Although not everyone needs to have their wisdom teeth pulled, for most of us, the day comes when these teeth—located at the very back of the mouth, top and bottom—will cause a problem and need to be removed. This is because most jaws are too small to fit four fully erupted wisdom teeth, also called third molars. Even when the teeth fit, they’re usually so far back in the mouth that it’s extremely difficult to keep them clean, which can lead to gum disease or tooth decay.
Wisdom teeth are typically the last teeth to develop, coming in between the mid-teenage years and the early twenties. If they grow in completely, chew well, don’t show signs of decay or gum disease and don’t cause pain, they don’t need to be removed.
When wisdom teeth are impacted
In some cases, wisdom teeth aren’t able to break all the way through the gums. Impacted wisdom teeth can cause infection and other oral health problems. Signs that you might have an impacted wisdom tooth include pain, bleeding and swelling of the gums.
But just because you can’t see your wisdom teeth doesn’t mean they’re impacted: In 10 to 25 percent of Americans, one or more third molars never grow. Your dentist or oral surgeon can assess and diagnose impacted wisdom teeth using X-rays. He or she will discuss with you whether there’s room for them to erupt and how difficult it will be to have them removed, should that become necessary.
It’s best to remove impacted wisdom teeth before their root structure is fully developed. In some patients, that’s as early as age 12 or 13, and in others not until the early twenties. The American Association of Oral and Maxillofacial Surgeons has conducted studies that show the best time to have third molars evaluated by an oral surgeon is by the time a patient is a young adult. Problems with impacted teeth come up more frequently after age 30.
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