Features

• The wisdom teeth are located on the top and bottom of the mouth, at the very back, and are the third molar from the front. These teeth are called "wisdom teeth" because they generally emerge when the patient is 17 to 21 years of age, or old enough to have a certain amount of "wisdom." While many patients must have their wisdom teeth removed, due to poor alignment or not enough room in the mouth, some wisdom teeth develop properly and do not need to be extracted.
  
  

When Wisdom Teeth Need To Be Extracted

• When wisdom teeth emerge, they break through the gums, causing a flap of tissue to grow over them. Food can become trapped in this flap and a serious infection can occur, resulting in the necessary surgical procedure. In addition, wisdom teeth must be extracted if they grow in crooked or face the wrong direction. Wisdom teeth must also be extracted if the jaw is not large enough or if there is not enough room in the mouth. If the mouth does not have room for the wisdom teeth, the teeth may be unable to break through the gums and may become impacted, making extraction necessary. Finally, if patients are unable to clean the wisdom teeth, they may begin to decay, oftentimes resulting in a necessary extraction procedure.
  
  

Symptoms That Wisdom Teeth Need To Be Extracted

• Wisdom teeth that grow in at an angle generally need to be extracted (WebMD)
  
  Generally, wisdom teeth that are in need of extraction do not have any serious or noticeable symptoms, however in some conditions, the teeth show obvious signs that they are not growing in properly. These symptoms include pain or jaw stiffness near the impacted tooth, pain and irritation from a tooth coming in at an awkward angle, an infected swelling in the flap of gum tissue located in the back of the mouth, crowding of other teeth, tooth decay or gum disease near the back of the mouth or a feeling of discomfort as the teeth rub against your cheek, tongue or top or bottom of your mouth. Generally, these symptoms begin to develop when the patient is 15 to 25 years of age. Rarely do patients over the age of 30 require wisdom teeth extraction.
  
  

Diagnosis

• Dentists perform simple tests, such as feeling in the back of the mouth and along the gum line, to determine whether a wisdom tooth is coming in successfully. In addition, X-Rays may help determine whether wisdom teeth are moving, and if their alignment will allow them to grow in safely.
  
  

Procedure

• If a dentist suspects that a patient's wisdom teeth are growing in and won't have room, or if they are at an improper alignment, he will recommend that the teeth be extracted by an oral surgeon. Although patients may only experience symptoms for one of the four wisdom teeth, oral surgeons usually recommend that all four teeth be extracted at the same time, to save costly procedures later on in the patient's life. Many oral surgeons also agree that it is easiest to extract teeth in patients in their early 20s or younger, as the roots of the teeth and the jawbone are not completely developed.