Some very young teenagers, when not plain children, undergo the removal of their wisdom teeth.

This is wrong.

In my opinion, it is very wrong. As a dentist, I am not necessarily a better professional than, let’s say, the doctors at Midland Oral and Maxillofacial Surgery, in Michigan. Just like my paisano Julio Visconti, from Almería, was not a better watercolor painter than John James Audubon. But, in my opinion, removing the wisdom teeth from such young patients is absurd, dangerous and unnecessary.

People that know me will be able to confirm that I have never even tried a steak or a chicken wing in my life. But just because I am an herbivore, that doesn’t mean I don’t have a bit of a fighter in me. Remember the Spanish fighting bulls! Or maybe Louis from Beastars, or Judy Hopps from Zootopia. So, in this article, I am going to be very tough with my criticism.

Why? Just why? Why would a 9, 10, 11, 12, 13, 14 or 15-year-old patient need to undergo the procedure? Can somebody provide a proper reason?

Dentistry is a very complex and variable discipline. All sorts of strange and unusual situations are possible. But that’s it: a young teenager or kid needing to get a wisdom tooth out (let alone more than one) is something totally unusual. Not something to promote on your website as “a rite of passage” and “a routine but important procedure” that “children and parents elect”. This is misleading, this is false and this is NONSENSE.

At such a young age, the third molars are usually still developing, deep in the bone, far from the oral cavity and therefore, not infected. They are teeth like any other, not some sort of failure of nature that automatically requires “a rite of passage” to get solved. So, if they are fine and asymptomatic (and at these ages, they are pretty much always going to be), they don’t need to get removed.

In healthy patients, there is no reason to go and remove the third molars “just in case”. If the patient is a teenager whose wisdom teeth aren’t even fully formed, this is even less justified, for a variety of reasons.

I fail to see how removing the wisdom teeth is going to promote a “healthy, beautiful smile”. At this point, everybody understands that the Earth is not the center of the Universe, so everybody should also be aware that wisdom teeth do not push, cause crowding or ruin orthodontic treatments. Even when they are leaning towards the other teeth or have no place. This is an urban legend. So, I don’t see how wisdom teeth could have any kind of impact on the smile later in life.

And even assuming the removal was necessary “because of a lack of space” (it is not), because of whatever risk they consider is associated with an impacted wisdom tooth, the removal is still not justified at such a young age. Why? Because there is still a lot of potential for evolution!

Wisdom teeth may move or shift inside the bone, becoming more favorable for a proper eruption. And if the patient is very young, even the jaw or maxillary themselves could grow. So, how do you intend to evaluate the “lack of space” of a tooth, if the bones that should contain it are still growing? You simply can’t. Some dentists even fail to properly evaluate whether wisdom teeth are impacted or not, on panoramic x-rays, in older patients that are no longer growing. So, just imagine when the patient is still growing!

Last but not least, assuming again the removal was necessary for whatever reason, earlier doesn’t necessarily mean easier. It often means harder, in fact. This is particularly true concerning the removals on children and the youngest teenagers. Getting to the wisdom teeth when they are small, barely formed and deep in the bone is a greatly challenging, complex and invasive surgical procedure that often requires a big osteotomy (bone removal) and comes with a painful, long and complicated post-operatory period. Waiting would be wiser: once the wisdom tooth is more formed, closer to erupting or already erupted, its extraction is going to be easier, quicker and less traumatic, if it is ever necessary. I invite you to check out the corresponding article for further insight about this.

This issue of such young patients undergoing the removal of wisdom teeth is pretty much unheard of in most of the world, and for good reason: it is not necessary. The USA is an exception. So much so, that the Guinness World Record for the youngest patient that underwent the removal of third molars was set in the USA. The current record was set in 2022, and it seems to be one of those exceptional and rare cases I talked about before, so I don’t have anything to say. For once, it seems that there was an exceptional and definite orthodontic reason to perform the removal of a single wisdom tooth.

But the previous record, set in 2002, was not as clearly justified. This record corresponded to Matthew Adams, aged 9 years and 339 days old when he had his lower two wisdom teeth removed due to “lack of space”, on October 24, 2002. “Lack of space” is not a proper reason on its own to recommend the removal of wisdom teeth, as detailed on a dedicated main article. Yet, this is the sole reason provided to justify performing the removal on this 9-year-old boy, which was done at the aforementioned surgery clinic in Michigan.

I contacted them to inquire about Matthew Adams’ spectacularly early case of wisdom teeth removals… and I got no reply. So, I can’t but assume his record-setting removal was fully unjustified. Like virtually all the removals on very young patients, that they seem very happy to offer and perform on a regular basis. From what we can can read in this old article, it appears as if the removal had an orthodontic indication (both bottom wisdom preventing the second molars from erupting), but I am still not convinced. Was it really the case for both wisdom teeth? Why not waiting a bit more, for an easier removal? And if the retained second molars were the reason to remove Matthew's thirds, then, when other kids arrive at their clinic with no impacted wisdom teeth... they must be ethical and disadvice the extraction. Right?

I will only rectify my tough words here if I get a proper reply and explanation from them. Otherwise, my fair criticism stays. For real: a 9-year-old getting his wisdom teeth out! Just think about it with a cold mind. Isn’t that just plainly insane?

I will also criticize Guinness World Records for having stablished such a record to begin with. Their policies are clear about protecting minors, so how come this doesn’t apply when it comes to minors undergoing unnecessary medical procedures? The removal of teeth is a serious intervention, not something to be considered in such a frivolous way. By the way, GWR didn’t reply to me either, when I also contacted them for further insight about Matthew Adams’ case.

So, in most of the world, it is understood that children or young teenagers don’t need to get their wisdom teeth removed. The USA is an exception to this. And France is also an exception. I practice in France, so I have been able to know a few pretty awful clinical cases of people that underwent the removal of their wisdom teeth at very young ages. I will proceed to describe a few of them.

I saw a woman in her 20s that, at 12 years old, got all her wisdom teeth removed under general anesthesia. The French love general anesthesia for the removal of wisdom teeth, as much as Americans seem to love laughing gas or sedation. Her gums didn’t heal properly after the procedure, and to this day, she still has a deformed, annoying piece of gum behind her second molar.

A woman I know had an 11-year-old daughter whose wisdom teeth were even less developed than this (x-ray taken at 13):

And she was a bit appalled, because a wise and old French dentist recommended her to undergo general anesthesia to get all four of them removed as soon as possible. Of course, I told her not to do that and she listened to me. Up to this day, her daughter keeps all her wisdom teeth, asymptomatic, healthy and without any issues.

I know a 14-year-old that had a single wisdom tooth that was preventing a second molar from properly erupting, and she still got all of them out, including the other three that were fine.

I know another woman, whose case you can see on this other article, that got all her wisdom teeth wrongly diagnosed as impacted when she was only 15 years old. The diagnosis of impaction was completely wrong: she was mutilated. Meaning: she got normally developing teeth out.

Pretty awful cases, don’t you think? Also, don’t overlook the psychological impact of a procedure like this on minors. Undergoing such a violent and invasive procedure at a young age could potentially make the poor youngsters terrified of the dentist for the rest of their lives. It is the case of some of my poor French patients.

For every parent out there that’s wondering: don’t get your young child’s wisdom teeth removed. Don’t do it. Don’t let anybody fool and manipulate you with stories of “dental damage and discomfort”, or “to promote a healthy, beautiful smile”.

If there is no specific (and rare) indication, such as a third molar preventing a second one from erupting, the removal is never going to be justified at such young ages, during such early stages of development. It will be unnecessarily hard, violent and dangerous. The removal, if ever necessary, will get easier with time.

And there is even a good chance your child will end up getting potentially functional, normal and healthy teeth removed. Because that’s what wisdom teeth are: teeth like any other, not defects of nature. Don’t get your kid mutilated. And no matter if you’re running out of time before your insurance stops covering the removal: even when impacted, most wisdom teeth don’t need to get removed at any particular point in life.

Special mention here to Medicaid recipients in America, as the removal of wisdom teeth tends to be fully covered by it until 18-years-old, and less often after: the way this coverage works is incentivicing you to overtreat your young child. And this is madness. Check out the article I wrote about "insurance-induced" pressure for further insight.

Would you rush to remove any other of their body parts depending on what your insurance covers or stops covering? Or because you got an offer, or whatever reason other than your child’s HEALTH and wellbeing? Of course not! You wouldn’t.

The same applies to wisdom teeth. Don’t be afraid. And remember that I am here for you. Feel free to contact me. I will be happy to discuss your case (or your child’s case).

And to end this article, I will bring up a famous phrase from the song Another brick in the wall, by Pink Floyd: hey, surgeons! Leave those kids alone.

Saludos cordales.