What's the right age to get your wisdom teeth removed?

- Factors influenced by the extraction process. / Age-related issues. / Research findings. / When do most people get them out? (graphs)

1) What's the best age for wisdom tooth extraction?

There's no set rule stating a specific age by which a person "must" have their wisdom teeth removed. That's because third molar extractions can be performed successfully for patients in all age groups.

But as we outline below, from a standpoint of statistics there are a number of age-related factors that tend to place comparatively older patients at greater risk for complications.

The typical recommendation for 3rd molar extraction -

Based on the factors and issues outlined on this page, dentists typically recommend that wisdom teeth should (most ideally) be removed between the ages of 18 and 24 years.


2) Why is the age range 18 to 24 preferred?

a) Why age 18?

A dentist will usually want to delay a wisdom tooth extraction until that point in time when about two-thirds of its root has formed.

It is usually best to remove impacted wisdom teeth when their roots are only 2/3rds formed.

The ideal stage for wisdom tooth extraction is 2/3rds root development.

They wait for this stage because if the tooth is less developed (smaller, more ball-like), it can be more difficult to manipulate during the surgical process.

The age at which 2/3rds root development has occurred will vary with each individual. But generally speaking, this stage will have been reached by around age 18 years.

b) Why age 24?

Choosing the age of 24 for the upper end of the ideal range is based on the fact that the dentist wants to remove the tooth within that time frame when their patient's risk for complications is at a minimum.

X-ray showing 2/3 and full root formation of an impacted wisdom tooth.

With age comes fuller root formation and additional factors that collectively tend to both increase the difficulty of the extraction process and affect the patient's ease with post-surgical recovery.

And in regard to these issues, studies have suggested that age 24 years makes a good cut off point (see below).

c) An overriding factor.

Of course, any discussion about the preferred age for extracting wisdom teeth implies that a decision can be made about the need for their removal in the first place. However, in some cases it takes additional time to determine if a particular tooth really is likely to remain impacted.

Some teeth that have an errant initial inclination, or seem slow to erupt, may ultimately come into normal position if given enough time. So in these cases, the dentist may need an additional few years of observation to make their determination.

d) A different approach - Third molar germectomy.

Germectomy is generally defined as the extraction of a tooth whose root is less than one third formed. And while the use of this approach is not widespread, it can be practiced with wisdom teeth.

Doing so implies that the patient will be comparatively young. A stage of 1/3rd root formation or less for third molars is generally associated with patients ages 8 through 17 years.

That means that performing a germectomy can be somewhat difficult clinically (limited oral access, reduced patient cooperation). It also means adjacent developing teeth might be placed at risk of damage.

However, Chiapasco (1995) [page references] found that the incidence of complications associated with third molar germectomy was no higher than that for conventional removal at age 18 to 24 years.


4) Complication rates for wisdom tooth extractions tend to vary with age.

Numerous third-molar studies have confirmed that, as a rule of thumb, relatively older patients experience a higher incidence of complications with the extraction process, postoperative recovery and post-surgical healing than comparatively younger ones.

The most common complications being those same ones most often associated with wisdom tooth extractions in general: 1) dry sockets (alveolar osteitis), 2) root fracture and 3) nerve damage (paresthesia).

What research reports.

  • Pogrel (2007) cites a study involving over 4,000 patients who had wisdom tooth extractions. It found that the risk of complications for patients over the age of 25 years was 1.5 times the rate experienced by those who were younger.

    It also concluded that, within any particular age group, the incidence of complications for a patient generally increased with each year of age.

  • Another study (Chiapasco 1995) that evaluated third molar surgeries found the complications rate for patients ages 17 to 24 to be 2.8%. For those over the age of 24 years (a population ranging in age from 25 to 67), the incidence rate was 7.4%.
Nerve damage (paresthesia) is more likely in older patients.

Complete root formation may make it more likely nerve damage will occur.

Why is age an issue?

There are a number of factors that collectively create this age-related effect. Some of them are:

Root formation.

The wisdom teeth of comparatively older patients are more likely to be more fully formed.

  • With other factors being similar, teeth with longer roots tend to be more difficult to extract. As a result, more surgical trauma may be created, which makes the process of post-surgical healing more involved.
  • Longer roots are more likely to lie in close proximity to anatomical structures (like nerves, see illustration), which may become damaged or otherwise involved during the surgical process.
Bone density.

Bone rigidity tends to increase with age (due to a higher degree of calcification).

That means that a greater degree of force, or more bone removal, may be required during the extraction process, thus making it more traumatic.

Reduced capacity for healing.

It's normal that with age a person will find they are generally less resilient and healing and recovery become more drawn out.

Age alone isn't a contraindication.

Collectively, the factors above explain why a higher level of complications are experienced by comparatively older patients.

But it's important to note that for healthy individuals, age alone should not necessarily be considered to be a significant risk factor (in the sense that an extraction should not be performed if sound reasons warrant it).


When do most people have their wisdom teeth taken out?

Evaluating the number of web searches for the terms 'wisdom teeth' and 'dry sockets' is revealing.

It seems likely that most people have their teeth removed during their summer vacation.

This only makes sense since most third molar extractions are performed for people between the ages of 18 and 24 years, a group whose schedule is often closely coordinated with the school calendar.

a) Our 'wisdom teeth' graph makes a pretty good case for this claim.

As evidence for this theory, take a look at our graph.

 
Monthly web searches for the term 'Wisdom Teeth.'

The 5 years of data we evaluated (2004 - 2009) demonstrates that web search volume for the term 'wisdom teeth' spikes at times corresponding with school-term breaks, especially summer.

Of course, we're making the assumption that most people only perform web searches about activities they are planning or are involved with. With a subject as dry as wisdom teeth, that seems a safe enough bet.

b) Our 'dry socket' graph seems to confirm our 'wisdom teeth' findings.

As further evidence, take a look at the graph below.

 
Monthly web searches for the term 'Dry Socket.'

For this graph, we evaluated the search term 'dry socket' (a common complication associated with wisdom tooth extraction). And when plotted, it seems to demonstrate that search traffic related to this term peaks in mid to late summer too.

 

 
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