Wisdom teeth, also known as third molars, typically emerge in the late teens or early twenties. While these molars served a crucial purpose for our ancestors, today, they often pose more problems than benefits. There are a lot of different philosophies when it comes to identifying which wisdom teeth should be removed, and what should be the appropriate timing for their removal. In our experience, one should NOT wait for them to “emerge” or start becoming sensitive or symptomatic.
Growth of the dental arch is generally completed by the time the 12-year molars have erupted. While the patient may continue to grow, the size of the dental arch does not change much as the patient ages. For the wisdom teeth to fully erupt into the mouth, there must be enough room behind the 12-year molars.
Ultimately, to keep the wisdom teeth, they must be in a cleanable, maintainable and functional position. Otherwise, problems usually result, such as crowding of the teeth, damage to the 12-year molars, cysts, and most often infection. The need for future removal can be identified early by the patient’s dentist, Orthodontist, or Oral Surgeon. Once this is decided, what is the most appropriate timing for removal and why?
In terms of timing, what we look for is incomplete root development, somewhere between when the roots are half to two-thirds formed. This corresponds to anywhere from 12 to 18 years old. From person to person, there is extreme variability in dental development. No two people are the same, essentially, your dental age and your chronologic age do not correlate, so it is not possible to determine one standard age to remove the wisdom teeth.
Most parents are aware of their children’s dental development. Some children’s teeth erupt early, and other children develop later. The only way to accurately determine where your children are in development is by using radiographic imaging such as a panoramic x-ray.
Overall, the earlier you can identify and plan to address the removal of wisdom teeth, the better. The other significant advantage of removing teeth in younger people is that things are more elastic, resilient, and heal quickly. In addition, most kids in school have the flexibility of scheduled breaks and vacations for healing, whereas adults tend to have many more responsibilities that make scheduling treatment more challenging.
All told, if you can identify someone with no space for wisdom teeth to completely erupt and be in a functional and cleanable position, the best time for treatment is before the teeth have fully formed.
