Family First Dental

March 6, 2006: When to remove wisdom teeth?

When should you remove your wisdom teeth? Wisdom teeth should begin to be evaluated when people are about 14 or 15 years of age. The average age for wisdom teeth removal is 17 years old (in my own practice). Not everyone needs their wisdom teeth out but it is very common.

Why is there commonly not enough room for wisdom teeth? Let me share the theory that makes the most sense to me. If you look at the human diet, it has drastically changed in the last 100 years. Just imagine eating meat 100 years ago. It was tough! You had to really chew to eat. Our modern diet I refer to as the McDonalds diet. Our food is very easy to eat. Now think about a fast food hamburger. You can almost eat it without teeth. So what difference does it make? Our jaw muscles are not nearly as developed as they were just 100 years ago. And here is the key...Bones develop in response to muscles. (Not vica versa). So, jaws are developing smaller and there is a lack of room for your teeth which are the same size.

Why not wait til they bother you? I like to pick on teenagers for several reasons. First, the healing curve for a teenager is awesome. They seem to heal much faster than someone who is even 25 years old. My theory here is that their bone may be less dense and have a better blood supply. Second, wisdom teeth come out less traumatically when the roots are not fully formed. The last 10 to 20% of the root formation is where they often form nasty curves. These curved roots anchor the tooth in the bone and cause the dentist to be much more aggressive to remove them. And, more aggressiveness or bone trauma means more pain and healing time. Curved roots can also cause other complications such as nerve numbness or a hole into your sinus cavity (when they are removed). 17 year old patients on average have roots which are about 75% formed and perfect for removing. Thirdly, teenagers have the time to have their teeth removed. I had to have one of my wisdom teeth removed 6 years ago and it was tough! When you have a family, it is nearly impossible to schedule a week off. Finally, teenagers are usually on their parents insurance. I see a lot of 20 and 30 year olds who suddenly have wisdom teeth aches but have no insurance. They regret not having it done when they were covered.

The other end of the spectrum is removing wisdom teeth too early. I don't like to remove wisdom teeth when they are "full boney impactions". What this means is that the teeth are fully covered by bone. To remove teeth this early means they have to be uncovered first and in my experience this leads to more swelling and pain. 14 and 15 year olds quite often have wisdom teeth in this stage. I also have to make larger incisions in the gums and stretch the patient's cheek more in this stage. I prefer to wait until the teeth can be removed easier and thus when they should heal easier.

Although 17 years old is the most common age for wisdom teeth removal, they should be evaluated earlier. I have had quite a few 15 year old patients that have developed early. Their roots would probably be fully formed by 17 and then more difficult to remove.

If you are in the office, don't be afraid to ask for my opinion or evaluation!

Thanks for reading,

David Gryzick