Q: My son is 17 and when he went for his check-up the dentist said he should have his wisdom teeth pulled. Why can’t they stay where they are? Can’t we wait and see if they come in by themselves? Shouldn’t he see an oral surgeon for that?

A: I think that’s the first three-part question I’ve ever gotten. It sounds like you are very concerned about doing something that may not be necessary or that can wait until later. I understand your concern and will try to answer your questions so you can make an informed decision.
Wisdom teeth are the last permanent teeth that your child will get. They begin to form in the early teens and, if all is well, usually begin to erupt between the ages of 16 to 21.

In the past it was sort of a “rite of passage” to have your wisdom teeth removed anywhere from your mid-teens to your early twenties. The thinking has changed somewhat with regard to removing third molars as they are otherwise known. The reasons for their removal are varied. They deal mainly with a lack of room for eruption, lack of access for proper oral hygiene, the possible development of gum disease or cavities resulting from the inaccessibility.

Your child should have x-rays periodically to determine how the wisdom teeth are developing as well as their positioning in the jawbone. Once your child reaches their early teens their dentist can determine if the teeth can remain or if they should be removed.

If there is enough space in the mouth for them not to cause problems then they should be able to remain in place. If there is inadequate room for them they should be removed. If they are not, there are numerous problems that can arise later that can complicate the situation immensely.

It is much easier to do the extractions at a younger age before the roots are fully formed. In most cases, it is not necessary to see an oral surgeon for the extractions. Many dentists today routinely remove third molars.

If your child is nervous or anxious about the procedure, nitrous oxide gas or sedation can help to make them more comfortable. A referral to an oral surgeon is most commonly made for specific reasons. The most common being your dentist doesn’t do extractions of third molars, the teeth are lying close to the nerve, the roots are curved or your child has special needs.

Consult with your dentist and ask them to show you the x-rays and explain why they need to be removed. If you are not satisfied with their answer consult another dentist or an oral surgeon for their opinion. It’s your child and ultimately you have to comfortable with you decision.