A popular reason why wisdom teeth are removed prior to orthodontic treatment is to avoid the recurrence of dental crowding when they erupt.
This view is not supported by the scientific evidence, and thus every case should be assessed individually. Tooth movement and dental crowding occur as part of the natural aging process whether the wisdom teeth are present or absent. The situations which could require having the wisdom teeth removed will be discussed.
In general, there is a consensus in the dental literature that wisdom teeth are removed if they have surrounding gum disease, have cavities that can’t be restored, are infected or have associated tumors or cysts. Additionally, wisdom teeth that are erupting improperly and/or damaging the neighboring teeth need to be removed.
Orthodontic treatment may require the removal of wisdom teeth to create space to correct crowding, or if the wisdom teeth have moved into an unfavorable position and are interfering with function.
There are instances where remaining wisdom teeth can be moved orthodontically to replace badly decayed and extracted neighboring molars.
In summary, unless there is a general need or a specified orthodontic need for wisdom teeth removal, they should not be extracted.
The above sequential X-rays show the presence of four wisdom teeth (green arrow), two heavily restored molars (circled red), and areas of previous molars extractions (red arrows). In the final X-ray, the wisdom teeth have been brought forward to replace the missing molars.
