At some point in most people’s lives they are faced with the question if need their wisdom teeth taken out or if they should keep them.


The majority of patients trust their dentist to help make this decision.  So what are the pros an cons of both options from a dentist’s point of view?


The argument for leaving them in:

  1. There is plenty of room for them and you chew with them.
  2. The tooth/teeth is/are sitting on the nerve and could risk permanent paresthesia (permanent numbness) if the tooth is to come out.
  3. The patient has had them for a long time and hasn’t had any problem with them although there is not quite enough room for them.

The argument for taking them out:

  1. There is not enough room for them.
  2. They are impacted (under the gum and/or bone) which means that there is not enough room for them.
  3. They are starting to erupt but there isn’t really enough room for them and the gum tissue around them is irritated and possibly infected. This condition is known as pericoronitis.
  4. They are decayed, and filling the cavities is not the recommended treatment.
  5. The lower wisdom tooth is rotated either at an angle or horizontally, and the second molar has decay as a result.
  6. It is impossible to keep the teeth clean and now there is a periodontal pocket around involved with the wisdom tooth.
  7. I have heard people tell me that wisdom teeth should be removed because it will cause their teeth to shift. This has been shown to not be the case, that teeth will shift to the midline even when the wisdom teeth are missing. I do include this here because I have heard it so often!

So, there is usually a good reason to take wisdom teeth out, and it is most commonly because adequate room is lacking for them to come in. As I continue to practice, I look for more reasons to keep the teeth rather than extract them. Early in my career I recommend that almost all of them come out. Keep in mind that younger people typically heal quicker than older people. So, if there is a good reason to remove the wisdom teeth, do it earlier in life.