When Should I Have My Wisdom Teeth Removed?

The following information is aimed at helping patients distinguish the proper timing for the removal of wisdom teeth. The most common question asked by patients is “When should I have my wisdom teeth removed?”

The timing for removal of wisdom teeth is based on three things, the age of the patient, root formation, and position of the tooth. As far as the age of the patient goes, the younger the better. Younger patients do better for surgical procedures and have lower overall complications. Regarding root formation; the ideal time to remove wisdom teeth is when there is one third root formation. On a panaramic x-ray the patient’s wisdom teeth would look squarish. It is also a good time to remove wisdom teeth between one third and two thirds root formation. When there is more than two thirds root formation we find that there is an increase of risk for removing wisdom teeth, especially nerve injury to the inferior alveolar nerve, and maxillary sinus involvement.

 
wisdom tooth with 50% root formation
 
wisdom tooth with 2/3 root formation

One of the considerations when looking at the wisdom teeth is whether they will be able to erupt into a more easily removable position. The root formation brings the tooth up to the surface causing the eruption of the tooth. However in cases of wisdom teeth when there is insufficient space, the tooth may not be able to erupt no matter how much root formation we wait for, and that root formation can make them more likely to have nerve injury, or sinus complications.

In certain cases, the patient may have zero root formation but has partially formed crowns. When the wisdom teeth are blocking out second molars they should be removed early. Therefore, if the patient is undergoing an unrelated surgery but will receive IV sedation, it is recommended to remove the partially formed crowns at the same time if they are easily accessible. Often times we have had to do exposure and ligation procedures on a canine of young patients (around 12), who have requested IV sedation, and because of the level of sedation, it was advantageous to remove the wisdom teeth at the same time. 

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Wisdom teeth have the greatest variability in time of eruption and root formation of any tooth. We have removed wisdom teeth which were considered to be in the ideal root formation category, (from one third to two thirds root formation), that were in patients as young as eleven years old and have also seen patients that were 25 and who still have had only two thirds root formation. The most common age for wisdom teeth to be in the 1/3rd to 2/3rds root formation stage is 16 years old.

Our recommendation is to have patients get a panoramic x-ray at the age of 15 years old, and be prepared to have them out around sixteen. This is the most common time for removal of wisdom teeth.


Dr. Reynolds  is a Physician (i.e. have earned an M.D. degree) in addition to being Dentists. He will carefully evaluate your medical history and help decide on the risks and benefits of wisdom tooth removal in light of your particular health scenario. We believe strongly in tailoring your experience to best match your overall health so that you can have the best possible outcome.

References:

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