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Wisdom Teeth - Remove or Keep

Facts, advantages & disadvantages of removal

What is a wisdom tooth and where does it sit with its three "siblings"?

"If you want to show your wisdom teeth, you have to open your mouth wide"
German proverb

In technical jargon, the wisdom tooth is called the third molar. It is the rearmost molar in the oral cavity. Normally, a third molar is already created in each of the four jaw areas (= dentition quadrants) of a person before birth. Thus every person should have four wisdom teeth, and one speaks of 32 teeth in the human dentition. At the same time, many people's wisdom teeth have either not yet erupted or have already been removed.

On this page you will find the most important questions and answers on the subject of wisdom teeth.

Why do we have wisdom teeth?

The wisdom tooth is a relic from our ancestors. Their jaws were larger due to the different eating habits and the associated chewing behavior. At that time, 32 teeth had enough space without any problems. Today, however, the jaws are smaller in relation to other parts of the face.

At a time when the diet consisted much more of raw meat, roots and leafy parts of plants, more chewing surfaces were needed. These third molars helped to grind the somewhat tough food and thereby make it more digestible. In today's society with refined foods and modern preparation techniques, these wisdom teeth are no longer necessary. In addition, the development of the cranium and the jaw or the rows of teeth have developed separately from each other and as a result the wisdom teeth now and then again and again no longer find a place.

When do the wisdom teeth erupt?

The change of teeth to the adult dentition is initially completed with the eruption of the second molar. This usually takes place around the age of 12. The stragglers of adult dentition tend to break through when you're in your late teens or early twenties, between the ages of 18-25. At the same time, wisdom teeth can also erupt much later. According to the Guinness World Records, the oldest person was 94 when a wisdom tooth erupted. There are also people in whom the third molars remain hidden under the gums for a lifetime. It is also not automatically given that there are four wisdom teeth in the jaw of everybody. Not everyone has third molars. It can also be that there are only three, two or one instead of four.

Why is the third molar tooth called wisdom tooth?

The term wisdom tooth comes from the "advanced" age when the third molars penetrate. To a certain extent, they are laggards in the development of the teeth. But the term can also be taken as ironic. For a long time there has been a discussion as to whether and to what extent the third molar is jointly responsible for a large number of diseases in the oral area. However, opinions differ on this. As a result, the “spirits” differ as to whether the wisdom teeth should be removed as a precaution or not.

Incidentally, the designation of the third molars also depends on the cultural environment. The Koreans refer to the third molars as "love teeth" because one experiences first love around the typical time of the breakthrough. Japanese uses the term "unknown to parents" because most people will have moved away from home by the time their wisdom teeth arrive.

Advantages & Disadvantages of Wisdom Teeth Removal

Wisdom tooth out - yes or no?

A great many people are confronted with this question in the course of their lives. Similar to other life experiences, the decision what should happen to one or more wisdom teeth is not the most beautiful but a necessary phase in the “health history” of the person concerned. Because today quite a few people have their wisdom teeth removed, even if there are no noticeable problems apart from the pain when the teeth erupt. In many Western countries this preventive practice is known as prophylactic surgery.

Patients are often confronted with the following arguments on the part of the treating dentist:

  • The third molar could interfere with the bite and inappropriately wear the teeth
  • The position of the molars - tilted, crooked or twisted in the bone - could cause TMJ disorders
  • As the wisdom teeth grow, the teeth could be too close to one another, which would jeopardize good oral hygiene at home, which could lead to “classic” dental diseases such as periodontitis or tooth decay.
  • A single or multiple wisdom teeth have only partially erupted and complications such as abscesses, tooth decay, inflammation of the gums are suspected.
  • A strong branching of the roots of one or more wisdom teeth is given or is emerging.

Again and again it is pointed out that in some cases the wisdom teeth could be the direct or indirect cause of cysts, tumors, nerve damage, periodontal diseases.

Even if it is a widespread practice in some countries to remove wisdom teeth as a precaution, and even if the scientific basis of these "preventive measures" is still hotly debated today, each removal should be viewed as an individual case and the decision should be carefully examined . Because every wisdom tooth operation, with or without general anesthesia, also involves risks.

What are the benefits of wisdom tooth removal?

Since wisdom teeth can be the cause of complications, the benefits are in avoiding these potential complications. Removal of wisdom teeth may have the following advantages:

  • Less bite disorder - The third molar can interfere with the bite and wear other teeth or cause discomfort when chewing and swallowing.
  • Protection for other teeth - In principle, there is also the risk that a wisdom tooth can damage another molar, or the risk of infection in this area is increased.
  • No crowding - The development of a wisdom tooth can also cause other teeth to press together, creating pressure that requires orthodontic treatment to straighten other teeth.
  • Temporomandibular joint disease - The emergence or the unfavorable further development of TMJ diseases are always related to wisdom teeth.
  • Less risk of cyst formation - There is also a risk that a kind of sac will develop in the jawbone around the wisdom tooth. This pouch can fill with fluid and form a cyst that can damage the jawbone, teeth, and nerves.
  • Improvement of the risk of tooth decay - Wisdom teeth can negatively affect the risk of tooth decay, as wisdom teeth seem to have a higher risk of tooth decay than other teeth. The reason for this could be that the wisdom teeth are more difficult to clean due to their position in the oral cavity and that food residues and bacteria are more easily trapped between the gums and a partially erupted tooth.


What Are The Benefits Of Preserving Wisdom Teeth?

In the case of an acute disease of the wisdom tooth, in addition to treating the disease, the removal of the wisdom tooth is often an option. But not only in this specific case, but generally in each individual case, the question of why a wisdom tooth could be important should also be investigated when making a decision. Because if a wisdom tooth develops normally, is healthy and there is enough space in the jaw and thus stands or can stand well in the row of teeth, it should be preserved. Because wisdom teeth can also serve as a replacement for lost and damaged teeth. For example, a wisdom tooth can be used for an autotransplant. For example, a wisdom tooth can be transplanted to replace a missing five.

It should be remembered that a wisdom tooth removal is a surgical procedure. Every operation is not only associated with inconvenience but also with risks for the patient. These risks include, for example, nerve damage such as paresthesia - dullness and tingling - in the lips and / or tongue or infections in the wound, for example.

Today there is no prescription for the preventive removal of wisdom teeth. This means that each patient must be assessed on a case-by-case basis, which speaks for or against the removal of a wisdom tooth. The dentist is the right contact here. As a patient, you should also have the feeling that sufficient time has been taken for a detailed discussion regarding the advantages and disadvantages to be weighed up as to whether a wisdom tooth should be extracted.

How do you know whether your own wisdom teeth are coming or piercing or what pain is associated with it?

If the wisdom teeth penetrate the visible row of teeth, it can be very painful. Most of the time, the pain can be felt in the back of the mouth. If you look in a mirror, you may even notice that your wisdom teeth have started to poke through your gums. The area may be painful, red, or inflamed. Basically, you can look out for the following signs or symptoms:

  • Red or swollen gums
  • Tender or bleeding gums
  • Pain in the jaw
  • Swelling around the jaw
  • Bad breath
  • An unpleasant taste in the mouth
  • Difficulty opening your mouth

In any case, you should clarify the signs or symptoms. Wisdom teeth can damage other teeth or cause other problems in the mouth area.

What should be considered when caring for wisdom teeth?

The eights, as they are also called in technical jargon because of their location, occupy the rearmost position in the row of teeth. This is linked to the fact that normal dental care usually requires more attention and skill so that plaque and tartar does not form. Because the increasing formation of tartar very often favors "classic" dental diseases such as periodontitis or caries.

FAQ - 6 FREQUENTLY ASKED QUESTIONS For wisdom teeth

When it is clear why one or more wisdom teeth hurt, the following measures can help. A numbing tooth gel can be applied to reduce the sensation of pain in the gums. Ibuprofen, an over-the-counter pain reliever, can also be taken to reduce inflammation. In connection with aching wisdom teeth, the following home remedies are also mentioned again and again: placing an ice pack on the painful area, rinsing with salt water, carefully chewing cloves, applying onion compresses. Further general information on toothache can be found here.

Extracting a wisdom tooth is often more complicated than removing other teeth. One reason for this is the fact that wisdom teeth, in contrast to "normal" teeth, which only have two or three roots, can also have four or five roots. This often also leads to the fact that wisdom teeth are pulled early to avoid grasping the root. Because when the roots are fully developed, they provide a very stable anchorage that has to be dissolved during an extraction. Serious complications such as a broken jaw or permanent nerve damage can also occur with proven specialists, but they only occur very rarely. In any case, detailed examinations and clarifications using imaging methods are recommended in order to assess the individual risk. Informing the patient about possible complications in the course of a surgical procedure should also be an integral part.

If a tooth is still completely hidden under the gum for some inexplicable reason, this is called a retained wisdom tooth. With a partially retained wisdom tooth, parts are already visible but the eruption is not complete. The term “retained” is derived from the word “retention” and means to hold back.

If there is a medical need, the statutory health insurance will cover the costs for the removal of wisdom teeth in accordance with the tariff regulations in Austria. If a wisdom tooth operation is carried out by a doctor of your choice, the health insurances cover approx. 80% of the health insurance tariff. If the wisdom tooth operation is carried out under general anesthesia and not just with local anesthesia, this is usually to be paid for by the patient himself. The final cost to the individual will depend on several factors. Does a doctor of choice or a statutory health insurance doctor carry out the operation? Do you have private health insurance or what costs are covered by this contract? In the best case, every patient should inform themselves in advance about the advantages and disadvantages of an operation and obtain a treatment plan. The treatment plan usually includes the anticipated treatment costs.

Basically, tooth decay can be treated well today. As with other teeth, it should first be checked whether other teeth are also affected and what a caries treatment could look like. It happens again and again that the wisdom teeth are twisted or only half erupted. This makes dental care difficult in this rear jaw area. It can also happen that the wisdom teeth are very close to the next molar due to a lack of space. As a result, it is also difficult to clean the interdental space. Therefore, wisdom teeth require special care. If the tooth decay can be treated successfully and there are no further significant benefits from removal, removal is not necessary. Each case has to be considered individually.

In the optimal case, when everything goes smoothly and the wisdom tooth has no special features, such as twisted roots, a wisdom tooth operation takes about 20-30 minutes. The typical wisdom tooth removal ranges between 30 and 60 minutes for one tooth. However, the operation can take much longer if, for example, several teeth are removed at once or aggravating factors such as five branched roots are added.

In the majority of cases, if there are no particularities with regard to the root or the position of the wisdom tooth, local anesthesia is sufficient for removal. This is the case when all four wisdom teeth are to be removed in one session. As with other treatments with anesthesia, local anesthesia is applied in the immediate vicinity of the wisdom tooth in the jaw area. The local anesthetic usually ensures painless removal. However, there is still a certain feeling of pressure. Sedation or general anesthesia occurs when the wisdom tooth is in particular position (near a nerve) or when complications are to be expected. Even in patients with a pronounced fear of dental treatment, twilight sleep (dissection) or general anesthesia are repeatedly considered. The use of sedation and general anesthesia requires special oral surgical equipment in the dental practice and the presence of an experienced anesthetist.

Basically, it is important that you regularly resume home oral hygiene twice a day. However, you should be extremely careful when brushing your teeth close to the surgical site. The surgical site itself should be touched as little as possible during this period. A gentle rinse with an antibacterial mouth rinse after approx. 24 hours for 2-3 days is recommended. If the healing process is good, the surgical site can be gently cleaned with a soft toothbrush after the first ten days.

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