Wisdom teeth: Is it better to keep them or have them taken out?

Removing wisdom teeth that have not broken through and are not causing symptoms has no proven benefit. However the operation almost always causes pain and swelling, and can lead to complications.

The wisdom teeth are the last and furthest back on each side of the upper and lower jaw. They are the third molar, and usually start to break through when people are between about 17 and 24 years of age. You can read more about wisdom teeth in our Fact Sheet.

When wisdom teeth are causing pain, infection or ulcers, or they are interfering with orthodontic treatment, people will often choose to have them removed. However orthodontists often advise young people to have wisdom teeth removed even when they are causing no symptoms. This includes those which have not erupted or broken through. They are called impacted or retained wisdom teeth.

The argument made for removing them is that the wisdom teeth could develop problems, cause harm to other teeth, or cause over-crowding and push on other teeth. Another argument is that wisdom teeth have no real function, and the sooner they are removed the better. But operations to remove the wisdom teeth can cause complications: almost every patient will have swelling and pain afterwards, and about one in 100 people (1%) may have permanent nerve damage, for example.

In order to find out what the consequences are of removing healthy impacted wisdom teeth, researchers from the Cochrane Collaboration looked for trials of this treatment and systematically analysed them. They found two trials with teenagers and young adults that compared whether or not it is better to remove healthy impacted wisdom teeth. In one trial, some of the people had their wisdom teeth removed and the others did not. While in the other trial, a wisdom tooth on one side of each person's mouth was removed, but not on the other.

The researchers concluded that these two trials are not enough to show whether it is better to remove healthy wisdom teeth or not. Whether removing wisdom teeth has any positive influence on developments with the other teeth could neither be proven nor disproven. The data showed however that removing the impacted wisdom teeth could not guarantee that the lower biting teeth (incisors) did not push on each other. Longer term studies are needed to see what happens years afterwards.

© IQWiG (Institute for Quality and Efficiency in Health Care)