM on July 30, 2006

The real reason to have them out is so that your dentist or oral surgeon can make his BMW payment this month. Seriously, if they don't hurt leave them in. You can always have them taken out later if they cause a problem.
posted by caddis at 9:15 AM on July 30, 2006

My mom, my dad, myself, and my husband all have our wisdom teeth. My husband does have to be extra careful about denal hygiene, but none of the rest of us have any problems. Mine are just sitting there under the gums, hanging out. My dentist asks me sometimes when I'm going to have them out, and when I ask "Do they actually need to come out?" I get the hoohah about "most people," which I don't buy either. If they're not bothering you and they're not in line to cause problems, then I wouldn't worry about it . . . but then again, I don't take surgery lightly either, so I usually fall on the "no knives until necessary" side of the fence.
posted by Medieval Maven at 9:20 AM on July 30, 2006

they tell me all four are impacted. again, they don't hurt or anything.
posted by brandz at 9:20 AM on July 30, 2006

Is this a question of money? IANAD, but I would leave them in until they cause a problem or your insurance will cover it. There's no reason to blow a bunch of money on a procedure that you might not need.

That being said, I had mine out. All 4 were coming in sideways and I'd just finished > $3,000 worth of braces work.
posted by sbutler at 9:21 AM on July 30, 2006

In my experience, you only need to have them removed if they don't have any space to grow in. Mine were growing right underneath other teeth, so I had to have all four removed. My brother never had his removed, and now that they've grown in, his bottom row of teeth are crooked.

Did your dentist say that you needed to have them removed? He or she should be able to show you the x-rays, which might show you whether they're impacted or not. I heard that the older you are, the more it hurts to have them taken out, but maybe that's a myth.
posted by hooray at 9:26 AM on July 30, 2006

When I asked...
posted by sohcahtoa at 9:28 AM on July 30, 2006

British National Institute for Clinical Excellence says no. (I'll leave it to others to make the British bad teeth jokes.)

Plus, in my experience, dentists find this treatment to be a nice way of making a few hundred dollars. My new dentist said I really really needed it and applied a lot of pressure to have them out. My old dentist (my uncle and a university professor of dentistry) just laughed.
posted by TrashyRambo at 9:30 AM on July 30, 2006

I had three out of four removed. My other teeth were being crowded (screwing up the braces I endured as a wee lad). The fourth was so far up, I decided to leave it in because it might have caused problems with my sinuses if it was removed. There was the belief by my oral surgeon and myself that there might be a big hole there if it was removed.

My point is your widom teeth, depending on where they are could impact your other teeth and/or your sinuses. act cautiously.

Fwiw, you get good meds while recovering, but I was out of work for two days and had it done on a Friday to avoid that.
posted by JohnnyGunn at 9:35 AM on July 30, 2006

All 4 of mine were impacted and the dentist suggested I get them out. I ignored him. About 10 years later they started crowding my teeth so I got them out. After I healed I realized that my wisdom teeth had been a source of discomfort for years but it was so gradual that I didn't really notice it. If the dentist tells you to get them out, I would advise you to do it.

Also it's my understanding that the (long) roots of the wisdom teeth can disrupt nerves in the face.
posted by Soda-Da at 9:43 AM on July 30, 2006

i have to agree with caddis. i know for a fact my dentist has a heated garage.
posted by brandz at 9:48 AM on July 30, 2006

When I was a teen, my dentist/orthodontist suggested I have them yanked even though they weren't causing me any trouble then. I looked into the available data then to support the practice of prophylactic wisdom tooth removal in asymptomatic patients, and basically found none. So I declined, and years later I have no regrets. My teeth aren't crowding, I haven't suffered any ill effects, and a literature search today continues to come up empty when it comes to this matter.
posted by drpynchon at 9:55 AM on July 30, 2006

The only 4 teeth in my entire mouth that came in straight were my wisdom teeth. (Weirdly, they also seem to be much less prone to cavities than my other molars.) I've had braces twice (once as a teen, once just until just last week) and had major jaw surgery to correct my bite, and they're the one thing no one had to touch.
posted by scody at 9:58 AM on July 30, 2006

I had all four wisdom teeth removed when I was in grad school three years ago. They weren't giving me trouble, but the dentist said that they were impacted and might cause problems later, so I should get them out while I was still on my parents' kickass health insurance. I wound up with temporary nerve damage to my lip, two dry sockets, severe swelling on my jaw, and I had to complete my student teaching experience while looped out on vicodin.

I'm not saying that you should never get them removed. But dude, if they're not bothering you, weigh the pros and cons carefully before making your decision.
posted by christinetheslp at 10:51 AM on July 30, 2006

I'm 25 and still have mine in, with no plans on getting them out. Despite all the dire warnings that because of the way they were orientated they would mess up all the expensive correction done by my braces, nothing has happened.
posted by 517 at 10:57 AM on July 30, 2006

My dentist told me that on the basis of my X-rays, keeping my wisdom teeth would probably be OK, as long as I was careful about making sure that I brushed them. I don't have dental insurance, they're not giving me any problems, and I'd prefer to avoid unecessary surgery, so I plan to keep mine. Is your situation similar? I have no idea, I'm not your dentist. However, as people in this thread have attested, there can be legitimate reasons for the removal of wisdom teeth, some of which involve long-term risks and problems rather than immediate pain. If you don't trust your dentist because of his heated garage, it would probably behoove you to get a second opinion [and perhaps find another dentist], rather than dismissing the possibility of removal as complete bunk. You might end up being told that yeah, it's really not necessary for you - but then again, you might find out that the fact that all of yours are impacted puts you at risk for various problems, and that removal really truly is better.
posted by ubersturm at 11:00 AM on July 30, 2006

My daughter has perfect teeth. Never needed braces. The wisdom teeth are coming in and they're crowding out the other teeth. She'll have to have them out earlier than most people. Since her dentist never suggested she needed braces (and that's where the real revenue comes from), I don't think he's kidding about this.

My husband had two of four pulled - but he had to have the other two pulled 3 years ago because they gone bad. I have one of my wisdom teeth - one wasn't there, and two were pulled. I've never had any problems with the one that's still there, but the others were under teeth, so for us, the answer, is, it all depends.
posted by clarkstonian at 11:05 AM on July 30, 2006

I left mine in with no ill-effects for quite a long time, until one day the lower two started getting weirdly infected. The back of my lower jaw would get hot and sort of swell up for a couple of days, then burst with blood, then heal, then swell again....and over and over, with minimal to no improvement with antibiotics.

Had 'em removed, don't regret it. The problems came out of the blue too, no noticeable warning at all. Just woke up one day and things went downhill from there.

...so I guess I'm saying: I thought removal was unnecessary, and found out otherwise.
posted by aramaic at 11:13 AM on July 30, 2006

I chose not to have mine out at age 20 - I'm 36 now. Here's my experience:

* No pain
* My teeth did crowd - I had a slight overlap in my front teeth that definitely has gotten worse over the years. Only a problem if you mind looking like a dork (I don't).
* Ask your dental hygenist how to brush to really get those back teeth. Mine are hard to reach - the hygenist told me how to wiggle my jaw around to make sure I got them all.
posted by selfmedicating at 11:15 AM on July 30, 2006

My dentist told me I shold have mine removed to 'avoid eventual weakening of the jawbone.' I poked around and found the anecdotal evidence of prophylactc removal as revenue booster, and changed dentists.
posted by mwhybark at 11:49 AM on July 30, 2006

My boyfriend's father is a dentist, and a really nice guy. He does not drive a BMW or have a heated garage or in general live in luxury. He also does not overcharge or order unnecessary procedures, and often lowers his fees for people who can't otherwise afford dental work that they really need. So not all dentists are money-grubbing bastards.

I have asked him about the wisdom-teeth issue before, and here's what he said: basically, the problem for most people with wisdom teeth is that there is not enough room in the mouth for them to come in, and they become impacted. This causes a lot of pain and can lead to infection, etc, and they have them removed right away. For others, the teeth manage to come in but are squeezed too tightly, or not fully errupted, and more prone to infection later on. This is exacerbated by the fact that, because they're so far back in the mouth, wisdom teeth don't tend to get brushed and flossed as thoroughly as they should.

If your teeth aren't bothering you right now, you can always wait and see if you develop an infection or abscess before having them yanked. But one problem is that with time, wisdom teeth become more difficult to remove as the bone around them grows denser. Complications are less likely when they're taken out sooner.

Of course, there are some people who have plenty of room in their mouth for wisdom teeth to happily exist. If you aren't sure if you're one of those people or not, I recommend finding a good, honest dentist and asking for their opinion.
posted by bookish at 11:57 AM on July 30, 2006

As I recall, my orthodontist's monologue on the subject went something like this:

"Well, let's see what the X-rays look--YEEOOOWWW!"

Apparently, having your wisdom teeth growing in sideways is just not a good thing. Had 'em yanked pronto, no problems then or since. As the other posters have noted, if there's nothing actually wrong with the molars and they aren't affecting your other pearly whites, you can leave them alone without ill effects.
posted by thomas j wise at 11:57 AM on July 30, 2006

If your dentist is saying they are impacted (explained here), then you may actually NEED to have them taken out. If you don't trust your dentist, get a new one to check it out.
posted by Medieval Maven at 12:09 PM on July 30, 2006

An oral surgeon told me I should have mine out when I was 16. He didn't say they were impacted, I don't think. I think it was a "just 'cause it's easier to do it now" type of thing. Ten years later, one has finally shown its face. I'll mention it to my dentist next time, but none have ever hurt anymore than any other tooth coming in. I didn't even notice this one had broken on through to the other side until I happen to jab my finger into my mouth and felt it there.

If you're skeptical, that's what second opinions are for.
posted by lampoil at 12:36 PM on July 30, 2006

From experience I can tell you that if they develop problems they may come on fast and hard. I ignored advice to get them out because they weren't bothering me until one day I woke up in excruciating pain. Because I had waited, the surgeries were more complicated, more expensive, and had to be done over two weeks.

I agree that you should find a dentist you trust and ask whether, given your jaw/teeth structure, you are likely to experience issues in the future. As for the dentist making a profit...my dentist took an emergency appointment for me and sent me off to an oral surgeon for the procedure, charging me nothing. I'm not sure if that's standard but he certainly didn't make any money off me.
posted by lalex at 12:37 PM on July 30, 2006

Ask your dentist to show you your X-rays. If you see something like the mis-alignments on the page Medieval Maiden linked to, consider extraction.
Factor in the health of your gums, especially if you have had pain or swelling.
If you are concerned about your teeth, you are surely flossing regularly; this is even more important if the wisdom teeth are causing any degree of crowding.
If you decide to keep your wisdom teeth, consult your hygienist about using an electric toothbrush. It is not a matter of being too lazy to brush, it is the fact that the small rapidly rotating electric brush does a better job.
posted by Cranberry at 12:48 PM on July 30, 2006

Like Aramaic, I started having recurring infections in the lower wisdom teeth, because they never fully came in. I brushed them as well as I could, but food would get into the pocket caused by the soft tissue around the partially-erupted tooth. There wasn't much I could do to prevent that. And the pain, oh the pain... anyway, I had them out in my 30s (oddly, I only had 3 wisdom teeth to remove!), and it was not pleasant. I was told I should have had it done years earlier.

Anyway, if they are impacted, consider that the pain could be coming eventually even if it doesn't hurt now. If you have dental insurance, I'd say get 'em out if they're impacted! If you don't have insurance, wait and try to get it!
posted by litlnemo at 1:29 PM on July 30, 2006

I trust my dentist completely, he has never done anything to my teeth just to make money, is always careful to explain things well, has cut me breaks financially many times and in general is a great guy. I had my wisdom teeth out because: one was impacted and got infected and I never wanted to deal with that again (pain, nausea, swelling, ick), I have a smallish jaw and wasn't able to brush the nonimpacted ones as well as they should have been brushed, and they were causing general jaw and head pain. I wish I'd had them out as soon as my dentist suggested it, since now my previously dead-straight bottom teeth are slightly crooked because there wasn't enough room for them and my wisdom teeth.

If you don't trust your dentist, get a new one. I don't see why anyone would keep a dentist they didn't trust.
posted by biscotti at 1:55 PM on July 30, 2006

I've had several teeth extracted during my lifetime for various reasons, but I was told as a teenager that I could probably keep my wisdom teeth as long as they didn't develop any specific problems.

Since then, I have had both of my top wisdom teeth removed (on two separate occasions) because they developed serious decay—fragments actually broke off of the teeth. They never caused any pain, though. I still have both lower wisdom teeth, but they are hard to keep clean. My dentist says he'll recommend extraction if they develop cavities.

So keeping the wisdom teeth is definitely an option for some people, but the long-term problems are real. A different dentist might have told me to get all four teeth removed as a preventative measure, and this might not have been bad advice.
posted by mbrubeck at 4:48 PM on July 30, 2006

Oh, and like several other posters', my teeth are a little crooked from crowding since the wisdom teeth came in.
posted by mbrubeck at 4:49 PM on July 30, 2006

Well, I remember several dentists over twenty years ago suggesting the removal of my wisdom teeth. I have never had braces and my teeth are straight and well positioned (thank you Lord). I have had no crowding, rotting, or other horribles, despite the dire warnings in my youth from some quite reputable dentists (and one certified quack). I think some people need them out, but why go prematurely?
posted by caddis at 5:23 PM on July 30, 2006

I agree that if you do have problems (and if they're truely impacted you probably will) they will come hard and fast. And be more painful and more complicated and more expensive than you imagine.

Mine grew in with no problems, plenty of room for them. But they were never full sized (sat lower than the other teeth), and were impossible to clean properly because of that. I was told to get them out as they were non-functional and highly likely to get infected, but I didn't. A couple of years later the problems started. I had enough to money to remove the worst one, so I did. Cost $90 and took two minutes to pull, recovery time was nil. It was fairly rotten by that stage but the other ones seemed OK (no pain). Against my dentist's advice I left the others.

They were fine for six months. Then they weren't. Constant pain and illness, to the point I couldn't actually work during that time. Three months (damn waiting lists) later I got them out. Because the jaw was now infected I had to have it done surgically, costing thousands of dollars ($2400, local anaesthetic only) and requiring a week's recovery time. That moment when the dentist shows you the x-ray of where your jaw bone has been eaten away by the infection? Not fun. The illness was from the infection, it was like having a head cold or throat infection forever, the same pain and fever and rundown feeling. Plus only sleeping a couple of hours at a time thanks to the drilling pain in my face. I had no idea it could get that bad, that fast or be that expensive.

If your teeth are growing in straight and not going to cause problems then cool. Very careful cleaning etc can probably stop them rotting also, although this depends on the shape of your teeth. But keep in mind that if they do go wrong, it's so much worse if they've been left than if you get them dealt with early. Infections around your teeth cause a lot of damage, both to your overall health and to your jaw. The whole jaw bone being eaten away thing is a normal part of the infection/cavity process for wisdom teeth, not some scare story.

So you maybe should get a second opinion, or at least ask your dentist in more detail why he wants you to get them removed. Find out what he thinks is going to happen and make your decision based on that. After all, he's going to make a lot more money charging you thousands to get them surgically removed than he'll get for just pulling them now. It may be that they're OK for now, but get them yanked as soon as the problems start. It's not worth leaving them and hoping.
posted by shelleycat at 5:38 PM on July 30, 2006

I used to get really nasty headaches with a sharp pain that would shoot up the side of my skull. It felt like one of my wisdom teeth was wrapping itself around my optic nerve and doing horrible things to it.

I had all four of the little bastards removed and I've felt better ever since. No more headaches, jaw pain, etc. I had my tonsils removed around the same time too. Made life a lot easier.

Why didn't I have it done before? Oh, easy. My mom was too cheap. If it won't cost you an arm and a leg, go ahead and get the things taken out. Getting the things yanked made my life a heck of a lot better.
posted by drstein at 8:18 PM on July 30, 2006

You could try making it clear to your dentist that you would only get your wisdom teeth done somewhere a long way away, "while staying with my aunt in SF" or whatever, and see if they still thought it necessary. (Getting a local second opinion is unlikely to be trustworthy on the "you rub my back and I will rub yours" principle.)
posted by Idcoytco at 2:58 AM on July 31, 2006

Luckily, I only had two wisdom teeth, both on the bottom. They were fine, barely breaking the gumline--until a year ago, when part of the right one broke off (because of a cavity). I decided it was time to get it yanked out, just so I would quit worrying about whether it was going to get infected or not. The other one is still in and will stay in unless it gives me problems or breaks off. Of course, mine were not considered impacted, nor were they crowding my other teeth. YMMV.
posted by cass at 7:06 AM on July 31, 2006

All 4 of mine were horizontally impacted, and would have been pushing my straight teeth out of alignment if I didn't still have my permanent retainer. I had them extracted when I was 18.

My brother just had his pulled at 33, when they started bothering him. He had a much more difficult time than I did - I had them pulled during Spring Break, when I could take all the drugs prescribed and just lay low. He's a stay-at-home Dad with a wife in the Navy, so he had to get by on only Advil for pain relief so that he could drive and take care of their daughter.
posted by xsquared-1 at 7:20 AM on July 31, 2006

I was told when I was 15 to get my wisdom teeth pulled. I wouldn't. I don't like any form of surgery. At 20 I got a cavity in one of them and begged to just have it filled, and got my way. At 23 one of them really started hurting. I sort of ignored it, months later it was excruiating. I went to the dentist. He said I needed to have it pulled right away, it was infected. It was the worst pain I've ever had. I called the oral surgeon and said I need to get an infected wisdom tooth pulled and he said the next appointment was two months away. I lost all composure and finally was told to come right away. I should have had them pulled when I was 15.
posted by sulaine at 7:52 AM on July 31, 2006

My experience is very similar to mbrubeck's -- still have my bottom wisdom teeth, and the upper ones were extracted separately (a couple years apart) due to decay. When I was younger, my dentists were NOT urging me to have them removed. (This 'most people' business reminds me of tonsils -- my age demographic matches the time when most kids were having theirs removed, but I still have mine.)
posted by Rash at 9:54 AM on July 31, 2006

I've got 5 wisdom teeth (look at the art on the CD of Schrei X by Diamanda Galás if you'd like to see the x-ray) and no insurance, so I don't see dentists or hear about how they should come out. The teeth haven't bothered me yet; I kind of hope I'm old enough (38) that they've stopped moving.
posted by bink at 7:17 PM on July 31, 2006

I had all mine yanked at once while on the way back from a Med cruise, a 24hr rack pass sounded good to me, it was free, and negated any problems later. If you're military, I'd grab it.
posted by BillyG at 6:45 AM on August 1, 2006

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