It is wise to remove wisdom teeth, the last four molars at both ends of your upper and lower arches, if they become “impacted.” That happens if they try to break through the gums when your mouth is overcrowded and are prevented from fully growing out by neighboring teeth, often causing pain. These wisdom teeth can make the area hard to clean or cause misalignment of other teeth, leading to infections in 12% of cases, so manydentists remove them when patients are young if they anticipate problems.

Their name derives from the fact that they are the last teeth to come in, typically emerging between ages 16 and 21 (but as late as 25), when someone is supposedly wiser than when they were a child. They are relics of evolution, the final flat teeth with cusps to grind food when humans were hunter-gatherers eating mostly rough and tough food such as leaves, nuts, seeds, bones, and raw meat. Since the advent of agriculture 10,000 years ago, softer foods like cooked grains have become predominant, making these molars (the third on each side) less important, so our jaws adapted to grow less forward, causing the crowding. Starting with the Industrial Revolution, impacted molars became common.

Any infection related to wisdom teeth can raise the risk for cardiovascular disease, pneumonia, and endocarditis (an infection of the heart valves).

If your wisdom teeth were never removed, whatever your age now, you should have your oral health assessed by your dentist to be sure they are not contributing to causing periodontal disease (infections of the gums, teeth, and jawbone). This can only be fully determined with a digital x-ray, which has very low radiation. Symptoms of wisdom teeth that may need extraction include:

• Pain around any wisdom tooth or that area of the jaw.
• Swelling or bleeding of the gums around the tooth.
• Frequent cavities on these teeth.
• Red, white, or dark spots on any wisdom teeth.
• Discomfort when you bite on a wisdom tooth.
• Frequent sinus congestion.
• Bad breath or an unpleasant taste when you chew, which might indicate an infection.

Fortunately, if a wisdom tooth needs to be removed, it is a pain-free process.  You will first be given a CT scan to provide a detailed view of the tooth and the nerves around it, to determine the exact course of the procedure. A local anesthetic is injected and a prescription of pain medication is prescribed afterwards. You should expect to bite on gauze for a while to stop any bleeding and apply an ice pack (or bag of frozen vegetables) on and off to reduce swelling for a couple of hours. Plan to only eat soft foods and drink lots of fluids for a few days (but avoid drinking through a straw, spitting, or smoking).

Be wise and call for an examination of your overall oral health as soon as possible.