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When it comes to your wisdom teeth, understanding when and why they may need to go is what’s most important to your oral health care.

Wisdom teeth are a bit like the appendix—at one point necessary for our survival, but now no longer so useful. And unlike the appendix, wisdom teeth can cause colossal problems for most people when not removed. Here are the key things to know:

Managing an evolutionary relic.

Wisdom teeth have deep roots below our gum lines, but also in our ancestry. This third set of flat molars was vital for our ancestors to eat their diet of raw roots, leaves, meats, and nuts – and their larger jawlines could easily accommodate those extra teeth. But our diets and how we eat have evolved, so knives and forks are doing much of the work that wisdom teeth used to do. Our jaws have also slimmed down, making it difficult for these molars to fit in our mouths comfortably, hence the need for wisdom teeth extraction.

Not all mouths are created equal.

Most adults get four wisdom teeth behind the first and second set of molars, but everyone is different. We also see patients with only two or three wisdom teeth, over four, or none at all!

Waiting for the eruption.

The name “wisdom teeth” has a few claimed origins, but the most common is that these teeth erupt when children are older and presumably wiser. We can typically spot wisdom teeth via x-ray while they are still below the gumline when a patient is about 12 years old. As part of your oral health care at Loudoun Smile Center, we’ll closely monitor the stages of your wisdom teeth – patients can expect to see or feel wisdom teeth try to find the surface of your gums between ages 17 and 25.

To remove…or not to remove?

About 85 percent of wisdom teeth will need to be removed, according to the American Association of Oral and Maxillofacial Surgeons. But if they grow in completely and remain free from cavities and pain, we won’t recommend removing them. Your wisdom teeth will need to be monitored closely during exams, cleanings, and through x-rays. We will recommend removal for wisdom teeth that:

  • Only partially erupt
  • Don’t have room to erupt
  • Are impacted
  • Cause jaw pain
  • Contribute to crowding of other teeth
  • Move other teeth out of alignment
  • Grow in sideways or tilted forward
  • Cause tooth decay or infections

Stuck with nowhere to go.

You may be told your wisdom teeth are “impacted.” This means these molars are trapped in a position with no room, crowding the rest of your teeth. We often see this when the wisdom teeth grow in at an angle, flat on their sides, or get stuck within the jawbone and don’t fully erupt. Impacted wisdom teeth often cause pressure and pain, damage to nearby teeth or bones, and/or bacterial growth.

Timing the takeout.

Determining if and when your wisdom teeth should be removed is our job as your dental provider. We typically recommend impacted wisdom teeth be removed when the roots are between one-third and two-thirds formed, as waiting longer increases the risk of injury to the nerves and sinuses. We also recommend having your wisdom teeth removed earlier (late teens to early 20s) rather than later in life. After 35, oral surgeries bring on more complications: the roots of our teeth form more fully as we age, making extractions tougher, and the jaw has less vascularity, so healing takes longer.

Now what?

While we don’t perform oral surgeries at Loudoun Smile Center, you’re in skilled hands. Once we determine that your wisdom teeth should come out, we’ll refer you to our network of highly qualified oral surgeons. Your surgeon will walk you through the process, including pre- and post-surgery procedures, and aftercare. Need to know more about wisdom teeth – either yours or your child’s? At Loudoun Smile Center, we’re always here to help…talk to us at your next visit!