When Wisdom Teeth Can Stay and When They Should Go

By Your Health Magazine Contributor

Your Health Magazine Contributor

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When Wisdom Teeth Can Stay and When They Should Go

The third molars at the back of your mouth are your wisdom teeth. Removal isn’t necessary for all. Let a dental assessment guide your decision if you’re considering care at LifeSmiles Dental.

In its October 23, 2024 oral-health survey release, the share of Canadians who experienced oral pain or avoided certain foods because of mouth problems was 26%, Statistics Canada reported. Oral problems broadly are what that figure covers, not wisdom teeth specifically. If you can keep healthy, functional wisdom teeth clean, they can stay. With disease or an unfavourable position, there’s reason to consider removal, particularly if a neighbouring tooth is being damaged.

Why Partially Erupted Wisdom Teeth Need Attention

A partially erupted tooth is one that has come only partway through the gum. Over part of the crown, the portion normally visible above the gumline, a flap of gum tissue can remain. Food and bacteria can hide from your toothbrush behind the flap and at the back of your mouth, making a partially erupted wisdom tooth hard to clean.

A hard-to-reach pocket under that flap can hold food and bacteria, which can leave the surrounding gum inflamed or infected. Teeth that can’t emerge normally, Mayo Clinic’s guidance on impacted wisdom teeth explains, can develop decay or gum disease. A fluid-filled sac called a cyst is another possible problem, along with damage to a neighbouring tooth.

An extraction isn’t necessary just because the tooth is hard to clean. By examining the gum around the wisdom tooth and the adjacent second molar’s surface, your dentist looks for existing problems and checks whether you can clean the area effectively.

How a Dentist Builds the Recommendation

Symptoms and the Clinical Examination

How discomfort affects eating or opening your mouth matters to your dentist, who asks when it started and how often it returns. A pattern matters even when discomfort is brief. For recurring pain, that pattern matters too.

To check how much of the wisdom tooth has erupted and whether its exposed surfaces are clean, your dentist looks beyond the painful spot during the examination. The gum covering a partly erupted tooth can also need inspection. The surrounding gum is checked for inflammation before your dentist examines the neighbouring tooth for visible decay or other damage.

What Dental X-Rays Add

On dental X-rays, a tooth’s angle and depth are visible, along with where it sits beside nearby teeth and bone. Damage or disease hidden during your mouth examination can also become visible on dental X-rays.

Your dentist uses dental X-rays to see where a wisdom tooth sits, including hidden effects on nearby structures. The recommendation also depends on symptoms and examination findings.

Treatment isn’t decided by an X-ray alone, even when it shows an unusual angle. Against that image, your dentist weighs what you describe and what the examination shows. If you’d like to understand how they fit, ask to review the X-ray alongside the examination findings.

Monitoring Compared With Removal

The American Association of Oral and Maxillofacial Surgeons’ third-molar guidance states, “The absence of symptoms does not equal the absence of disease.”

Even with active care through monitoring, a tooth left in place isn’t guaranteed to remain free of disease.

If keeping the tooth carries more risk than surgery, or established disease or damage is present, your dentist can recommend removal. That decision isn’t settled by pain. The tooth and surrounding tissue need assessment when there’s pain.

Warning Signs That Merit Prompt Assessment

If you notice any of the changes below, arrange to have your back molars examined. Symptoms alone don’t give a diagnosis:

• Near the back molars, pain or tenderness
• Gums: bleeding or red/swollen
• Swelling around the jaw
• An unpleasant taste; breath that stays bad
• Mouth opening feels difficult
• After improving, symptoms that come back

For pain behind the back molars, contact a dentist about a wisdom tooth (the same applies to jaw swelling or an unpleasant taste, swollen or bleeding gums, and trouble opening your mouth). Don’t dismiss symptoms just because they’ve faded. If those symptoms come back, have the affected area checked.

Call a dental office promptly if pain worsens or is severe. Noticeable swelling or trouble opening your mouth needs a prompt dental check. Where you feel pain doesn’t identify the tooth that needs treatment, so your dentist examines the area to distinguish a wisdom tooth problem from trouble in the neighbouring molar or gum.

How LifeSmiles Dental Supports Local Patients

Adults and children, including families and new patients, can receive dental care at LifeSmiles Dental. For wisdom tooth guidance, the services lifesmiles dental lists include extractions and wisdom teeth services alongside oral surgery. Alongside urgent dental care, the practice also offers dental sedation. To decide whether sedation suits you, talk it through with your dentist. Contact a clinic to request your wisdom tooth appointment.

A screenshot of the LifeSmiles Dental homepage.

Local families have several options for seeking care, with the practice’s five locations spread across the Winnipeg Metropolitan Region. At Grant Park Mall and Sargent Avenue you’ll find its Winnipeg clinics; there’s another at Westminster. Outside the city, patients can also use the clinics in La Salle and Selkirk.

Care personalized to each patient’s oral health needs is how LifeSmiles Dental describes its approach. During that discussion, ask where its wisdom teeth services fit with what your examination showed. Don’t assume you need a procedure just because it’s on the list. New patients are welcome too; the practice invites you to arrange an appointment by contacting the nearest clinic.

Frequently Asked Questions

Can a symptom-free third molar remain in place?

Yes, a symptom-free third molar can stay if an assessment finds it healthy and functional and you can keep it clean. You’ll still need to come back for follow-up. Depending on what your dentist finds, follow-up can involve checking your mouth periodically and taking dental X-rays when indicated. Those findings tell your dentist when to schedule visits; at follow-up, the tooth and nearby tissues are checked against earlier findings, including any changes that show on an X-ray.

Does wisdom tooth discomfort always lead to extraction?

No, discomfort means you need an examination; it doesn’t automatically mean the tooth has to come out. To find what’s causing the discomfort, your dentist checks for decay or trouble with the gum around a partially erupted tooth. Once there’s a diagnosis, you and your dentist can discuss cleaning the area or continuing to monitor it. Your dentist can recommend removal if disease or damage means the tooth can’t be kept. Before assuming a nonsurgical option will suit you, ask your dentist to examine the tooth and surrounding gum.

What should you share at a wisdom tooth appointment?

Tell the dental team where you feel discomfort, including when it first started. Mention any swelling or trouble opening your mouth, then explain what makes the discomfort worse. Tell your dentist about episodes that settled down and then came back, rather than describing only how the area feels on appointment day. If you have earlier dental X-rays, ask the office about transferring them so your dentist can decide whether they’ll help at the appointment.

Conclusion

Whether your wisdom tooth stays or comes out depends on your dentist’s assessment of it, not just on whether you feel discomfort. Your dentist plans care for the tooth and nearby tissues by using what they find now and at follow-up. New or changed symptoms call for a dental examination. Even with comfortable teeth, keep your next scheduled dental checkup appointment.