Why does the wisdom tooth need to come out?

People often joke that their wisdom teeth grow because they are too wise. The wisdom tooth refers to the third molar, the eighth tooth in the row. However, we are no less wise if we decide to have this tooth extracted.

Wisdom teeth are the last teeth in the row and typically erupt the latest, between the ages of 16 and 25. Their shapes can vary greatly, with different numbers of cusps and even more diverse root structures. The eruption of a wisdom tooth can be complete, meaning that the opposing teeth meet properly, providing additional chewing pairs. However, the opposite often happens. Sometimes the tooth does not erupt at all, which we call impacted. A partially erupted tooth, known as semi-impacted, is partially covered by bone and partially by gum. More and more people each year lack the genetic blueprint for these teeth, indicating their evolutionary disappearance.

When is extraction necessary?

  • If the tooth is symptomatic, meaning it causes pain, there is inflammation around it, or it is destroyed by cavities.
  • If the position of the tooth threatens surrounding structures (e.g., it grows into an adjacent tooth or is near a nerve).
  • If the tooth lacks an opposing tooth (antagonist), as it will then over-erupt and lose its function.
  • If the tooth is semi-impacted, creating a pocket between the gum and the tooth where food collects, leading to inflammation due to difficulty cleaning the area.
  • If the tooth is not easily accessible, making proper hygiene impossible.

Extraction of such teeth is recommended before the age of 30 when the bone is still elastic and regenerates quickly, although extractions can still be done in later years.

It is worth mentioning that extracting wisdom teeth as a preventative measure to avoid positional changes in the front teeth is not valid. Studies show that the position of wisdom teeth has minimal or no impact on the position of other teeth. Therefore, extraction does not prevent tooth movement in middle age.

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