Do I really need both wisdom teeth extracted?

My dentist is going to remove my lower right wisdom tooth because it aches. He says that if I don’t remove the upper right wisdom tooth, it will drop into the space of the lower one and eventually hit my gums or interfere with other teeth. Is that true. Do I need both wisdom teeth extracted? I am 54 years old and do not want unnecessary complications. I am anxious to begin teeth whitening treatment. Thank you. Regina


Your dentist is right. It is wise to remove wisdom teeth in pairs for several reasons.

  • Drifting – Keeping the upper right wisdom tooth can cause it to drift into the lower space.
  • Bite disruption – The unevenness can disrupt your bite or contribute to tooth decay or gum disease.
  • Tooth decay or gum disease – Without a lower tooth to chew against, if the upper tooth disrupts your bite, tooth decay or gum disease can occur in other teeth.

What Can You Expect with Wisdom Teeth Removal?

You can expect painless surgery and progressive recovery with wisdom tooth removal. Impacted wisdom teeth can be challenging to extract. If your dentist is not experienced with a variety of cases and your teeth are impacted, he may refer you to an oral surgeon.

Comfort – Before surgery, the oral surgeon will sedate you.

Surgery length – Your time in surgery depends on how many teeth the surgeon will remove and if they are impacted. Average time for removing all four wisdom teeth is about 1.5 hours.

Progressive recovery – You will see some swelling and feel soreness, but post-operative instructions explain how to manage them both and keep comfortable. Each day, you will progressively feel better. Although complications are rare, your oral surgeon will explain the signs and symptoms of complications, including:

Photo of upper and lower teeth whitening trays in a blue case; for information on free teeth whitening from the office Plano dentist Dr. Miranda Lacy.
Teeth whitening can begin after wisdom tooth extracation
  • Dry socket
  • Infection
  • Sensory nerve damage
  • Sinus perforation

Follow-up visits – You may have one follow-up visit after extraction, but it is often not needed.

Your dentist will schedule an appointment to check the extractions sites and ensure your gums and remaining teeth are healthy before starting teeth whitening treatment.

Plano, TX female dentist Dr. Miranda Lacy sponsors this post.

Is tooth extraction my only choice?

Two of my left molar teeth are infected. Both teeth have old fillings in them. After over a month of pain that I managed with Advil, I went to the dentist. The dentist took an x-ray and said both teeth have an abscess, and he wants to extract them both. I asked him about my options, and he said there aren’t any. Is this a standard solution for molar teeth with abscesses? – Thank you. Noah from Austin


A dentist is ethically and legally obligated to explain your options. Unless your dental insurance is government funded, your dentist must explain your options. Government programs will pay for the cheapest option, which is extraction.

Treatment Alternatives to Tooth Extraction

Side-by-side diagram of an infected tooth being cleaned out with root canal treatment (left) and a healthy tooth to the right.
An endodontist can resolve previous root canal issues

If your teeth are infected, root canal treatment is the best treatment option. An abscess at a tooth root is a sign that the tooth pulp—living tissue—is dead. Tooth nerves are in the pulp, so your root canal treatment will be painless and more comfortable than tooth extraction. When third molars, or wisdom teeth, are infected, tooth extraction is best because wisdom tooth anatomy is complex.

Faulty Fillings and Tooth Pain

Faulty fillings can cause tooth pain and lead to infection. If your dentist did shoddy work on your fillings and knows it, he may want to extract your teeth without explaining your option.

What Happens After Tooth Extraction?

If a dentist extracts a second or first molar, the upper tooth will probably drift into the space and hit the lower gum. You can lose the upper tooth also. If there are no teeth behind your second molar, you probably won’t have complications.

Keep in mind that Dr. Lacy has not examined your teeth, and we cannot provide an accurate diagnosis. We recommend that you get a second opinion from an experienced dentist who will explain your treatment options. It would be unusual, but if you require extractions and dental implants, you can speak with the dentist about financing or payment plans if needed.

This post is sponsored by Plano, TX female dentist Dr. Miranda Lacy.