Wisdom Teeth Removal: When Is It Necessary?

By Dr. Sergei Kuznetsov, DDS, MD: Oral Surgeon at Park Slope Dental Arts

Wisdom teeth are often called your third molars. They are the last teeth to develop, typically appearing in the late teens or early twenties. For some people, they come in without issue. For many others, they cause problems that make removal the smartest option.

At Park Slope Dental Arts in Brooklyn, wisdom tooth extractions are one of the most common procedures I perform. Here’s how to know if yours might need to come out, and what the process involves.

Why Do Wisdom Teeth Cause Problems?

The short answer: most modern jaws don’t have enough room for them. Human jaws have gradually gotten smaller over thousands of years, but wisdom teeth haven’t gotten the memo. When there isn’t enough space, these teeth can become impacted, meaning they’re trapped beneath the gum line, growing at an angle, or pushing against neighboring teeth.

Even wisdom teeth that emerge partially can create issues, because they’re difficult to clean and prone to trapping bacteria.

Signs Your Wisdom Teeth May Need Removal

Not all wisdom teeth cause obvious symptoms, which is why regular dental exams with X-rays are important. However, the following signs often indicate a problem:

• Pain or tenderness in the back of your mouth, especially when chewing
• Swollen, red, or bleeding gums around the last molars
• Jaw stiffness or difficulty opening your mouth fully
• Persistent bad breath or an unpleasant taste, which can signal an infection
• Swelling in the jaw or cheek area
• Crowding or shifting of other teeth as wisdom teeth push forward

If you’re experiencing any of these symptoms, it’s worth having a wisdom teeth evaluation sooner rather than later.

Common Reasons for Removal

• Impaction. This is the most frequent reason for extraction. Impacted wisdom teeth can be fully trapped in the jawbone, partially emerged through the gum, or angled sideways against the adjacent molar. Each scenario carries potential risks, including infection, cyst formation, and damage to neighboring teeth.
• Infection and gum disease. Partially erupted wisdom teeth create a flap of gum tissue that traps food and bacteria, leading to a painful condition called pericoronitis. Recurring infections in this area are a strong indication of removal.
• Decay. Wisdom teeth are notoriously difficult to brush and floss because of their position at the very back of the mouth. Cavities in wisdom teeth are common and often not worth restoring when the tooth is already problematic.
• Damage to adjacent teeth. A wisdom tooth growing at an angle can press against the second molar, causing decay, bone loss, or resorption of the neighboring tooth’s root.
• Cyst development. In rare cases, a sac of fluid (cyst) can form around an impacted wisdom tooth, potentially damaging the jawbone and surrounding structures.
• Orthodontic reasons. If you’ve had orthodontic treatment or are planning it, removing wisdom teeth may be recommended to prevent them from undoing your results by pushing other teeth out of alignment.

When Wisdom Teeth Don’t Need Removal

Not every wisdom tooth needs to come out. If your wisdom teeth are fully erupted, properly positioned, healthy, and cleanable, there may be no reason to extract them. We monitor these teeth at regular check-ups and recommend removal only when there’s a clear clinical benefit.

What to Expect During the Procedure

• Pre-surgical assessment. We take detailed imaging, typically a panoramic X-ray or 3D cone beam scan, to evaluate the position of your wisdom teeth, their proximity to nerves and sinuses, and the best surgical approach.
• Anesthesia and sedation. The procedure is performed under local anesthesia, and sedation options are available for patients who prefer to be more relaxed. We’ll discuss what’s best for your situation beforehand.
• The extraction. For erupted wisdom teeth, the process is similar to a standard extraction. For impacted teeth, a small incision in the gum is made, and the tooth may be sectioned into pieces for easier removal. The procedure typically takes 30 to 60 minutes for all four teeth.
• Immediate aftercare. We place gauze, provide pain management instructions, and send you home with a detailed recovery guide. Most patients have someone drive them home, especially if sedation was used.

Recovery Timeline

Most patients recover well within a week:

• Days 1–2: Swelling and discomfort peak. Ice packs, soft foods, and prescribed medication keep you comfortable. Avoid straws, spitting, and smoking.
• Days 3–5: Swelling begins to decrease. You can gradually introduce more solid foods.
• Days 7–10: Most patients feel back to normal and return to all regular activities.

We’ll schedule a follow-up to check healing and remove any sutures if needed.

Don’t Wait for Pain

Many wisdom tooth problems develop silently. By the time you feel pain, the issue may be advanced. Regular imaging lets us track your wisdom teeth over time and recommend removal at the right time, giving us the chance to avoid unnecessary complications. 

If you’re in your late teens or twenties and haven’t had your wisdom teeth evaluated, or if you’re experiencing symptoms, schedule a consultation with Dr. Sergei Kuznetsov at Park Slope Dental Arts in Brooklyn. We’ll assess your situation and create a plan that works for you.

 

Disclaimer: The content of this page is for informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your dentist or other qualified healthcare provider with any questions you may have regarding a medical condition. Treatment outcomes may vary. Examination is necessary for proper diagnosis and treatment planning. This content was created by humans with the support of AI.