When Is Third‑Molar (Wisdom Tooth) Removal Indicated?

Third molars finish root formation around age 18–22; pathology often surfaces once terminal occlusion settles and hygiene access collapses distal to seventeen.

Surgical indications we document

• Repeat pericoronitis or cellulitis stemming from partially erupted crowns
• Progressive periodontal probing depths distal to seventeen
• External resorption jeopardising neighbouring second molars
• Odontogenic cystic change on sequential imaging
• Pre-orthodontic arch-length coordination

Watchful monitoring still applies

Fully erupted, opposing functional molars lacking pocketing can remain indefinitely if recall bitewings stay dormant.

Surgical synopsis

Elevated flap, buccal bone removal and tooth sectioning under regional block typically wrap up under an hour regardless of eruption angulation.

Postoperative arcs

1. 0–24 hours: iced compress packs, mashed diet, nicotine abstinence
2. Days 2–4: mucosal oedema peak then regression
3. Day 7: suture removal when silk placed
4. Weeks 2–4: clot organisation remodels trabecular socket

CBCT sparing philosophy

When roots approximate the ID canal or sinus floor dips lingually we stage CBCT to engineer osteotomy angles without surrogate guesswork.

Our oral surgery checklist includes antibiotic stewardship only where soft-tissue infection already exists.