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Risks Involved With Not Removing Wisdom Teeth

Wisdom teeth removal commonly occurs in a patient's mid-teens to early twenties, typically on breaks from school.  However, a commonly asked question is, “Do I need to have my wisdom teeth removed?”  While this depends on your specific clinical condition, there are a number of important factors to consider.

We will review several below:

The Nature of Teeth 

Your teeth develop and grow over time.  We typically first start to see our permanent teeth erupt (or appear) into the mouth around 6 years old with our front teeth.  Not long after this, between 7 and 10 years old, your wisdom teeth begin to calcify, or develop.  By 12 to 16 years old the crowns are completely developed.  The crown is what we typically think of as a tooth, or what we see when we look in our mouths.  At this point, wisdom teeth are typically still fully encased, or “impacted”, in the bone.  This is often the same time that braces are placed.  By the time braces come off, the wisdom tooth roots are usually starting to develop and it is time for a visit to the oral surgeon to evaluate if it is appropriate to remove your wisdom teeth.  

The Position of the Teeth Creates Risks

Oftentimes as the wisdom teeth develop there is not enough room in the jaw bones for them to fully grow and erupt into the mouth.  This will commonly lead to impacted teeth that are partially or fully buried in the bone or gums.  This can lead to malformed wisdom teeth or periodontal (gum) problems.  Wisdom teeth may grow in angled or laying sideways due to inadequate space.  This can lead to resorption (eating away) of the root of the second molars or create periodontal pockets.  If periodontal pockets are present, this can lead to food impaction and ultimately infections or abscesses.  

Even if the wisdom teeth do erupt into the mouth partially, there is quite frequently not enough room for them to fully erupt to enable appropriate cleaning to include flossing and brushing of the entire surface of the tooth.  This can also lead to increased risks for caries (cavities), gum disease, gingivitis, food trapping, and infections.  This is when patients will usually present with complaints of pain associated with their wisdom teeth.  

Occasionally, when wisdom teeth cannot erupt completely, they will develop pathology such as a cyst or a tumor.  It is very important that any pathology is evaluated and biopsied or removed in a timely manner.  

Removing Wisdom Teeth Later in Life Can be Harder and Riskier

It is possible to have wisdom teeth removed later in life, if, or when they become a problem.  However, all data shows that risks and complications associated with wisdom tooth removal increases after the age of 25-30 years old.  The older one gets, the greater these risks become.  It is important to evaluate wisdom teeth for removal before the roots are fully developed as the longer they grow, the greater the risk of injury to the inferior alveolar nerve (the nerve that gives you feeling on your chin and lower lip).  The older a patient gets the less resilient the nerve will be to recovery.  

Additionally, increased age is associated with a greater risk of a bony defect at the site of extraction, greater risk of jaw fracture, and increased incidence of oral-antral communication (opening into the sinus).  Thankfully, these are not high risks, especially in the hands of a well trained, board-certified oral surgeon such as the surgeons at Northwest Oral and Maxillofacial Surgery.  

One final consideration when removing wisdom teeth when you are older is that the jaw bones are denser, or stronger.  This may mean more surgical work to remove the tooth from the bone.  This is typically associated with more swelling and discomfort, which often lasts a few more days than when surgery is completed under the age of 30.  

In closing, it is important and recommended to have an evaluation of the condition of your wisdom teeth sometime between your mid-teens and early twenties.  This allows your oral surgeon to review your case and advise you as to the most appropriate course of action, whether it is to continue to observe the wisdom teeth or if it is time to remove them.  If it is most appropriate to remove the wisdom teeth, it is best to do it before the age of twenty-five to ensure a speedy recovery.  

If you are considering wisdom teeth removal surgery, contact us to schedule an initial consultation. Our board-certified oral surgeons specialize in wisdom teeth removal and work closely with referring doctors to provide comprehensive care for all our patients. For more information on wisdom teeth removal visit our website. 

Contact Northwest Oral & Maxillofacial Surgery


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