01/02/2026
Ok, I’m breaking my own rule here. But this one was just too good. And also I love John Hamm.
We’ll call it my one trend for 2026.
Now, on a serious note:
Patients often tell me their dentist said they would “never need” their wisdom teeth out. But pathology in impacted third molars doesn’t usually show up with pain. It shows up quietly. On a pan like this one.
We have decades of data showing that impacted third molars are not biologically inert. Studies consistently show that even deep, fully impacted teeth can develop caries, cysts, periodontal defects, and infections long before the patient feels anything at all. A large prospective study from the UK demonstrated that pathology increased each year that third molars were retained. The AAOMS white paper notes clearly that disease can be present in impacted teeth without symptoms, and that early removal prevents progression that often requires more morbid treatment later in life.
Adolescents and young adults heal remarkably well. They have lower rates of complications, faster recovery, and significantly reduced risk to the nerve. Once a patient reaches their late twenties or thirties, the calculus changes. Bone becomes denser, roots fully form, and the risk of infection, pain, nerve injury, and poor healing increases. By the time caries or infection appear on a radiograph, the surgery becomes more technically demanding and the recovery is harder.
This is why proactive, planned removal in adolescence or early adulthood remains the standard approach for teeth that are positioned like this. Waiting for symptoms means waiting for pathology, and pathology almost always makes the situation worse.
Dentists! Please stop telling your patients that you want to “wait to see if the teeth will erupt.” Or that since the teeth are fully impacted, they will “never need to come out.” Early removal is not about being aggressive. It’s about preventing avoidable disease and giving the patient the easiest surgical course with the safest long-term outcome.
Disclaimer: Not medical advice. Educational content only.
