If you’re between the ages of 17 and 25, there’s a good chance someone has already talked to you about wisdom teeth. Maybe your dentist mentioned your wisdom teeth during your last checkup, or your friends shared their own removal stories with you. It’s such a common topic that it almost feels like a rite of passage. But here’s the question I hear all the time in my practice: do you actually need to have your wisdom teeth removed?

I’m Dr. Edmon Ahdoot, and at Smiles by Eddie, I’ve spent years helping patients make informed decisions about their dental health. Today, I want to share what I’ve learned about wisdom teeth and help you understand when removal is truly necessary and when you might be able to keep them.

What Are Wisdom Teeth Anyway?

Let me start with the basics. Wisdom teeth are your third molars, the last set of teeth to develop in your mouth. They typically appear between ages 17 and 25. That’s where they get their name – they show up when you’re supposedly wiser than you were as a child.

Here’s a fascinating scientific fact: researchers have found stem cells in your wisdom teeth, and they believe these cells could help treat future medical conditions. Pretty amazing when you think about it.

But here’s where things get interesting. Our ancestors actually needed these teeth. Thousands of years ago, early humans ate tough, raw foods like roots, uncooked meat, and nuts. Wisdom teeth were helpful to our early ancestors who ate tough, uncooked foods that wore away their teeth. They needed that extra grinding power at the back of their mouths to break down their meals.

However, things have changed dramatically. With cooking and making food softer, the size of our jaws has diminished, often with room for the last molars to form in the jaw but not enough room to erupt. This is why so many people today run into problems with their wisdom teeth.

The Numbers Tell an Important Story

Let me share some data that might surprise you. Dentists extract more than 10 million third molars from about 5 million people in the United States each year, at a cost of over $3 billion. That’s a staggering number when you really think about it.

But here’s what really caught my attention during my research: Most older adults in the United States have had their wisdom teeth removed, but most young adults have not. In fact, a 2024 survey found that 53% of Americans had undergone wisdom teeth removal, with a lower rate of 26% among those aged 18-29.

Show Image

This chart shows something really important. The older generation had their wisdom teeth removed at much higher rates than younger people today. Why? The dental recommendations have actually changed over time based on new research and better understanding of when removal is truly necessary.

When Do You Actually Need Them Removed?

This is the most important question, isn’t it? I always tell my patients that wisdom teeth removal isn’t automatic. You need them removed when they’re causing problems or will likely cause problems soon. Here are the situations where I typically recommend removal:

Impacted Teeth: This happens when your wisdom teeth don’t have enough room to grow properly. They might be stuck in your jawbone or growing at an angle that pushes against your other teeth. 90% of 20 year olds have at least one wisdom tooth that hasn’t erupted or has erupted partially. When teeth are impacted, they can cause serious issues if left untreated.

Infection and Pain: Sometimes wisdom teeth partially break through your gums, creating an opening where bacteria can enter. This leads to an infection called pericoronitis. The pain and swelling can be intense, and repeated infections are a clear sign that those teeth need to come out.

Crowding Your Other Teeth: While this is debated in the dental community, some wisdom teeth push against your other molars as they try to erupt. This can cause crowding and alignment issues that affect your bite and overall dental health.

Decay and Cavities: Wisdom teeth sit so far back in your mouth that they’re incredibly difficult to clean properly. Even with excellent oral hygiene, these teeth are more prone to decay and cavities simply because your toothbrush can’t reach them effectively.

Cyst Formation: In rare cases, fluid-filled sacs called cysts can develop around impacted wisdom teeth. Over time, these can damage your jawbone and nearby teeth.

When You Might Not Need Removal

Here’s something many people don’t realize: not everyone needs their wisdom teeth removed. I’ve seen plenty of patients whose wisdom teeth came in perfectly straight, with enough room, and cause no problems at all.

Only 12% of truly impacted teeth are associated with pathological conditions such as cysts and damage to adjacent teeth. This means the majority of impacted wisdom teeth don’t automatically require removal unless they’re causing specific problems.

If your wisdom teeth have fully erupted, are positioned correctly, can be cleaned properly during regular brushing and flossing, and aren’t causing pain or damage, there’s often no reason to remove them. In fact, the UK’s National Institute for Clinical Excellence began discouraging routine wisdom tooth removal in 2000, and in 2008, the American Public Health Association released a similar statement opposing the removal of undiseased third molars.

The Controversy in the Dental Community

I want to be transparent with you about something important. There’s genuine debate in the dental community about wisdom teeth removal. At least two thirds of these extractions, associated costs, and injuries are unnecessary, constituting a silent epidemic of iatrogenic injury, according to research published in the American Journal of Public Health.

This doesn’t mean wisdom teeth removal is wrong. What it means is that every case needs to be evaluated individually. Some dentists still recommend removing wisdom teeth before problems develop, while others prefer to monitor them carefully and only remove them if issues arise.

My approach falls somewhere in the middle. I believe in careful evaluation using X-rays and clinical examination to assess each patient’s unique situation. If your wisdom teeth are likely to cause problems based on their position and your jaw structure, early removal might be easier and lead to better recovery. However, if your wisdom teeth are healthy and positioned well, I see no reason to remove them “just in case.”

What About Timing?

If you do need wisdom teeth removed, timing matters. The recovery tends to be easier when you’re younger because the tooth roots aren’t fully formed yet. Most oral surgeons recommend removal in the late teens or early twenties if extraction is necessary.

However, wisdom teeth can be removed at any age. I’ve performed extractions on patients ranging from teenagers to those in their 70s. The procedure is just more straightforward when you’re younger, and healing tends to happen faster.

Making Your Decision

So, how do you know what’s right for you? Here’s my advice:

First, get a comprehensive evaluation from a dentist you trust. This should include X-rays that show the position of your wisdom teeth and how they’re developing. Ask questions about your specific situation. Don’t be afraid to get a second opinion if you’re unsure.

Second, understand your own dental health and habits. If you have excellent oral hygiene and enough room for your wisdom teeth to come in properly, you might be fine keeping them. However, if you struggle with dental care or your jaw is too small, removal might be the better option.

Third, consider your family history. Dental issues often run in families. If your parents or siblings had problems with their wisdom teeth, you might face similar challenges.

Finally, think about the timing. If you’re heading off to college or starting a new job, you might want to plan extraction during a time when you can take a few days to recover without major disruptions to your life.

The Bottom Line

Do you really need your wisdom teeth removed? The honest answer is: it depends. Every mouth is different, and what’s right for your friend or sibling might not be right for you.

There is insufficient reliable scientific evidence for dental health professionals and policymakers to determine if asymptomatic, disease-free impacted wisdom teeth should be removed. This means the decision comes down to a combination of professional expertise and your personal situation.

What I can tell you with confidence is this: if your wisdom teeth are causing pain, infection, damage to other teeth, or significant crowding, removal is typically the right choice. If they’re healthy, positioned well, and you can keep them clean, there may be no reason to remove them at all.

The most important thing is to have regular dental checkups so we can monitor your wisdom teeth as they develop. With modern imaging technology and careful clinical evaluation, we can catch potential problems early and make informed decisions together about your treatment.

At Smiles by Eddie, I’m committed to helping you make the best choice for your dental health. If you’re wondering about your wisdom teeth, schedule a consultation with me. We’ll take a thorough look at your situation, discuss all your options, and create a plan that makes sense for you.

Remember, wisdom teeth removal isn’t a one-size-fits-all procedure. It’s a decision that should be made carefully, based on your unique dental anatomy and needs. Don’t let anyone pressure you into unnecessary treatment, but also don’t ignore warning signs that removal might be necessary.

Your smile is important, and keeping it healthy means making informed decisions about every aspect of your dental care – including those wisdom teeth.

References:

• American Public Health Association: Opposition to Prophylactic Removal of Third Molars
• Smithsonian Institution Human Origins Program: Why Do We Have Wisdom Teeth?