Wisdom teeth. Third molars. Thirds. A lucky %35 of people never develop any, and less than %5 have normally erupted wisdom in their mouths [actually more like %1.7, but let’s not argue]. The question we’re discussing today today “When should wisdom teeth be removed most safely, and with the easiest recovery?”. The answer is simple: We base our removal of wisdom teeth on the development of the teeth, and schedule them in this “Golden Window” to decrease the chances of complications, and ease of recovery. Lets look as some photos of X-rays to illustrate the point. These wisdom teeth are from a 15 year-old [the are the small partial teeth on the far left of the row of xray teeth–one on top and one on bottom] The development of these teeth is early, and the recovery from the surgery to remove these teeth would be longer and more difficult. They could be removed now, but all things considered–I’d recommend waiting another two year for this patient. Lets look at another case:The wisdom teeth are typical of anywhere from 16-20 years old patient. The point is not the age of the patient, it’s the size of the teeth: They are about 2/3 formed and do not have full root development. They have also moved as far up into the mouth [i.e. migrated coronally] as far as they are going to do by themselves, and have started to break through the bony covering over the top of the crown. Now is the time to schedule the surgery. Now. Not in 7 or 8 months. The earlier mentioned “Golden Window” for this case is closing up soon. This means that the difficulty of the recovery for the patient is going to be longer and more difficult if removal is delayed more than 30-40 days. If easiest and safest surgery is what you’re looking for, this is the time to do it. These are fully formed wisdom teeth. They will be more difficult to remove [i.e. will cost more], they will leave a bigger defect when removed and recovery will be more difficult for the patient. This means more pain, swelling and longer recovery. Should they be taken out? I’d say if they are causing symptoms of pain and swelling, or are partially erupted into the mouth, then yes. In this case, the sooner removal is performed, the better.
In summary: If wisdom teeth cannot fit into the mouth full erupted and in occlusion, then they should be removed. The timing is important to avoid as much pain, swelling and complications as possible. The safest time to remove wisdom teeth is when they about two-thirds formed. This rule is especially true for the lower wisdom teeth, which cause most of the pain and complications encountered when they are removed fully developed.