Why Remove all 4 Wisdom Teeth?

Patients often ask us, as oral & maxillofacial surgeons (OMS), if it is essential to remove all four wisdom teeth at once, regardless if they are not bothering them.
That decision can be difficult. When all four wisdom teeth are free of infection and not causing any pain – OR if only one of the teeth is problematic – an OMS will still recommend removing all.

Here is Why: 

Because of their location in the back of the mouth, wisdom teeth are usually difficult to keep free from plaque, and bacteria from food that can be harmful. This will result in infection, decay, and gum disease. Even wisdom teeth buried under the gum tissue may cause these same issues.

So, why not adopt a wait-and-see approach to wisdom teeth coming in (or yet to erupt) that haven’t caused any trouble? Here are some items to consider:
• It is easier to remove wisdom teeth in younger patients, the roots of wisdom teeth are not completely formed, and the surrounding bone structure, there is less chance of damaging nearby nerves or other structures. The overall risk of any surgical complication becomes more common in adulthood.
• The recovery for a patient is one time, versus multiple times per surgical visit. 
• This includes an additional healing period and a restricted diet.
• Prope care for any remaining wisdom teeth requires routine inspections and X-rays.
• The expense can be more due to visiting an OMS office multiple times for each additional wisdom tooth extraction, should they become problematic later.

For these reasons, you and your oral surgeon should discuss whether you should have all four wisdom teeth extracted at the same time.

Risks of Keeping Wisdom Teeth:

The decision not to extract wisdom teeth is reasonable in some circumstances and should be made by the patient, a guardian/parent (if applicable), and the OMS. However, the patient must understand wisdom teeth that are not removed can:
• Cause damage to neighboring teeth.
• Develop pathologies such as cysts, abscesses, and tumors.
• Develop cavities that can’t be restored.
• Lead to infections and other periodontal diseases.

Questions about wisdom tooth removal should be discussed with Dr. Kalant or Dr. Pink, at your initial consultation. Our doctors evaluate each patient individually and make a recommendation based on any discomfort, high risk of disease, or recommendation from their referring doctor. 

It is recommended that patients undergo an evaluation and X-rays of their wisdom teeth every year.