Is it necessary to extract your wisdom tooth if it is not causing any problems?

Doctor's Answer

Thanks for your question and I understand you have a question about wisdom tooth removal even if the wisdom tooth is not causing any pain.

Firstly, it's really important to be seen by dentist for any current wisdom teeth condition, even if there is no pain.

There are many ways that wisdom teeth can be in positions affecting surrounding structures, such as:

- caries (decay) on a wisdom tooth
- impacted wisdom teeth with gum infection
- wisdom teeth causing caries on the second last molar

Interestingly, most cases do not cause any obvious symptoms such as pain even if there are dental diseases caused by the wisdom tooth.

The most worrying thing is if it is too late to save even the second last molar once a patient experiences any symptoms around their wisdom teeth.

In most cases, if a patient has a severe gum infection around the wisdom tooth, including the second last molar, or has severe caries on a wisdom tooth, pain may come from the second last molar.

Therefore, the main purpose of wisdom tooth extraction is more to prevent the loss of the second last molar or serious gum infections, which most likely would happen based on research.

These cases are typical examples where a dentist may recommend wisdom tooth extraction even though there may be no pain:

1. Caries (decay) on a wisdom tooth

In this case, a filling can be done if necessary or the wisdom tooth is fully erupted in the right position.

2. Gum infection around wisdom tooth (including the second last molar engaged)

3. Impacted wisdom tooth (not fully erupted). In this case, part of the wisdom tooth is visible.

- If a wisdom tooth is impacted, the area around the wisdom tooth is most likely not easy to clean.
This includes the wisdom tooth itself and especially in between the second last molar and wisdom tooth.
- This can cause bone resorption of the second last molar, which cause the shaking and loss of the second last molar
- This can cause decay on the root area of the second last molar, which cannot be treated by filling, so it should only be extracted.
- Constant trapping of food in between the wisdom tooth and second last molar could potentially cause gum infection and caries on wisdom tooth and second last molar, which will cause the loss of both teeth.

4. Dental cysts or tumors around wisdom tooth (this does not happen very often)

Number 1 and 3 occur the most often at my dental practice in cases of wisdom tooth removal before the wisdom teeth cause any pain, from my experiences.

The above are very simple examples. The wisdom tooth is sometimes like a "bomb" which potentially causes many problems for those cases.

So it is advised to get a proper examination with an X-ray and get wisdom teeth removed for above cases to prevent from further pain. This is especially since healing time is longer after wisdom tooth extraction if the wisdom teeth caused pain, compared to if the wisdom teeth caused no pain.

Preventing complications is better than wisdom tooth removal after symptoms occur if it is a very obvious case.

Thanks for your valuable question about wisdom teeth and I hope my answer is helpful for you.

Please feel free to contact us or leave further question if there are further questions.

Thanks so much.

Warm regards,

Ryan Yun (Dr)

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