Do wisdom teeth always have to be removed? For a long time, extracting the back molars was considered a routine procedure. Today, specialists assess the question much more differently: Many wisdom teeth can stay as long as they don't cause any discomfort. Whether an intervention is necessary is decided on a case-by-case basis - also because wisdom teeth can now serve as the body's own tooth replacement.
Wisdom Teeth: An Evolutionary Heritage
Wisdom teeth are an evolutionary legacy from times when hard food required strong molars. But today, many people simply don't have enough space in their jaw. In 20 percent, the back molars are not even developed. In the other 80 percent, wisdom teeth usually emerge between the ages of 17 and 25 and complete the dentition to 32 teeth. It becomes tricky when the teeth only partially emerge or lie crooked in the bone. Possible consequences are then inflammation, pressure sensations, or pain.
Blanket Extraction Considered Outdated
Anyone who notices discomfort should have it checked by a dentist early on. However, this does not mean that pliers must be used immediately. Whether the back molars can stay depends on position, shape, and jaw size. If wisdom teeth have enough space and fit cleanly into the row of teeth, there is no reason to rush. This is confirmed by Associate Professor Dr. Frank Peter Strietzel from Charité Universitätsmedizin Berlin: The blanket extraction of all wisdom teeth is outdated. Many can remain in the mouth for a lifetime if, like all other teeth, they are checked regularly and do not cause any discomfort.
When an Intervention Makes Sense
It becomes critical with lack of space, cavities, crooked growth, or recurring inflammation. If a wisdom tooth only partially emerges, bacteria can easily collect under the gum, warns the dental initiative proDente e.V.. Swelling, pressure, and throbbing pain extending to the ear are then not uncommon. Before the age of 25 is considered a good time to remove wisdom teeth, as long as the roots are not yet fully developed. The procedure is then easier, the wound heals faster, and the risk of complications is lower.
Modern diagnostics have changed through new procedures. Three-dimensional X-rays show exactly where nerves and blood vessels run and enable minimally invasive procedures with smaller wounds that heal faster.
A Second Life for the Tooth
In addition, there is now the opportunity for a kind of tooth recycling: A healthy wisdom tooth can close a gap elsewhere. With this so-called autogenous transplantation, the body recognizes its own tooth as part of the body and rarely rejects it. Biological, body's own tooth replacement that stimulates bone growth and eliminates rejection reactions. In adolescents, the transplanted tooth survives after five years in around 90 percent of cases.
Whether a wisdom tooth stays or goes is therefore decided on a case-by-case basis. In addition to dentists, maxillofacial surgeons and orthodontists are important contacts.
