Don’t be afraid.

I don’t mean afraid of the removal. You know, my dear reader, that we are not here to talk about that. In fact, yes: be afraid of the removal. Or at least, cautious about it. There is a very big chance you don’t really need to get your wisdom teeth removed.

Just like Manuel de Falla was not a better composer than his friend Igor Stravinsky, I am not a better dentist than yours. But I still have the right to an opinion.

And, in my opinion, wisdom teeth are not a big deal. Or at least, they are much less of a big deal than many people think. Both patients and dentists.

Like the Spanish Empire, they have a terrible black legend. This is the term used to define the historiographic tendency to portray the Spanish Empire under an unfairly negative light. Even Daniel Defoe in Robinson Crusoe (1719) criticized the Spanish Empire as incredibly cruel, so this is nothing new. The European Middle Ages also have a black legend: unfairly regarded as the maximum period of barbarism and brutality in history, and the very word “medieval” is literally used as an insult, so go figure!

In reality, the Spanish Empire was not particularly ruthless. No more than any other imperial powers of its time. And the Middle Ages in Europe were not particularly spooky or barbaric: no more than other past eras.

And in reality, wisdom teeth are not particularly problematic. They are teeth like any other. Seriously. They are not a disease or a quadruple tumor. They are teeth. Nothing to be afraid of. Nothing that automatically needs treatment and action like some sort of defect of nature. I have had patients with no symptoms or pathology whatsoever, that came wondering if they still needed to get their wisdom teeth removed. Either them, or their parents were concerned for no reason. Kinda heartbreaking, if you ask me. What kinds of horror tales did these poor people hear?? Once again, with things like this, no wonder so many people are afraid of the dentist!

In most cases, people don’t even notice their wisdom teeth. Wisdom teeth causing problems of any kind are clearly the exception, a minority of the cases. If they have plenty of space and formed in a good position, third molars will come in like the normal teeth they are, and many people will not even notice them. Just like most kids don’t notice their first or second molars coming in (around 6 and 12 years old, respectively). In fact, when I see a teenager or a young adult for a check-up and tell them that their wisdom teeth are coming in, they are often surprised. They were not aware of this milestone.

In many cases, wisdom teeth don’t have enough space to come in. I think this problem is acquired, and I blame it on a soft diet while growing up, not evolution, genetics or anything similar. But even in these less favorable cases, wisdom teeth rarely cause problems. I can count with my fingers the times I have seen an impacted wisdom tooth that needed to get removed. It happens, but it is a rare problem overall. And did you notice how I said “an impacted wisdom tooth”, in the singular? I tend to speak in the singular because it’s often only one that causes problems. Or maybe more than one, yes, if the patient is really unlucky. But working as a dentist since 2022, do you know how many times I have seen a patient that needed to get all four wisdom teeth removed at the same time? Zero.

Jay W. Friedman said that most of the pain and illness attributed to third molars in pop culture is caused by the surgery, not by the teeth themselves. I wholeheartedly agree. His amazing article is among the Resources that back the minimally invasive philosophy of this project. I invite you to give it a read.

Be careful what you read, though. There is a huge bias that favors the visibility of the minority cases of problematic wisdom teeth. This happens on social media, and on forums where people ask stuff about their wisdom teeth. These spaces are basically an echo chamber revolving around the problematic cases of wisdom teeth, which are not the norm nor the majority of the cases.

And why is that so? Because people that have asymptomatic wisdom teeth rarely bother to talk about them, or to post or ask stuff online about them... unless they are undergoing an (unjustified) removal! This further contributes to the unfair image they have in popular culture as nothing more than a source of problems. This is a wrong image.

In fact, if you ended up reading this website, there is a big chance it is because you have a real problem with a wisdom tooth. Maybe a problem that, for once, does require you to get it removed. So, maybe you are frowning now at my bold claims about wisdom teeth not being a big deal. But I insist: they are not a big deal. You are unlucky to be an exception to the rule of wisdom teeth that are perfectly fine. And if you were not such an exception, would you have bothered to read about wisdom teeth online? Of course not.

So, for real: if this is not your situation, and you feel completely fine, don’t be afraid of keeping your wisdom teeth. Statistically, most likely, you will not need to get them removed, no matter what you’ve heard or what they’ve told you. And yes, again, this includes if you don’t seem to have enough space for them: if you have a crowded incisor, that is also due to a lack of space, however, you wouldn’t think of removing it, would you? The same principle applies to wisdom teeth, that are teeth like any other. And please, no, wisdom teeth will not make your teeth crowded or ruin your orthodontic treatment: this is a legend.

Dentists are not safe from biases either. I met a pediatric dentist in Spain that complained about how many cavities the kids she treated had. At the same time, I had recently read studies that showed how the incidence of cavities in young children had been decreasing in many countries, including Spain. When I brought this up, she replied with something like “Well, it doesn’t seem to be the case!”. Was she wrong? I don’t think so. She was just biased: she spent most of her time dealing with children with lots of cavities. This gave her the impression that the problem was a lot worse than it actually was.

I believe that something similar happens regarding wisdom teeth: even dentists have a biased, unrealistic and too negative opinion about them. Even the most ethical and less invasive of all, in general. Because they won’t give a second thought to the many cases (the majority of cases) of wisdom teeth that cause no problems. But when it’s a problematic wisdom tooth they are dealing with, they will focus their attention and energy on the problem, removing or treating the wisdom tooth. This will make them also get the wrong impression that wisdom teeth are “only a source of problems”.

Furthermore, I think there is another bias at work: there might be a correlation (not causation) between the presence of wisdom teeth in the mouth, and certain dental problems, such as periodontitis. Why? Because if removing wisdom teeth is considered “standard care”, those that actually take care of their teeth and go to the dentist regularly, will necessarily end up with more wisdom teeth removed (even without a real need) than those who don’t see a dentist.

Think of it this way: if you neglect your teeth, you will get problems like periodontitis, and also, you won’t bother to see a dentist regularly. If you don’t see a dentist regularly, you will not be proposed a prophylactic removal of wisdom teeth. So, you will end up with periodontitis, while keeping your wisdom teeth. However, it is not your wisdom teeth that are causing the periodontitis: it is you, neglecting your teeth.

Stll, a statistic showing a correlation between the presence of wisdom teeth and periodontitis could be established. A flawed statistic, for correlation doesn’t imply causation, but still a technically correct one.

We should all be wary of these false impressions, both dentists and patients. Please, take good care of your teeth, see your dentist regularly for cleanings and check-ups (yes, even if you think you are fine)... and avoid the unnecessary removals of wisdom teeth! Don’t contribute to flawed statistics: you should have perfect teeth, you should be seeing your dentist regularly, AND you should have 32 teeth in your mouth too.

I speak as a minimally invasive dentist that values teeth and respects nature with everything that comes with it. Back to the bias of “directed energy” that I mentioned before: I can have a tougher time filling wisdom teeth than other teeth, or cleaning (scaling) around them, but I am not going to go and condemn them as some sort of defect of nature for this reason. That would be kind of a prideful approach, if you ask me. Dentists should not neglect wisdom teeth.

You see, I am only expressing my opinion, but isn’t this a valuable opinion? It’s up to you to decide its value, but it is an opinion that you, my dear reader, have a right to know: there are voices and opinions beyond “wisdom teeth are useless, just take them out”. And I am here to offer them to you. Like the Spanish proverb says: Cada gallo canta en su gallinero y el español en el suyo y en el mundo entero. Meaning: Every rooster crows in his henhouse, and the Spaniard in his own and in the whole world.

And here I am, as a Spanish dentist with a critical point of view on wisdom tooth removals, spreading wide and far the minimally invasive word, and at your service, if you want to discuss about wisdom teeth. Don’t hesitate to contact me.

Saludos cordales.