Is it necessary to extract all 4 wisdom teeth?

[larryy]

Hi Everyone. I recently went for a clean/check up and the dentist advised me that I should get all 4 wisdom teeth extracted. I had an X-ray scan done and would just like to hear some other opinions. The wisdom teeth are not causing me any pain or discomfort. Any advice would be greatly appreciated regarding the wisdom teeth and other teeth in general. Thank you all for reading.

 

[honestdoc]

I always favor conservative, less traumatic options. As long as you aren't having pain and have no bone disease, gum disease, cavities, etc, and you are keeping them clean, I would leave them. Other dentists may choose to extract them to prevent future problems which maybe more popular. Keep in mind that any extraction/surgery run the risk of injury and trauma. Does the benefits outweigh the risks?

 

[MattKW]

I would advise you to remove them, and if you look closely you'll also see a 5th wisdom tooth in the upper right corner of the Xray (upper left in your mouth). These teeth are never go to be of significant use, and it appears as if the lowers are partially covered by gum.
How can you maintain these plaque traps for the next 50 years? You don't want to be an elderly person with other health problems that make extractions difficult, e.g. osteoporosis, blood thinners, poor healing, ...

 

[Busybee]

I can see the logic in wanting to do this when someone is young but I also had a school friend who died having their wisdom teeth out as a teen. Every surgical procedure carries a risk, leaving the teeth in the mouth also carries a risk.

 

[MattKW]

Yes, logic drives the decision, and the logical decision points towards doing when younger. If we're trading anecdotes, I had a personal friend whose unerupted wisdom tooth developed a huge cyst and he had to have his right jaw resected at age 62. I have the Xrays. The risks are much, much less when you're younger.

 

[Busybee]

I've been told by a dentist that there is greater risk of facial nerve damage if you have the extractions after the age of 30. Is that true and if so why?

 

[MattKW]

I've been told by a dentist that there is greater risk of facial nerve damage if you have the extractions after the age of 30. Is that true and if so why?

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The factors that have been suggested to explain this situation are increased bone density, surgical difficulty, complete formation of the root and reduced capacity for subsequent healing. It's not just the paraesthesia but complications generally.

 

[Busybee]

The NHS only removes them routinely if they are impacted or infected. A private dentist offered to remove mine at 25 but I was horrified. I only found out when it was too late that there are risks in extraction as you get older. They did cause problems with my bite and one is really difficult to clean because it's at an angle. I did have them sealed which has really helped. But it's a shame the NHS are not more open about the long term problems you can get by leaving them intact. By the time they grow people stop going to the dentist regularly as it's no longer free.

 

[MattKW]

As I understand it, the NHS follows the NICE Guidelines which are quite conservative. It's also convenient for the NHS as it saves money (cynical). I have seen some literature which is wondering if there should be a rethink about the Guidelines.

 

[Oceansightdental]

I agree with Dr. Matt. You absolutely need all of your wisdom teeth removed (all 5). The lower right one has a cyst. The lower left one has created substantial crowding issues. Once you remove the bottom two wisdom teeth, your upper wisdom will move downwards and create issues. The sooner you remove these problematic teeth, the easier it is to treat them. They'll start getting painful and infected within the next few years, but removing them when you're in pain is more challenging and not the correct approach. Any dentist that would advise you NOT to remove your wisdom teeth has not had enough experience with wisdom teeth and the consequence of ignoring them. Best of luck!
Ali Jazayeri DDS