It is one of the most common questions we hear from our patients sitting in the chair: “Do I really need to go through with this?” For many, the idea of oral surgery sounds daunting. You might look in the mirror, see that your smile looks fine, feel no pain, and wonder if wisdom teeth removal is truly necessary or just a rite of passage that you can skip.
At Dental Care of Beverly Hills, we believe in empowering you with the right information so you can make the best decision for your oral health. While every smile is unique, the trouble with wisdom teeth—officially known as third molars—is that they are notoriously unpredictable. Let’s dive deep into what these teeth are, why they cause so much trouble, and how we determine if it is time for them to go.
Understanding the “Third Molar” Mystery
To understand why these teeth are often problematic, we have to look at biology. Wisdom teeth are the last set of molars to erupt, usually appearing between the ages of 17 and 25. Historically, our ancestors needed these extra grinding teeth to chew coarse foods like roots, nuts, and tough meats. However, as human diets softened and our jawbones evolved to become smaller over thousands of years, we simply ran out of room.
Today, a large portion of the population simply does not have the jaw space to accommodate four extra teeth. When a tooth tries to enter a space that doesn’t exist, it becomes “impacted.” This means the tooth is stuck beneath the gum or bone, or it comes in at an odd angle. While some people are lucky enough to have fully erupted, functional wisdom teeth, they are the exception rather than the rule.
The Silent Threat: Asymptomatic Wisdom Teeth
One of the biggest misconceptions we encounter is the idea that “no pain means no problem.” It is very easy to assume that if your teeth aren’t hurting, everything is fine. However, wisdom teeth can be silent troublemakers. Even if they haven’t caused you a sleepless night yet, they could be developing issues below the surface.
We take a proactive approach because disease generally happens before symptoms appear. By the time you feel severe pain, damage to the jawbone, infection, or harm to adjacent teeth may have already occurred. We use advanced imaging, including panoramic X-rays and 3D scans, to look at the position of the roots and the density of the bone. This allows us to predict future movements of the teeth and recommend wisdom teeth removal before it becomes an emergency situation.
5 Signs It Is Time for Removal
While we rely on X-rays for a definitive diagnosis, your body will often give you signals that your third molars are acting up. Here are the most common signs we look for:
- Pain and Sensitivity: This is the most obvious sign. You might feel a throbbing sensation in the back of your mouth, or sensitivity when biting down.
- Gum Inflammation: When a tooth partially breaks through the gum, it creates a flap of tissue where food and bacteria can get trapped. This leads to pericoronitis, a painful infection that causes swelling and bad breath.
- Crowding and Shifting: If you have had braces, this is a major concern. The pressure from erupting wisdom teeth can push your other teeth out of alignment, undoing years of orthodontic work.
- Sinus Issues: Surprisingly, wisdom teeth in the upper jaw can push against the sinuses, causing congestion, pressure, and headaches.
- Cysts and Tumors: In rare but serious cases, fluid-filled sacs called cysts can form around the wisdom tooth, damaging the jawbone and nerves.
The Risk of Impacted Teeth
Impaction is the primary reason we recommend surgery. According to the American Association of Oral and Maxillofacial Surgeons, an estimated 85% of third molars will eventually need to be removed due to impaction, crowding, or decay. This is a staggering data point that highlights just how common this issue is. When a tooth is impacted, it might grow horizontally, putting immense pressure on the second molar in front of it. This can lead to resorption, where the root of the healthy tooth is eaten away by the pressure of the wisdom tooth.
Why Age Matters
We often get asked, “Can I just wait until I’m older to deal with this?” While you technically can, we strongly advise against it. There is a “sweet spot” for removing wisdom teeth, typically between the ages of 15 and 25.
During this timeframe, the roots of the wisdom teeth are not fully formed. They are shorter and less anchored in the jawbone. Furthermore, the bone surrounding the teeth is softer and more flexible. This combination makes the extraction easier and significantly reduces the risk of complications, such as nerve damage. As you age, the roots lengthen and can curve around the sensory nerves in the jaw. The bone also becomes denser.
Data Point: Research indicates that patients over the age of 25 have a 1.5 times greater risk of complications during recovery compared to younger patients, and the healing process takes significantly longer. By handling this in your late teens or early twenties, you are setting yourself up for a much smoother experience.
Can You Ever Keep Them?
We want to be clear: we do not pull teeth just for the sake of pulling them. There are scenarios where we will tell a patient they can keep their wisdom teeth. We will generally give you the green light to keep them if:
- They are healthy and free from decay (cavities).
- They have fully erupted (broken through the gums completely).
- They are positioned correctly and biting properly with the opposing teeth.
- You are able to clean them thoroughly with a toothbrush and floss.
The last point is crucial. Because these teeth are so far back in the mouth, reaching them with floss is incredibly difficult. If you cannot keep them clean, they become a breeding ground for bacteria, eventually leading to decay and gum disease that can spread to your healthy molars.
The Procedure: What to Expect
We understand that the word “surgery” induces anxiety. However, modern dentistry has changed the game. At Dental Care of Beverly Hills, we prioritize your comfort above all else. Wisdom teeth removal is a routine procedure that we perform regularly with high success rates.
Sedation and Comfort
You shouldn’t feel pain during the procedure. We offer various levels of sedation depending on the complexity of the extraction and your anxiety level. This ranges from nitrous oxide (laughing gas) to relax you, to IV sedation where you drift off into a light sleep and wake up when it is all over. Most of our patients tell us they don’t remember the procedure at all.
The Extraction Process
Once you are comfortable, we make a small incision in the gum tissue to expose the tooth and bone. If the tooth is impacted, we may need to remove a small amount of bone that blocks access to the tooth root. Often, we divide the tooth into sections. This sounds intense, but it actually allows us to remove the tooth through a smaller opening, which preserves more bone and trauma to the mouth is minimized.
Recovery: Bouncing Back
Recovery is usually the part people dread the most, but with the right care, it is very manageable. The first 24 hours are critical. You will need to bite on gauze pads to stop bleeding and allow a blood clot to form. This clot is essential for healing.
You can expect some swelling, which usually peaks around day two or three. Ice packs are your best friend during this time! We will provide you with detailed instructions and, if necessary, prescriptions to manage any discomfort. The diet for the first few days consists of soft foods—think yogurt, smoothies (no straws!), mashed potatoes, and lukewarm soups. Most of our patients are back to their normal routine within three to four days, although full healing of the gum tissue takes a few weeks.
One critical rule to follow is avoiding “dry socket.” This happens if the blood clot dislodges, exposing the bone and nerves. To avoid this, you must not smoke, use straws, or rinse your mouth vigorously for the first few days.
Long-Term Health Benefits
Choosing to undergo wisdom teeth removal is an investment in your future oral health. By removing these potential hazards, you are protecting the alignment of your smile. We see many adults who had braces as teenagers, only to have their teeth shift in their 30s because they ignored their wisdom teeth. Preventing overcrowding saves you from needing orthodontics a second time.
Furthermore, you are reducing the overall bacterial load in your mouth. Wisdom teeth are difficult to clean and are often the first site of periodontal (gum) disease. Chronic gum inflammation has been linked to systemic health issues, including heart disease and diabetes. By removing the source of infection, you are contributing to your overall physical well-being.
For more information on how keeping your mouth healthy impacts your overall body, you can read this article from the Mayo Clinic on oral health and general well-being. It reinforces why we take infections in the back of the mouth so seriously.
Making the Decision
Ultimately, the decision involves a conversation between you and us. We don’t believe in a one-size-fits-all approach. When you come into our Beverly Hills office, we review your specific X-rays and discuss your lifestyle. If your wisdom teeth are healthy and you have a large jaw, we might just monitor them. But if we see signs of trouble, we will help you plan the removal at a time that fits your schedule.
We know that life is busy. Taking time off for surgery seems inconvenient. However, scheduling a planned surgery is always better than rushing in for an emergency extraction because an impacted tooth has suddenly become infected. Planned procedures allow for planned recovery, ensuring you are back on your feet quickly.
Your Smile is Our Priority
Navigating dental decisions can be confusing, but you do not have to do it alone. If you are feeling pressure in the back of your jaw, or if you simply haven’t had an X-ray in a few years, it is time to take a look. We are here to ensure that your smile remains healthy, straight, and pain-free for years to come.
Don’t let the fear of the unknown keep you from optimal health. If you have questions about wisdom teeth removal or want to see if you are a candidate for the procedure, reach out to us. We are ready to make this process as smooth and comfortable as possible, ensuring you leave our office with a healthier smile and peace of mind.
