Wisdom teeth play an important role in general dentistry and oral surgery. They can be completely healthy teeth that fit into the dental arch, or in other cases, they may not erupt or only partially emerge into the oral cavity because they encounter an obstacle during eruption (impacted wisdom teeth). There are also cases where the wisdom tooth is missing as a tooth germ, meaning it does not develop at all.

Diagnostics

In addition to a thorough clinical examination, radiological imaging is essential for diagnosing wisdom teeth. This may be a simple panoramic X-ray, but in many cases, a 3D CBCT scan is necessary to accurately assess the anatomical structures (e.g., the number and morphology of tooth roots, the position of the root in relation to the nerve, and in the upper jaw, the location of the maxillary sinus). These factors significantly influence the surgical technique and help evaluate the likelihood of potential complications.

To keep or remove?

If the wisdom tooth has fully erupted, properly aligns with the adjacent and opposing (so-called antagonist) teeth, is functional (i.e., participates in chewing), can be cleaned effectively, and does not negatively impact the maintenance of good oral hygiene, then—as it is a healthy tooth—preservation is recommended. However, if any or several of these criteria are not met, removal of the wisdom tooth becomes justified. This is primarily done to prevent potential future complications, diseases, and pathological changes, such as decay, inflammation, abscess formation, cysts, resorption of adjacent tooth roots, or crowding of the teeth. The resulting inflammations can have a negative impact not only locally in the oral cavity but can also serve as a focal infection source, affecting the entire body and causing systemic diseases in other organs (e.g., joint problems, cardiovascular diseases, eye disorders, dermatological issues, hair loss, immunological diseases).

When should they be removed?

Wisdom teeth can be removed as a preventive (prophylactic) measure. This is performed before any pathological change has developed, but due to the position of the teeth, there is a high likelihood of complications arising later. Ideally, this procedure should be carried out between the ages of approximately 17 and 21, when the teeth have not yet fully developed, resulting in a significantly easier surgical intervention and faster healing process. Therapeutic removal is indicated when there is already a problem, pain, or disease present, and the tooth is extracted to eliminate these issues. In such cases, it is advisable to perform the removal as soon as possible, before the condition progresses further.

How does the surgery take place?

Removal of wisdom teeth is performed painlessly under local anesthesia. After the procedure, a healing period of a few days follows, during which swelling of the face and mild pain may occur—depending mostly on the tooth’s location and the complexity of the surgery. Post-operative antibiotic therapy may be necessary, as determined by the treating dentist.

Regular dental check-ups allow monitoring of the position and developmental stage of wisdom teeth, making it possible to plan surgical intervention in a timely manner, before they cause more serious complaints.