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Wisdom Teeth Extraction at 40 yrs?
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Questions in the Oral and Maxillofacial Surgery forum are answered by Dr. Michael H Kirsch and Dr. Mario Tuchman. Topics covered include teeth extractions, wisdom teeth, dental implants, bone grafting, orthognathic surgery, facial bones realignment, facial trauma repair, jaw alignment, anesthesia , jaw cyst or tumor diagnosis, reconstructive jaw surgery, temporomandibular joint syndrome (TMJ) and TMJ surgery.

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Wisdom Teeth Extraction at 40 yrs?

Dear Dr.

My dentist recommended that I have my wisdom teeth extracted because they are pushing my other teeth out of alignment.  Somewhere I read that people over 30 may have severe problems because their wisdom teeth have been firmly rooted.  Are there any special precautions I should take?

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Third Molars:  Evidence Based Rationale for Treatment

The American Association of Oral and Maxillofacial Surgeons and the Oral and Maxillofacial Surgery Foundation are completing the seventh year of the landmark "Third Molar Clinical Trials".

The researchers have discovered that for patients ages 20 to 35 enrolled in a longitudinal clinical trial, retained third molars, even those that are asymptomatic and show no signs of disease, may pose serious health risks that include chronic oral inflammation from periodontal disease which also increases the risk for elevated inflammation throughout the body.

The data from these studies are unique in that periodontal disease effects "young adults" ages 20 to 35.  If untreated, the periodontal bacteria will encompass second molars and other teeth.

In 20 to 35 year old pregnant women, third molar periodontal disease increased the risk of delivering a low birth-weight infant and pre term birth. 6  For these patients, the periodontal inflammation in the third molar area poses a danger akin to smoking during pregnancy.

A growing body of evidence suggests that untreated periodontal disease provides a portal into the bloodstream for pathogenic bacteria.  Oral bacteria has been linked to more serious health problems, including coronary artery disease, stroke, renal vascular disease, diabetes and obstetric complications. Young adults also appear to be at risk, particularly from periodontal pathology affective third molars.

The AAOMS Third Molar Clinical Trail suggests that most thirds molars, even those that are asymptomatic and show no current signs of disease, are at risk for chronic oral infectious disease, periodontal pathology and tooth decay, and should be considered for removal in young adulthood.

Studies looking at third molar surgery show that increasing age is a risk factor for complications.  Therefore, removal of third molars should be considered before the patients' 25th birthday.

Periodontal pathology in the third molar region is difficult to treat successfully.  Even with repetitive treatments, eliminating the pathogenic bacteria may not be possible.

Retained third molars pose other health risks for affected patients, and may lead to the loss of adjacent teeth, or the development of cysts or tumors in the jaws.  After their removal, reconstructive surgery of the area may be required to repair, reconstruct and restore jaw function and facial form.  As an Oral and Maxillofacial Surgeon, I have seen many cases in which the patients condition could have been prevented if the third molars were addressed earlier in life.


Science has finally caught up with the long held belief that young patients should be critically evaluated for the removal of their third molars.  This includes a good quality extraoral radiograph (Panorex), intraoral examination, complete medical history and a thorough discussion of the risks, benefits and alternatives to removal vs. maintenance of the teeth.  

It is my sincere hope in communicating this information, that you will seek the advice of an Oral and Maxillofacial.  Not every patient referred to me for wisdom tooth evaluation requires surgery; however, every patient should be aware of their condition.

Information contained within this reply is intended solely for general educational purposes and is not intended nor implied to be a medical diagnosis or treatment recommendation.  This is not a substitute for professional medical advice relative to your specific medical condition or question. Always seek the advice of your own doctor for medical condition. Only your doctor can provide specific diagnoses and therapies.
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