Why Should Third Molar Teeth be Extracted?

It is appropriate to ask if third molar teeth should be removed if they haven’t caused any problems. There is generalized agreement in the medical and dental professions that the removal of third molar teeth is always appropriate when there is evidence of pathological changes such as periodontal disease, non-restorable carious lesions, infections, cysts, tumors, and damage to adjacent teeth. There is also generalized agreement that third molar teeth that are disease free, completely erupted and functional, painless, free of tooth decay, in a hygienic position with  healthy gingiva (gum tissues), and without other associated pathologic conditions may not require extraction.  These teeth do require daily home care and hygiene maintenance.  If these third molar teeth are retained, periodic clinical and radiographic examination by a dentist is necessary to diagnose any problems related to these teeth early. 

It is not wise to wait until third molar teeth develop symptoms. Unfortunately, it is not possible to predict when, or if, third molar complications will occur. Not all problems related to third molars are painful or visible.  Damage to surrounding teeth can occur without symptoms.  Routine dental x rays frequently do not show third molar teeth well.  When third molar teeth do develop problems, this condition can be much more painful and the teeth may be more difficult to treat. Studies have also shown that third molars which have broken through the tissue and erupted into the mouth in a normal, upright position may be as prone to disease as those third molars that remain impacted.  As third molar teeth develop, their roots become longer and often become very curved.  These teeth then become more difficult to remove and complications become more likely. The possibility of damage to nerves, adjacent teeth and other surrounding structures increases over time.  In addition, impacted wisdom teeth are more likely to cause problems as patients age.  With infections or pain related to third molars, there is limitation of function. Extraction procedures become more urgent and cause disruption of normal activities, routines and schedules.