Do all wisdom teeth need to come out?

No!

If you ever meet a dentist who says all wisdom teeth must be extracted, proceed cautiously! Let's review situations in which third molars (wisdom teeth) should be extracted. 

First, some background information. The average age for completion of eruption of wisdom teeth is 20 years, but eruption can continue to age 25 years in some patients. When the wisdom teeth in the lower jaw are forming they are laying horizontally and as the jaw grows the teeth naturally become upright. Failure of the tooth to rotate upward is the most common cause of impaction. The next most common cause is if the front to back space in the jaw is inadequate for the size of the tooth. Some males who are growing into their early 20's may have teeth that upright at age 25. Early removal of wisdom teeth reduces postoperative complications and allows for the best healing. Young patients recover faster and with less pain. So, what are some situations in which wisdom teeth should be removed?

• Prevention of periodontal disease in the tooth next to the impacted wisdom tooth (second molar); the earlier the extraction the better the bone healing
• Prevention of cavities in the second molar and wisdom tooth when a wisdom tooth is impacted or partially impacted
• Prevention of pericoronitis, an infection of the soft tissue around the crown of a partially impacted tooth
• Prevention of root resorption on the adjacent tooth from the pressure of the wisdom tooth
• Preparing for a dental prosthesis such as a denture
• Prevention of cysts and tumors; cysts and tumors can grow to enormous sizes requiring the removal of a significant portion of the jaw
• Facilitation of orthodontic treatment

Wisdom teeth that are causing pain or difficulty cleaning surely need a thorough examination. While there are good reasons for the removal of some wisdom teeth, remember, many patients can keep all 32 of their teeth. Talk to your dentist about the condition and development of your wisdom teeth. The best x-ray to view the status of all 4 wisdom teeth is the panorex.