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Oral health is one of my favorite topics to research. I find it fascinating that nutrition plays such an important part in oral health (and conventional dentistry doesn’t mention this!). Wisdom tooth removal is an unfortunate necessity because of the poor diet we have eaten for the last couple of generations and the smaller mouths that result. Or is it? It turns out that wisdom tooth removal may not be as universally necessary as we think.
What Are Wisdom Teeth for Anyway?
Wisdom teeth, also known as third molars, are the molars in the back of your mouth that erupt around the age of 18. With so many people getting wisdom teeth removed, many wonder why we have them to begin with. Anthropologists believe that the wisdom tooth’s role is in helping chew the rough foods our ancestors ate (raw vegetables, nuts, meat, etc). They aren’t as essential today with the ability to cook foods before eating (not to mention the large amounts of processed, soft foods in the modern diet), but they are still a living organ of the body.
Why Extract Wisdom Teeth?
If you had your wisdom teeth removed in your late teens or early twenties you may not have thought twice about it. Many dentists look at x-rays and recommend wisdom tooth extraction as a preventative treatment for most people. Here are the reasons that many dentists and oral surgeons recommend removal:
- May become impacted – Impaction happens when the wisdom tooth does not fully erupt out of the gum tissue because it’s blocked by another tooth. Impacted wisdom teeth may accumulate food around the gum and harbor bacteria. Most bacteria can decay the tooth next to it. If this isn’t dealt with it could cause a serious infection.
- They’re really hard to clean – Dentist also recommend extraction because wisdom teeth, being so far back in the mouth, are really hard to take care of. They worry that wisdom teeth might not be cleaned properly and become infected.
- May cause crowding – Some dentists worried that wisdom teeth coming in will crowd the other teeth in the mouth. This is especially concerning for those who already have a crowded mouth. Many people have crowded mouths due to a modern diet low in nutrients.
- Easier on young people – Some theorize that recovery may be easier for younger people and that it’s best to do it when the teeth are just emerging and roots haven’t set in.
Additionally, wisdom teeth aren’t essential (we can live without them), so many dentists see no drawback to extraction on a routine basis. With general and local anesthesia available, the procedure seems fairly benign.
The Problem With Wisdom Tooth Extraction
So you knew I was getting to this, right?
Any surgery, including wisdom tooth extraction, should be taken very seriously. General anesthesia, though used often without incident, is still not risk-free. Even local anesthetic has some risks.
Surgery should only be performed when the risks of not doing it are higher than the risk of doing it. Unnecessary medical procedures subject the body to unnecessary trauma.
Here are some of the risks associated with routine wisdom tooth extraction:
Risk of Cavitation
A cavitation is a hole in the jaw bone surrounded by dead or decaying tissue. It’s a breeding ground for bacteria, especially if the surgeon didn’t properly clean the socket or completely remove the periodontal ligament that attaches the tooth to the underlying bone. Cavitation can happen from other dental procedures but happens most often from extraction.
Cavitation isn’t a rare occurrence with wisdom tooth extraction. According to Amalgam.org, one study found that 88 percent of patients who had a wisdom tooth extracted ended up with cavitation.
Risk of Infection and Other Complications
When a cavitation forms, the risk of infection is much greater. Toxins, the byproducts of the metabolic process of the bacteria, enter the bloodstream and make their way to other parts of the body. Even mainstream medical and dental professionals are taking the connection between oral health and overall health very seriously. According to WebMD, poor oral health can lead to issues such as
- heart disease
- lung conditions
- poor birth outcome (for babies of women with oral health issues)
Additionally, dry socket is another concern. Dry socket happens when the blood clot over the extraction site loosens and falls off early. Then bacteria can enter the site and cause pain and infection. A second surgery may be necessary to deal with dry socket.
Paresthesia (permanent numbness of the lips or tongue) is a very real concern with wisdom tooth extraction. The chances of paresthesia vary based on the positioning of the tooth. But the worst case scenario (a tooth in the worst position) the risk of paresthesia is 6.8 percent. Other teeth in less severe positions obviously cause a lower rate of paresthesia from anesthesia.
Paresthesia can range from mild (general numbness/tingling) to severe (shooting pain). The possibility of paresthesia is even more concerning when you consider that 95 percent of extracted teeth did not pose a problem in the first place, as Dr. Jay Friedman argues in a 2007 American Journal of Public Health article.
Can You Keep Your Wisdom Teeth?
Now that we’ve talked about the risks of surgery, what are the risks of keeping your third molars? Here are some considerations to weigh:
Science Doesn’t Support Removal as a Preventative Measure
Dr. Friedman (cited above) continues to say in the same medical journal article that there is no evidence that removal of wisdom teeth reduces pathology. Most wisdom teeth (impacted or not) do not become infected.
Do Not Cause Crowding
As mentioned earlier, our modern diets of low nutrient foods make crowding in the mouth a concern for many people. So, it seems to make sense not to allow more teeth to enter an already crowded space. But science doesn’t support this idea. Wisdom teeth do not cause other teeth to crowd according to a 1992 study in the Journal of the American Dental Association.
The author argues that by the time they grow in, wisdom teeth are simply not forceful enough to move a whole row of teeth that are already strongly rooted. So whether there is enough room for wisdom teeth shouldn’t play a big part in the decision to take them out.
Risk of Complication Does Not Increase with Age
Conventional wisdom says that the chances of complications from wisdom tooth extraction gets higher with age. This is true to a certain extent (complications are lower in 12 to 24-year-olds than 24 to 34-year-olds).
In other words, many people are being subjected to moderate risk of complications to avoid the high risk of complication in a few that need the surgery between ages 24 and 35. What is not being considered in this school of thought is that the risk of complication is zero for those who don’t have the surgery.
When to Consider a Wisdom Tooth Extraction
While unnecessary wisdom tooth extraction is not safe, there are times when removal is the best and safest option. Here are some of the reasons wisdom tooth extraction may become necessary:
- impaction (though some impacted teeth are okay to leave alone)
- recurrent gum infection
- gum disease
- severe tooth decay
- abscesses, cysts, or tumors
- damage to nearby teeth and bone
The best way to know if you or your child are in need of wisdom tooth extraction is to discuss with a biological dentist, who will help you decide if extraction is necessary.
What If Removal Is Necessary?
Dr. Weston A. Price, a dentist known for his work in studying the effects of nutrition on dental health, has a protocol for extraction that reduces the risk of complications and helps boost healing. A biological dentist should be knowledgeable in Dr. Price’s protocol (or may have his own similar protocol) but you can ask questions to make sure when at the interview.
Dr. Weston A. Price’s Protocol
To get the best outcome from oral surgery, Dr. Price recommends the following before the surgery:
- Remove metals from the mouth pre-surgery (possibly including root canals).
- Optimize liver and kidney function and pathways.
- If ill from the tooth, the patient should take homeopathic remedies for a month before surgery.
- Assess and treat tonsil issues (Dr. Price believes that in some cases wisdom tooth issues stem from tonsil issues).
- Make sure there is enough protein in the diet for optimal healing.
After surgery, Dr. Price recommends patients do the following:
- Take at least 3 to 5 days before returning to normal activity to heal and avoid dry socket.
- Use a therapeutic laser for better healing and to reduce the use of prescription pain medications.
- Use homeopathic remedies for healing.
- Treat the surgical site with one to two vials of mineral-rich Quinton Marine Sea Plasma for healing.
- Eat (drink) healing bone broths especially during the first day or two when the site is still open. This helps avoid food particles from solid foods getting stuck in the wound.
Your biological dentist/oral surgeon may have a different protocol than this one that may include ice packs, salt water rinses, and pain medications. But the important part is to take very close care of the surgical site to reduce complications.
Wisdom Tooth Removal – Is It Safe?
If you or your child have been told you need wisdom teeth removal it may be worthwhile to get a second opinion. A biological dentist or oral surgeon can help you navigate the risks and benefits of your specific situation.
This article was medically reviewed by Dr. Steven Lin, who is a Board accredited dentist trained at the University of Sydney. With a background in biomedical science, he is a passionate whole-health advocate, focusing on the link between nutrition and dental health. As always, this is not personal medical advice and we recommend that you talk with your doctor or dentist.
Did you have your wisdom teeth out? What was your experience?
- Incidence Levels & Chronic Health Effects Related to Cavitations. (n.d.). Retrieved from http://amalgam.org/education/scientific-evidenceresearch/incidence-levels-chronic-health-effects-related-to-cavitations/
- Barker, J. (n.d.). Oral Health: The Mouth-Body Connection. Retrieved from https://www.webmd.com/oral-health/features/oral-health-the-mouth-body-connection#1
- Friedman, J. (n.d.). The Prophylactic Extraction of Third Molars: A Public Health Hazard. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1963310/
- Southard, T. E. (1992, August). Third molars and incisor crowding: When removal is unwarranted. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/1506593
- Osborn, T. P., Frederickson, J. R., Small, I. A., & Torgerson, T. S. (1985, October). A prospective study of complications related to mandibular third molar surgery. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/2995624/