Do I need to remove my wisdom teeth after braces?

Will the wisdom teeth “push” my other teeth to become crooked again? This is a common concern amongst orthodontic patients. We get asked about this a lot. Many patients are worried that the wisdom teeth will exert pressure on the front teeth causing the teeth to become crooked.

Studies have shown that patients who do not have wisdom teeth (congenitally missing) or already had the wisdom teeth removed still had teeth which became crooked later¹.  This means that the wisdom teeth do not cause the teeth to become crooked after braces.

The reason teeth become crooked again after braces is because of the natural movement of the teeth as the patient grows older. Therefore, retainer wear is especially important to maintain the alignment of the teeth after braces.

When should wisdom teeth be removed then?
You should consider having your wisdom tooth/teeth removed in the following conditions2:

  • Recurrent pericoronitis. Repeated episodes of gum swelling around the wisdom tooth.
  • Decay (caries) of the wisdom tooth. If it is difficult to clean the area surrounding the wisdom tooth, it might be preferable to extract the wisdom tooth. (Figure 1)
  • Decay (caries) of adjacent tooth. If the adjacent tooth is decayed, then removal of the wisdom tooth is necessary to allow filling to be done. (Figure 1)
  • Infection. Pericoronitis or decayed wisdom tooth can cause infection of the area around the wisdom tooth.
  • Periodontitis. Gum disease (periodontitis) can occur around wisdom tooth. A study showed that 1 in 4 person with non-problematic wisdom teeth had gum disease around the wisdom teeth area3.
  • Non-functional wisdom tooth. If the opposing wisdom tooth is missing (either extracted or congenitally missing), then the wisdom tooth may need to be removed. This is to prevent trauma of the gums on the opposing side due to elongation of the tooth (supraeruption). Figure 2.
  • Denture covering buried (impacted) wisdom tooth. If the buried wisdom tooth is very near the gums, then the tooth might need to be removed to prevent irritation from the denture.
  • Obstruction of adjacent tooth. If both the wisdom tooth and the adjacent tooth (second molar) are buried, then the wisdom tooth might need to be removed to allow the second molar to be straightened. (Figure 3)
  • Jaw surgery with braces. If jaw surgery is planned for the lower jaw, then the lower wisdom teeth would need to be removed at least 6 months before surgery to facilitate the jaw surgery procedure.
  • Figure 1. Decay (caries) of lower right wisdom tooth and adjacent tooth (second molar) (red circle). Decay of lower left wisdom tooth (yellow circle).

    Figure 2. Elongation (supraeruption) of upper right wisdom tooth due to missing lower right wisdom tooth (red circle). Possible trauma to gums (red arrow).

    Figure 3. Lower left wisdom tooth obstructing impacted adjacent tooth (second molar) (red circle). If the adjacent tooth is going to be uprighted, then the wisdom tooth will need to be removed.

    In conclusion, wisdom teeth do not cause the other teeth to become crooked. However, the wisdom teeth can cause some other problems even if you do not experience any pain or discomfort. Therefore, it is important to go for regular check-ups to ensure the wisdom teeth are problem-free.

    Don’t worry, you will not lose your “wisdom” after removal of your wisdom teeth. If you are unsure about the condition of your wisdom teeth, contact us to schedule an appointment for a check-up.

    Also wondering if something can be done to correct crooked teeth? Do check out our braces related posts by clicking here. Feel free to contact us for a no obligation braces consultation.

    Updated: 21 Sept 2021

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