Wisdom teeth, also known as third molars, are the last teeth to develop and typically emerge in the late teens or early twenties. While some people never experience issues with their wisdom teeth, many are advised to have them removed due to the higher risk of complications.
A common question patients ask is whether wisdom teeth have to be removed. The answer depends on how the teeth develop, the amount of space available in the jaw, and whether they are causing, or are likely to cause, problems over time. This article explains why wisdom teeth are often removed, what can happen if they are left in place, and when removal is typically recommended, helping you understand whether further evaluation may be needed
Are Wisdom Teeth Necessary?
In previous generations, wisdom teeth served a useful purpose, replacing molars that were often lost to decay or dental neglect. This is far less common today due to significant improvements in dental care.
As a result, wisdom teeth are more likely to cause problems than provide benefits. They often become impacted, meaning they remain partially or completely trapped beneath the gum tissue or jawbone. Impacted wisdom teeth increase the risk of bacterial infection, tooth decay, and other oral health concerns.
Why Do Wisdom Teeth Need to Be Removed?
For many people, the jaw does not have enough space to accommodate wisdom teeth properly. Because these teeth erupt later than the rest of the permanent teeth, they often lack a clear path to emerge normally. When this happens, wisdom teeth are more likely to become impacted, misaligned, or difficult to keep clean.
Wisdom teeth are also located at the very back of the mouth, an area that is harder to reach with routine brushing and flossing. This makes them more vulnerable to decay, gum disease, and infection. Even wisdom teeth that partially erupt can create openings in the gums where bacteria and food debris become trapped, increasing the risk of ongoing oral health issues.
Due to these factors, wisdom teeth are commonly removed as a preventive measure, not because they always cause immediate problems, but because they have a higher likelihood of leading to complications over time if left untreated.
“The reason wisdom teeth are often removed is because there isn’t enough room in the jaw for them to erupt properly. When they only partially come in, food and bacteria can get trapped around the tooth, increasing the risk of pain and infection over time.”— Dr. Brian Farrell, DDS, MD, FACS
What Happens If You Don’t Get Your Wisdom Teeth Removed?
Not everyone experiences immediate problems from their wisdom teeth. However, when wisdom teeth are left in place, especially if they are impacted or partially erupted, the risk of complications increases over time. Many issues develop gradually and may not be noticeable at first.
Common consequences of not removing wisdom teeth include:
- Impacted Wisdom Teeth: When wisdom teeth remain trapped beneath the gum tissue or jawbone, they are considered impacted. Impacted wisdom teeth can cause pressure, pain, and swelling, and they are more prone to infection and damage to nearby teeth.
- Infection & Gum Disease: Partially erupted wisdom teeth often create openings in the gums where bacteria and food debris become trapped. This can lead to infection, inflammation, and recurring gum problems that are difficult to manage without removal.
- Tooth Decay: Because wisdom teeth are located at the back of the mouth, they are harder to clean effectively. This increases the risk of cavities and decay, not only in the wisdom teeth themselves but also in neighboring teeth.
- Crowding & Tooth Shifting: When there is not enough space in the jaw, wisdom teeth may push against existing teeth as they attempt to erupt. This can contribute to crowding, shifting, or changes in tooth alignment over time.
- Cysts & Other Complications: In some cases, untreated wisdom teeth can lead to the development of cysts or other growths around the tooth. While less common, these issues can affect the surrounding bone and teeth if not addressed.
Impacted Wisdom Teeth and Why They’re a Concern
Wisdom teeth are considered impacted when they do not have enough room to emerge and remain trapped beneath the gums or jawbone fully. This is one of the most common reasons wisdom teeth are removed.
Impacted wisdom teeth are more difficult to clean and are more likely to lead to infection, damage to nearby teeth, pain, or the formation of cysts. Because symptoms may not appear right away, dental X-rays are often used to identify impaction and assess future risk.
When Is Wisdom Teeth Removal Typically Recommended?
Wisdom teeth removal is not automatically required for everyone. The decision is typically based on whether the position of the teeth creates a high likelihood of future complications, even if no symptoms are present today.
During an evaluation, factors such as jaw space, eruption pattern, and the direction the teeth are growing are assessed using dental imaging. Wisdom teeth that are unlikely to erupt normally or remain healthy long-term are often recommended for removal to reduce the risk of future issues.
In some cases, wisdom teeth may be monitored rather than removed. A professional evaluation helps determine whether proactive removal or continued observation is the most appropriate approach.
The Importance of an Oral and Maxillofacial Surgeon
Wisdom teeth removal can vary in complexity depending on the teeth’s position and jaw anatomy. When wisdom teeth are impacted or located near important structures, evaluation by an oral surgeon is often recommended.
Oral and maxillofacial surgeons use specialized training and imaging to assess risk and determine the safest approach to care, particularly in cases where future complications are more likely.
Next Steps for Wisdom Teeth Evaluation
Understanding how wisdom teeth develop and when removal may be recommended can help you make an informed decision about your oral health.
If you have questions about your wisdom teeth or would like a professional evaluation, you can schedule a consultation to discuss your options and determine whether removal or monitoring is appropriate at any of our North & South Carolina locations