Does Everyone Need Their Wisdom Teeth Removed? No, and Here’s How to Decide

No. Whether wisdom teeth should be removed depends on the problems or risks in your own mouth, and the fee depends on the proposed procedure. For impacted teeth with no symptoms or disease, a Cochrane review found insufficient evidence to say routine removal or retention is better (Ghaeminia and colleagues, 2020).

Ask the dentist to explain each tooth separately: what is happening now, what might happen if it stays and how it would be monitored. If removal is recommended, ask where it would be performed and whether a referral is needed.

The written estimate should identify the teeth, the procedure and any separate imaging, specialist, anaesthetic or hospital charges. Check each part with the relevant provider and insurer. Another patient’s out-of-pocket figure cannot establish your cost. Ask about recovery and follow-up as well, so your decision includes time away from work or study rather than just the extraction fee.

• Ghaeminia H, et al. Removal or retention of asymptomatic disease-free impacted wisdom teeth. Cochrane, 2020
• Australian Dental Association. Wisdom teeth

Healthy wisdom teeth may be kept, but no pain is not enough on its own to establish that they are healthy. The dentist needs to assess their position, cleanliness and surrounding tissues before discussing removal or monitoring (ADA, wisdom teeth).

Ask what the examination shows and whether an image would answer a specific question. If there is no disease, ask how often the area should be reviewed and what changes to watch for. The Cochrane review of symptom-free, disease-free impacted wisdom teeth supports an individual discussion because the evidence does not settle the choice for everyone (Ghaeminia and colleagues, 2020).

If you choose to keep the teeth, request practical advice for reaching the back of your mouth when cleaning. If removal is suggested, ask what finding or risk leads to that recommendation and what the alternative would be. You should have a reason linked to your own teeth, not simply be told that all wisdom teeth eventually have to go.

• Australian Dental Association. Wisdom teeth
• Ghaeminia H, et al. Removal or retention of asymptomatic disease-free impacted wisdom teeth. Cochrane, 2020

A dental abscess needs treatment of its source; antibiotics alone are not a lasting solution (healthdirect, tooth abscess). Around a wisdom tooth, the dentist needs to identify whether the problem is in the tooth, the surrounding gum or another area.

Describe any swelling, bad taste, fever or difficulty opening your mouth when you call. Say whether this has happened before and whether you have already taken antibiotics. Repeated gum infections are among the reasons a dentist may recommend wisdom tooth removal (ADA, wisdom teeth), but the decision still needs an assessment.

Ask what will be done for the immediate problem and what the longer-term plan is. If a referral is required, find out who arranges it and what to do while waiting. Seek emergency medical care for breathing or swallowing difficulty. When symptoms settle, keep the follow-up appointment so that the underlying cause and the options for preventing another episode can be discussed.

• healthdirect (Australian Government). Tooth abscess
• Australian Dental Association. Wisdom teeth