When's the right time to have your wisdom teeth taken out?

What's the best age?

There is no set rule regarding a specific age by which a person "must" have their wisdom teeth removed. Third molar extractions can be performed successfully for patients in all age groups.

From a standpoint of statistics however, research has shown that there are certain age-related factors that can place comparatively older patients at greater risk for complications. Related to these issues, dentists typically recommend that wisdom teeth should (most ideally) be removed between the ages of 18 and 24 years.

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

[ Related Page: What time of year do most people get their wisdom teeth out? ]

Why is the age range 18 to 24 preferred?

Why age 18?

A dentist will typically want to delay a wisdom tooth extraction until that point in time when about two-thirds of the tooth's root has formed. They wait for this stage because if the tooth is less developed it can be more difficult to manipulate during the surgical process.

The age by which this degree of root development has been reached will vary with each individual (it can be sooner or later). But in terms of the population as a whole, a common age for this stage of root formation to be present is on the order of 18 years.

Why age 24?

Choosing age 24 years for the upper end of the ideal age range for wisdom tooth removal 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.

With age come more complete root formation and other physiologic factors that both potentially increase the difficulty of the extraction process and affect the patient's post-surgical resiliency. In regards to these issues, studies have suggested that age 24 years is a good cutoff point (see below).

Third molar germectomy - Another approach for planning third molar extractions.

Germectomy is typically defined as the removal of a tooth whose root is less than one third formed. And while the implementation of this approach is not widespread, germectomy procedure can be practiced with wisdom teeth.

Doing so, of course, implies that the patient being treated is comparatively young (typically around ages 8 through 17 years). This means that practicing germectomy can be somewhat difficult clinically (limited oral access, reduced patient cooperation). It also means that performing a germectomy could pose risks for adjacent developing teeth. However, Chiapasco (1995) found that the incidence of complications associated with third molar germectomy was no higher than that for 18 to 24 year-olds (the typically preferred age range for wisdom tooth removal).

Wisdom tooth removal - Complication rates vary according to age.

Nerve damage (paresthesia) is more likely in older patients.

Numerous third molar studies have confirmed that, as a rule of thumb, relatively older patients experience a greater incidence of complications with the surgical process, postoperative recovery and the post-surgical healing process than comparatively younger patients do. The most common complications being those same ones associated with wisdom tooth extractions in general: dry sockets (alveolar osteitis), root fracture and nerve damage (paresthesia).

What the research shows.

For example, Pogrel (2007) cites a study involving over 4,000 patients that found that the risk of complications associated with wisdom tooth extraction for patients over the age of 25 years was 1.5 times that rate experienced by those under this age. They also found that, for any particular age group, the incidence of complications generally increased with years, through age 65.

Another study (Chiapasco (1995) found the rate of complications associated with wisdom tooth extraction to be 2.8% for patients ages 17 to 24 years. For those over the age of 24 years (a population ranging in age from 25 to 67 years), the incidence rate was found to be 7.4%.

Why is age an issue?

There can be numerous factors involved that help to create this age-related effect. They include increased bone density and more complete wisdom tooth root formation with older patients, both of which tend to increase the surgical difficulty of an extraction. Also, with age, people typically experience a generalized reduced capacity for healing.

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

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