Wisdom teeth do not always need to be removed. If they come in correctly positioned, have an opposing tooth and can be kept clean, there is no reason that they cannot be maintained. In many individuals though, this is not the case. Sometimes the wisdom teeth become impacted (stuck in the bone) because there is not enough space to accommodate them. Wisdom teeth can become angled and can exert pressure on adjacent teeth which can cause pain. Sometimes they can erupt partially and create an area where food and bacteria can collect and cause cavities or an infection.
It used to be thought that if wisdom teeth were not removed, they would cause the front teeth to crowd. Many studies have looked at this issue and it is now believed that although alignment changes can happen, it is most likely not due to the wisdom teeth and more likely may be due to small increments of growth that occur throughout life. For this reason, we evaluate whether there will be room for the wisdom teeth to erupt and be functional to make the decision about extraction.
If wisdom teeth need to be removed, it is usually best to do it early (around age 17 to the early 20s). It is generally easier to remove the wisdom teeth before the roots have become fully formed. Also as we age, the bone surrounding the teeth becomes denser and this can make tooth extraction more difficult. Young individuals will typically recover from surgery more quickly as well. Your dentist will monitor the development of your wisdom teeth and will be able to advise you about the appropriate time to have them removed, if necessary.