Wisdom teeth removal: When is it necessary?

Wisdom teeth — the third molars in the very back of your mouth — may not need to be removed if they are:

• Healthy
• Grown in completely (fully erupted)
• Positioned correctly and biting properly with their opposing teeth
• Able to be cleaned as part of daily hygiene practices

Many times, however, wisdom teeth don't have room to grow properly and can cause problems. Erupting wisdom teeth can grow at various angles in the jaw, sometimes even horizontally. Problems can include wisdom teeth that:

• Remain completely hidden within the gums. If they aren't able to emerge normally, wisdom teeth become trapped (impacted) within your jaw. Sometimes this can result in infection or can cause a cyst that can damage other teeth roots or bone support.
• Emerge partially through the gums. Because this area is hard to see and clean, wisdom teeth that partially emerge create a passageway that can become a magnet for bacteria that cause gum disease and oral infection.
• Crowd nearby teeth. If wisdom teeth don't have enough room to come in properly, they may crowd or damage nearby teeth.

Some dentists recommend removing wisdom teeth if they don't fully emerge. Many dentists believe it's better to remove wisdom teeth at a younger age, before the roots and bone are fully formed, and when recovery is generally faster after surgery. This is why some young adults have their wisdom teeth pulled before the teeth cause problems.

According to the American Dental Association, wisdom teeth removal may be necessary if you experience changes in the area of those teeth, such as:

• Pain
• Repeated infection of soft tissue behind the lower last tooth
• Fluid-filled sacs (cysts)
• Tumors
• Damage to nearby teeth
• Gum disease
• Extensive tooth decay

The decision to remove wisdom teeth isn't always clear. Talk to your dentist or an oral surgeon about the position and health of your wisdom teeth and what's best for your situation.