What is the worst that can happen if wisdom teeth are not removed?

Wisdom Tooth X-RayIf a dentist recommends removing wisdom teeth, it would be unwise to delay the surgery indefinitely. To do so may invite a variety of problems including damage to adjacent structures, such as sensory nerves, the maxillary sinus, and alveolar bone. Postponed wisdom teeth removal may be more complicated and require a longer recovery period. Additionally, damage caused by wisdom teeth to adjacent teeth and structures may not be easily repaired.

Tooth Decay

Keeping the back of the mouth clean with daily brushing and flossing is difficult in the best of circumstances. When wisdom teeth are present, good oral hygiene in this area is very difficult; a situation that often leads to cavities. Research has shown that more young adults have decay in the wisdom tooth area than previously thought.

Gum Disease

Wisdom teeth are not like other teeth in that they generally do not have adequate space to erupt. This is due not only to limited space, but also to the fact that gum tissues in the area are not designed to attach to the tooth in a normal way like other teeth. No matter how well someone maintains oral hygiene, it is very tough to keep the wisdom tooth area clean and bacteria free. Bacterial infection and inflammation often results in gum disease that can affect neighbouring teeth.

Involvement of adjacent structures

A young adult’s wisdom teeth generally have incomplete root systems, making surgery relatively uncomplicated. As wisdom teeth mature, their roots lengthen and may become involved with the surrounding structures such as sensory nerves or the maxillary sinus. In such cases, surgery may trigger a greater chance of complications.

Cyst and tumour formation

A fully impacted wisdom tooth sits in the jawbone surrounded by the sac in which teeth develop. Over time, however, this sac may enlarge and even develop unhealthy changes in the cells from which it is made. Problems occur when the sac surrounding the impacted tooth becomes filled with fluid and enlarges to form a cyst. As the cyst grows it may damage the jaw, neighbouring teeth and other surrounding structures. Very rarely, tumours develop from the same tissues that surround an impacted tooth, requiring extensive surgery and reconstruction.

What if wisdom teeth are kept?

If wisdom teeth are kept despite the fact that the dentist or the maxillofacial surgeon advised to remove them, it is important to monitor their health and condition regularly. X-rays and clinical examination should be done in the area every two years. Particular care of brushing and flossing of the area should also be taken into account.

See also in French.


22 thoughts on “What is the worst that can happen if wisdom teeth are not removed?”

  1. Hi, I just took an OPG xray and xray shows the two wisdom teeth in my lower jaw are angular and positioned towards the last molar. They will never come out as they are located under the bone. One of them look like the edge are overlapping with the last molar under the gum, the other one look like touching the edge of the last molar. Currently there is no pain, is there a need to remove? what will be the consequence if i do not remove? can i wait and see? As i really do no want to have the operation.

    1. Hi Jeff,

      If you keep your wisdom teeth, there is a chance that they never cause you any problems. However there is a small risk that they might create a cyst in your bone, and then they have to be removed. There other risk is that the one that is overlapping the other molar might cause damage to that molar. Usually a dentist or surgeon can give you their opinion on it.

      1. If the wistom teeth is damaging the other teeth, will I feel any pain? Or once I feel pain the damage has already progress too far?

        A few years ago, one dentist told me if I get my wistom teeth extracted, the way it’s positioned, there is a chance that I will lose the last molar as it won’t have support from the bone. Is this correct?

        Can I send you my xray so you can take a look and provide your view to see if I don’t get it extracted is it ok?

        1. Hi Jeff,

          Sometimes the damage done to the other teeth is so slow that you don’t actually feel pain.

          You seem to be left with a dilemma from 2 different opinions. One saying that if you keep your wisdom tooth, you will damage your other molar. The other is that if you remove your wisdom tooth, you will damage the molar. Personally I think that if the wisdom tooth is overlapping the molar on an x-ray, it can damage it and it’s better to have the wisdom tooth extracted.

  2. I have a small head and large teeth. The wisdom teeth had no hope of coming out.. All 4 had to be taken out in pieces, 2 before the age of 18 and 2 at the age of 25. It makes you wonder what percentage of the population 200 years ago died from the infections caused by the impacted wisdom teeth.

    1. The percentage is very low, also considering the fact that 200 years ago people had shorter longevity. Now we live longer and there is more health maintenance to be taken care of.

      But even now, if someone doesn’t remove impacted wisdom teeth, chances for complications are low, and death even lower.

  3. My daughter has to have one bottom molar tooth extracted, due to a peice of a tool broken off in her gum after a root canal. She is real sad because she is only twenty one years old and already has to have a molar tooth extracted. Should she keep one bottom wisdom tooth- to fill in the empty space- and just have the other three wisdom teeth removed?

    1. Hello Demetria,

      A wisdom tooth can sometimes erupt and take the place of an extracted molar. This happens more often on upper teeth than lower teeth, and it happens more often when the extracted molar was during the teen years.

  4. My dentist suggested removing mine when I was younger but it was never done. Im 27 now and they are coming through in all different directions and v v painfull. Is it too late to remove them? I dont know if I can afford the surgery

    1. No it’s never too late. You can rinse with salted water for the mean time, and take either Tylenol or Advil for the pain. When you are financially better, I suggest you consult a dentist to see if you need to extract your wisdom teeth, and how much the cost would be.

  5. My wisdoms have begun to peek through a bit @ 25. Im seriously thinking of keeping them after seeing an article on my internet page of this guy dying from complications after his wisdoms were removed! I have seen too many horror stories about that crap. Teeth are a huge pain and cause too much trouble and too much money. I dont know what to do! To keep or not to keep? I dont want to die in a dentist office!

    1. Someone died from complications following wisdom teeth removal? mmmmmmm you know how rare that is! It’s still very sad. If you are worried about the procedure maybe you can ask your dentist to check your wisdom teeth and a proper x-ray and he or she can discuss with you whether or not they need to be extracted and what the risks are.

  6. Hey I jus recently had my back molers removed and have lots of space but my wisdom teeth are coming in now and hurt real bad should I jus go to the dentist?

  7. No the worst that can happen is nerve damage which happens more often than you think. It happened to my mom and half her face was numb (that novocaine feeling) for years.

    The photo shown is the absolute extreme worst case scenario other than being upside down. This looks like a case where surgery is worth it.

    My own x-ray this week showed the wisdom teeth to be perfectly aligned like the left two, the only problem being that the gumline covers the back half of the back teeth. This of course can cause a painful infection but only has happened once or twice in my life. I’m debating having them removed.

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