Dear Dr. Hall,
I read with interest your comments regarding wisdom tooth extraction. I have had my wisdom teeth for my whole life (I am 34 now), as they did not cause me any problems growing in. Unfortunately, I did not care for them properly and, although the rest of my teeth are in pretty good shape, my wisdom teeth have all started to decay, to the point that they are basically about half gone. For some reason, the process of this decay has not caused me very much pain or discomfort.
My question relates to the fact that I would prefer to just let them decay on their own until they are gone, rather than risk the complications inherent to wisdom tooth removal at my age. I assume the surgery would be all the more complicated by the fact that there are bits and pieces of the teeth for the surgeon to pull on rather than the full teeth. What are the potential consequences of simply allowing them to decay on their own? Is it possible for this to happen without experiencing infection or complications? Would it be less dangerous than the surgery? Keep in mind that, thus far, one of them seems to be almost completely gone (although there are a few pieces still there), and the other three are half gone. So far, no sign of infection or pain. Thank you so much for your time and insight. I really enjoy perusing your web site.
– Jeremiah from California
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Jeremiah,
You raise some interesting questions. Yes, decayed teeth do eventually crumble and go away. There is some risk in letting that happen, though. Let me help you understand that risk, and then you can figure out what you want to do.
If a tooth appears to be intact but yet has deep decay, that decay will reach the living pulp tissue of the tooth, cause it to become infected, and that infection will spread through the end of the tooth, through the root, and deep into the jawbone. When these infections are encased either in bone or in a relatively intact tooth, that causes pressure to build up and pain. If the infection breaks through the bone and starts to drain, that relieves the pressure and thus relieves the pain. That will also tend to slow the advance of the infection in the bone, because the infection has an outlet. If the infection doesn’t find an outlet, though, it can get very nasty. For example, infections of lower teeth can cause swelling on the inside of the mouth. This swelling can move down the throat and threaten to close off your windpipe. Also, upper molars are not that far from the brain and there are blood vessels present that can carry the infection to the brain. So this isn’t something to mess with.
If a tooth breaks off, it does two things that help make the infection less serious. First, it creates a wide open situation where the infected, inner portion of the tooth becomes exposed, which gives the infection an outlet and helps prevent its spread down into the bone. Second, every tooth has slight eruption forces that are always operating. These forces tend to push the tooth further out into the mouth until it meets an obstacle, which is usually the opposing tooth in the opposite jaw. When the tooth breaks off, it no longer has contact with its opposing tooth, and those forces will tend to push the tooth out of the jaw a little. If it keeps decaying, then little pieces will continue to break off. Eventually, the tooth could be completely pushed out.
But be careful about judging just by what you see. Sometimes you can just see a small portion of the root, and it looks like nothing important is happening, but an x-ray will show that this root is quite long and goes down deep into the bone.
Another problem is that if you have one badly decayed tooth, you can have decay bacteria spreading over all your teeth and accelerating decay everywhere in your mouth.
As far as comparing the risk of letting your wisdom teeth fall out on their own versus extracting the wisdom teeth, I believe having them extracted would be less risk, no matter what the condition of the teeth. If they have started to push themselves out, making it so there is less risk for the infection getting deep into the bone, that also makes for fewer complications if you have them removed. But then extracting them is a whole lot more expensive than letting them fall out.
Dr. Hall
Other links: Read more about tooth infection, and antibiotics for teeth.
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About David A. Hall
Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.
I had the same situation. All 4 of my wisdom teeth have broken and come out piece by piece. I am 44 and literally the last piece of the last tooth JUST came out a minute ago. I never had them pulled and won’t. I am glad I am not the only one that had this situation 🙂
I am 56. My upper left wisdom tooth just fell off. I am glad I found this article!
My Dentist said it had cavities, but I declined filings as I was sure I would remove them, some day.
Two months ago, that tooth got really sensitive and hurt anytime ANY food came in contact with it. That pain then subsided and went away. The tooth was sensitive, but not nearly as much as during the two month “attack”.
I suppose that two-month episode was the infection and then the root dying. It was never loose. It just came out during a bite of food. No pain.
So the cap came off. The root is still in the Jaw.
I wonder if Dr. Hall believes that this root will work its way out naturally over time. I think he aludes to that in his comments when he mentions Eruption Forces.
Response by Dr. Hall – It sounds like you’re saying that the crown of your wisdom tooth broke off. Whether the root comes out on its own or tissue heals over the top of it depends on how big the piece of root is and how close to the surface it is. If I’m understanding what happened here, your wisdom tooth simply decayed away. In that case, there is probably very little of the root remaining and I imagine the rest of it would continue to decay until it is gone or the remnant falls out.
Hey I’m 22 and my wisdom tooth broke off but the root is still in there. And it’s starting to come out on its own and it’s only been like 2 weeks. That normal i kinda figured the gums would be just grow over it.
– David
I’m 24 and I was sleeping and when I woke up, my jaw started hurting. I ran my tongue along my teeth as I always do, and when I got to my top right area where my wisdom tooth would be, there wasn’t anything there. The only thing I feel are my gums. I think my wisdom tooth came out in my sleep and I swallowed it. Not too sure what to do.
– Robyn
Response by Dr. Hall:
Robyn,
Well, if you swallowed it, you’re done with it. It shouldn’t hurt anything. But your story sounds really weird. Your wisdom tooth would have to be pretty loose to fall out in your sleep. I’d get a dental checkup and see what is going on in your mouth in this area and with your other wisdom teeth.
My left upper wisdom tooth had become loose in the last couple of months and today, it came out completely. No blood. No pain. Does the hole heal on its own? – Maggie
Response by Dr. Hall
Maggie, sounds like your wisdom tooth was pretty far gone! Yes, the hole will heal just fine.
Hi, I am in dire need of some advice, I am a naturalist really and don’t agree or believe in the dental industry today. I have all my wisdom teeth, I am 38 most still haven’t erupted except my bottom left I had been erupting for maybe a yr still not fully erupted due to my tiny mouth. My current second molar #18 is decayed and broken. Everyone I have seen says root canal, crown, extract my wisdom behind it. I will not do this. I believe extracting 18 would create space in my mouth to allow wisdom to T-shirt front and some overcrowded front teeth to shift back? I have been researching and realizing any bad upper molars I have could possibly have to be extracted and create eruption. I also believe 2nd molar replacement should be practiced and would love for my son to have that opportunity, I believe in utilizing the wisdom teeth for there natural purpose of natural teeth replacement? i truly believe the industry is lying to the American people about this? – Kate
Response by Dr. Hall:
Interesting question, Kate.
I have this comment. If we believe that health care professionals are lying to us or otherwise out to get us, then I guess we’re on our own and we just need to put up with rotting teeth or whatever else is going wrong.
Anything I tell you will be based originally on things I was first taught in dental school, things I later learned from other professionals, and things I discovered from my own experience as a dental professional. If we accept your premise that health care professionals can’t be trusted, then we have to throw out all of that knowledge as unreliable, even what I tell you I have learned from my experience because, after all, I also am a health care professional.
So my question back to you is who do you believe and on what grounds? My guess is that you believe anyone else who is at odds with the profession. So maybe if I professed to be at odds with the profession you would believe me. That would be dishonest, but I guess it would earn me your trust.
The whole thing is very confusing and I guess the bottom line is that, with your admitted biases, I don’t know how to help you.
I am 21, my left upper wisdom tooth was cracked and broken awhile ago when my ex hit me with a baseball bat… About a week & a half ago part of it came out again, but it does not hurt & there’s no blood. But it is sharp so i just keep a small piece of cotton in the hole & It is wiggly, but not a lot.
I take good Care of my teeth but due to being hit a couple years ago its just that tooth thats been broken ever since. I hope it falls out on its own.
This happened to me today: my wisdom tooth that had been bothering me for 30 years came out whole! I had been trying to extract it myself for the last year and finally left it alone, figuring I have to have it removed. Then today, it just came out.
Hi I have a cavity in my wisdom teeth, and when they help to get it clean my wisdom teeth stings like crazy!!!
Hi I’m 21 this month and my wisdom tooth has almost completely rotted away on the top and all i see at the moment is a small piece of tooth and definitely feeling a fair amount of pain sometimes like throbbing pain when i drink water, but not milk or a soft drink. Is there any reason why I’d be reacting to regular water and not carbonated drinks or calcium filled milk?
– Darrian
Darrian –
If there is only a little bit of your wisdom tooth left, I would not expect that to be a source of pain. The tissue inside the tooth is dead, so there is no nerve left. I suspect that your pain could be coming from another tooth, but would need to examine you to tell. If your wisdom tooth is that far gone, you are highly likely to have serious decay in other parts of your mouth. A dental exam with x-rays would be a very good idea and could help prevent expensive or debilitating damages. – Dr. Hall
I’m very confused by all of this. I’ve had all of my wisdom teeth come in, the upper two having come in at a slightly diagonal position. All of them came in healthy though…except one which almost immediately (within a matter of weeks) showed signs of erosion but, from the looks of things, not decay? Now the entire side of it and most of the bottom has fallen off to the gums. Absolutely no pain…but it’s just crumbling away. The bottom fell out recently while brushing my teeth. It’s like it came in without the strength of all my other teeth…
I REALLY don’t have the money to get it pulled…and I don’t want the dentist to basically ram a metal spike into my tooth again, like he did the last one, to break it up. I’m a bit of a hypochondriac, so as he was applying all his body-weight to a damn metal spike in my mouth…the only thing going through my head was, “He could slip any second and I’ll be dead.”
…teeth are a pain in the rear, and a childhood of soda was such a horrific mistake. If I have kids, they’re not touching soda…just tea, lots of tea.
I have an upper left wisdom tooth that had a cavity filling in it. A week ago the tooth broke in half and seemed as only the filling was left. Well just now the filling broke off and it seems as if there is nothing left of the tooth but what is embedded in my gums. There is no pain or anything. Will the remainder push out or will the hole heal over? I am avoiding the dentist due to lack of funds. – Brad
Response by Dr. Hall:
What’s left of your wisdom tooth should keep on decaying until it is rotted away. Meanwhile, there is persistent infection present which could turn into an abscess. It’s always best to have the tooth out, but if funds don’t permit, it isn’t a huge risk in this situation to let it just rot away on its own.
Tanner B. asked a question here about a wisdom tooth that is starting to break off, wondering if he can get away without having to spend the money to have it extracted. Read Dr. Hall’s answer in this blog post: I can’t afford to have my wisdom tooth extracted.
Really marvellous article thank you!
Really glad to find this article, just want to share my story. About a year and a half ago I was 34, my upper right wisdom tooth also started decaying. It’s about half gone now, no pain unless I press on the nerve inside. I didn’t go to the dentist due to the cost and COVID.
They had to use so much force pulling my upper left one last time; With this one being so crispy, I feel it’s probably an even harder task. Now I’m finally about to visit my dentist for routine cleaning, and decided to do some research beforehand. Thanks!
Hello,
My wisdom tooth is growing in brown? I’m really confused as to why/how this is happening.
– Polly
Read the rest of Polly’s question and Dr. Hall’s answer with his post: Wisdom tooth growing in brown.
The American dental system is a sham. Teeth, like everything else in the human body requires almost no medical assistance. Don’t panic, and you have a better chance at a better life. If something becomes so painful and unbearable for weeks on end, then maybe see a quack.
Other than that, stay as far away from quacks as much as you can, including dental quacks.
– Erik