When Is the Best Age to Have Wisdom Teeth Removed? Expert Advice from Dr Kia Pajouhesh product guide

When Is the Best Age to Have Wisdom Teeth Removed? Expert Advice from Dr Kia Pajouhesh

By Dr Kia Pajouhesh, BSc, BDSc Hons - Founder, Smile Solutions. 30+ years of clinical experience.

There is a question that comes up again and again in dental consultations, yet is rarely discussed openly in dental circles: when is the best time to have wisdom teeth removed?

For many practitioners, the answer is reactive - when they cause symptoms, when they become impacted, when the patient is in pain. But Dr Kia Pajouhesh, founder of Smile Solutions and a practising dentist with more than 30 years of clinical experience, has a different and deliberate position: the ideal age to have wisdom teeth removed is 16 to 17.

This is not a fringe view. It is a position informed by decades of clinical observation, a deep understanding of jaw anatomy and bone biology, and a genuine concern for patient outcomes - not just in the chair, but over the course of a lifetime.

Dr Kia is so confident in this position that he extracted his own children's wisdom teeth at ages 16 to 17. He explains his rationale in detail below.

How Do We Know If Wisdom Teeth Need to Come Out?

Before discussing timing, it is worth addressing the diagnostic question. Not every person needs their wisdom teeth removed. Some people have naturally larger jaws, or are simply born with fewer wisdom teeth, and their third molars erupt normally into the mouth without causing any problems. These teeth can be retained and monitored indefinitely.

The key diagnostic tool is an OPG radiograph - a panoramic x-ray of the entire jaw that shows all teeth, roots, and available bone. In adolescence, an OPG will show the developing wisdom teeth and the space available for them to erupt.

If the space available in the jaw is smaller than the width of the wisdom tooth crown - meaning the tooth has no functional path of eruption - then there is no clinical benefit to waiting. The tooth will not create its own space. It will become impacted, and the question is not whether problems will occur, but when.

At Smile Solutions, an OPG can be taken at our in-house Collins Street Imaging facility on Level 9 of the Manchester Unity Building. This allows a wisdom teeth assessment to be completed in a single visit. Once the assessment confirms that extraction is indicated, Dr Kia's recommendation is clear: act as early as possible.

Why Age 16 to 17 Is the Optimal Window

Dr Kia identifies thirteen distinct reasons why earlier extraction produces better outcomes when wisdom teeth are indicated for removal. Each is grounded in anatomy, biology, and clinical reality.

1. Teeth Become More Brittle with Age

Dental enamel and dentine change in composition over time. As teeth mature, they become less flexible and more brittle. When a brittle tooth is subjected to the forces required for surgical extraction, it is more likely to fracture. Fracturing during surgery increases complications significantly - the surgical field becomes more complex, surrounding structures are at greater risk, and the procedure takes longer. More complications mean more swelling, a more prolonged recovery, and more post-operative discomfort.

At 16 or 17, the wisdom teeth are relatively young. They are less likely to fracture, and the surgery proceeds more smoothly.

2. Bone Becomes More Dense and Less Flexible with Age

Dr Kia uses an analogy that makes this point clearly. Consider a 16-year-old who breaks an arm skateboarding. The fracture heals quickly, fully, and usually without lasting consequence. Now consider a 30-year-old with the same injury - the recovery is longer, more complicated, and may leave residual effects.

The same biological principle applies to the jaw. In a teenager, the jaw bone is less mineralised, more flexible, and more responsive to healing. In a 30-year-old, the bone is denser, less forgiving, and slower to remodel. A wisdom tooth extraction in a 16-year-old heals more readily and with less post-operative morbidity than the same extraction at 25 or 30.

3. Roots Continue Growing Until the Early 20s - and Growing Roots Mean Growing Risk

This is arguably the most compelling clinical reason for early extraction, and the one Dr Kia regards as most critical.

Wisdom tooth roots continue developing well into the early 20s. As the roots of lower wisdom teeth grow longer, they develop an increasingly close anatomical relationship with the inferior alveolar nerve - the nerve that runs through the lower jaw and provides sensation to the lower lip, chin and teeth.

When the roots of a wisdom tooth are short and still developing, they are unlikely to be in contact with the nerve canal. The surgery is relatively straightforward, and nerve risk is low.

As roots elongate, they can approach, wrap around, and in some cases embed into the nerve canal. A surgeon extracting a tooth with roots curled around the inferior alveolar nerve faces a genuine dilemma: risk nerve damage by proceeding, or leave the root behind and manage the risks of a retained fragment.

Nerve damage following wisdom tooth extraction can cause altered sensation in the lower lip, tongue and chin. This may be temporary - resolving over weeks to months as the nerve heals - but in some cases it is permanent. Permanent paraesthesia is a devastating outcome for a young person. It is also one that, in many cases, is entirely avoidable by extracting the teeth before the roots have grown long enough to pose a nerve risk.

At 16 to 17, the roots of wisdom teeth are often still short and incompletely formed. The surgery is simpler, the risk to the inferior alveolar nerve is lower, and the chance of a clean, uncomplicated extraction is substantially higher.

4. Damage to Adjacent Teeth

When wisdom teeth are misaligned - a condition called mesioangulation, where the tooth is angled forward toward the second molar - they create a specific pattern of damage that is worth understanding in detail.

The forward-tilted wisdom tooth presses against the root surface and crown of the second molar in front of it. This contact traps food and bacteria in an area that is impossible to clean, leading to decay in both the wisdom tooth and the adjacent second molar. It also creates a chronic source of gum inflammation in that area.

Over time, the pressure and infection causes bone loss on the back surface (the distal) of the second molar. This bone loss can be significant, and once it occurs, it does not reverse. The second molar - a permanent, healthy tooth - is permanently compromised by the presence of the untreated wisdom tooth.

Removing the wisdom tooth early, before this bone loss has occurred, protects the second molar and prevents what would otherwise be an irreversible outcome.

5. Crowding of the Lower Arch

This point is acknowledged as somewhat contentious in dental literature, but it is a widely held clinical view and Dr Kia raises it as a real consideration. As wisdom teeth develop and press forward through the jaw, many clinicians believe they exert a forward force on the teeth in front of them, contributing to crowding of the lower incisors.

For patients who have invested in orthodontic treatment and achieved a well-aligned lower arch, late-erupting or impacted wisdom teeth can be a contributing factor to relapse - the gradual re-crowding that occurs after braces are removed. Removing wisdom teeth as part of a proactive approach to long-term arch stability is a reasonable position, and one many orthodontists share.

6. Pericoronitis - Preventable Infection and Its Consequences

Pericoronitis is an infection of the soft tissue surrounding a partially erupted wisdom tooth. When a wisdom tooth has broken through the gum surface but not fully erupted - a partial eruption that may remain static for months or years - the exposed soft tissue forms a pocket that traps food, bacteria and debris.

This pocket is impossible to clean effectively with a toothbrush. The result is a chronic reservoir for anaerobic bacteria, with recurrent bouts of acute infection. Episodes of pericoronitis cause pain and swelling in the jaw, difficulty opening the mouth, and general malaise. Each episode is typically treated with antibiotics.

But here is the reality: antibiotics suppress the infection, they do not resolve the underlying cause. The partially erupted tooth remains. The pocket remains. The next episode of pericoronitis is a matter of when, not if.

In severe cases - more common than most patients realise - pericoronitis can escalate to a spreading infection requiring hospitalisation and intravenous antibiotics. Ludwig's angina, a life-threatening deep space infection of the floor of the mouth, most commonly originates from lower wisdom tooth infection.

Every episode of pericoronitis, every course of antibiotics, every emergency dental visit is a predictable and preventable consequence of a tooth that should have been removed years earlier. Early extraction eliminates this entire sequence of events.

7. Bad Breath and the Impact on Confidence

This is a quality-of-life issue that matters enormously to teenagers and young adults, yet is rarely discussed clinically. Partially erupted wisdom teeth harbour a dense colony of anaerobic bacteria - bacteria that thrive in the oxygen-poor environment deep in the gum pocket.

Anaerobic bacteria are the primary cause of halitosis - bad breath. The volatile sulphur compounds they produce have a characteristic unpleasant odour that no amount of brushing, mouthwash or breath mints can fully resolve, because the source remains below the gum line and is inaccessible to cleaning.

For a 17-year-old navigating school, social life, and relationships, chronic bad breath is not a minor inconvenience. It affects confidence, social interactions, and self-esteem. Removing the wisdom teeth eliminates the bacterial reservoir and, in most cases, resolves the halitosis entirely.

8. Bacterial Load and Systemic Oral Health

Extending the previous point, the bacterial colonies harboured around partially erupted wisdom teeth do not simply stay in the pocket. Every time a person swallows, bacteria from the back of the mouth are swallowed into the gastrointestinal system. Over months and years, a partially erupted wisdom tooth represents a chronic source of bacterial load entering the gut.

There is growing recognition in dental and medical research of the relationship between oral bacteria and systemic health. An elevated oral bacterial load - of the type generated by persistent pericoronitis and anaerobic colonisation - increases the risk of decay elsewhere in the mouth, contributes to gum disease, and introduces bacterial species into the gut that do not belong there.

Eliminating this source at 16 or 17 is a small investment with broad health dividends.

9. The Evolutionary Context: Why Wisdom Teeth Are a Modern Problem

To understand why wisdom teeth so frequently cause problems in modern humans, it helps to consider our evolutionary history.

Our distant ancestors ate a very different diet to the one most Australians consume today. The tough, fibrous foods of pre-agricultural human diets - raw tubers, fibrous plant material, meat torn directly from bone - required intensive chewing. The mechanical demands placed on the jaw stimulated significant jaw bone growth and development during childhood and adolescence. As a result, our ancestors developed larger, longer jaws with ample space for all 32 teeth, including the four third molars.

Wisdom teeth are the third molars, and for most of human evolutionary history, they erupted normally into a jaw with sufficient space. They were functional chewing teeth, not problems to be solved.

Over the past several hundred years - and accelerating sharply in the modern era - dietary patterns have changed profoundly. Highly processed, soft, refined foods require far less chewing effort. Children's jaws no longer receive the same mechanical stimulation that drove the robust jaw growth of our ancestors. The result, demonstrated in anthropological studies of skull specimens, is a measurable reduction in the size of the human jaw over recent generations.

The critical point is that our teeth have not shrunk at the same rate as our jaws. Natural selection works slowly - our tooth size reflects hundreds of thousands of years of evolution, while our jaw size has responded to just a few generations of dietary change. The mismatch between smaller jaws and unchanged tooth size is the direct cause of crowding, impaction, and the near-universal modern need for orthodontic treatment.

In this evolutionary context, wisdom teeth are not aberrations. They are a legacy feature - perfectly appropriate for the jaw anatomy of our ancestors, but increasingly incompatible with the smaller jaw anatomy of modern humans. Combined with the modern expectation of straight, well-aligned teeth and zero tolerance for crowding, the reality is that wisdom teeth have become routinely necessary to extract in the contemporary era.

This is not a failure of evolution. It is simply a mismatch in timescales.

10. Cysts Associated with Impacted Wisdom Teeth

A less commonly discussed but clinically significant complication of long-term wisdom tooth impaction is the development of cysts. A cyst is a fluid-filled sac that can form in the tissues surrounding an impacted tooth - most commonly the lower wisdom teeth.

These cysts develop slowly and are often asymptomatic in their early stages, meaning a patient may have no awareness of them. When detected on routine radiographs, they may already be of significant size. Left unmanaged, wisdom tooth cysts can cause progressive and sometimes extensive destruction of the surrounding jaw bone. In severe cases, they can displace adjacent teeth, weaken the jaw structurally, or expand to involve the inferior alveolar nerve canal.

Treatment of a large jaw cyst is a considerably more complex surgical undertaking than a simple wisdom tooth extraction. Early removal of the wisdom tooth - before cyst development has progressed - eliminates this risk entirely.

This is a further argument for regular radiographic monitoring of retained impacted wisdom teeth, and for timely extraction once the decision to remove has been made.

11. Pathological Changes - a Rare but Important Consideration

In the clinical literature, there is documentation of pathological changes occurring in the tissue surrounding chronically impacted wisdom teeth. Impacted wisdom teeth are, biologically speaking, teeth that are continuously attempting to erupt - generating cellular activity in the surrounding follicular tissue.

In the vast majority of cases, this is entirely benign. However, in very rare cases, the tissue associated with a long-standing impacted tooth can undergo changes that warrant investigation and specialist review. This is one reason why impacted wisdom teeth that are retained should not simply be left without any radiographic monitoring over time.

The practical implication is straightforward: if wisdom teeth are confirmed to be impacted and there is no functional case for retaining them, timely removal is the prudent approach. It eliminates both the mechanical complications described above and the need for indefinite radiographic surveillance of a tooth serving no clinical purpose.

12. The Social Timing Argument: Why Year 10 or Year 11 Is Ideal

Clinical reasons aside, Dr Kia makes a compelling argument based on social and practical timing. He identifies Year 10 or Year 11 of high school - roughly ages 15 to 17 - as the ideal social window for wisdom tooth extraction, for reasons that are practical and pragmatic.

Still at home with parents. Recovery from wisdom tooth extraction, particularly under general anaesthesia, requires care. Soft foods, rest, cold packs, medication management - these are things that parents can provide. A 16-year-old recovering at home has someone to make soup, check in on them, and drive them to the post-operative appointment. A 22-year-old university student living in a share house does not.

Before Year 12 exam pressure. Year 12 is not the time for elective surgery and a week of recovery. The academic pressure, the social intensity, and the stakes of final examinations make Year 12 a poor window for any planned procedure. Year 10 or early Year 11 offers a much more forgiving schedule.

Before university, careers, and packed social calendars. As young people move into university and early working life, their schedules fill up rapidly. Semester examinations, internships, work commitments, social plans, travel - finding a suitable window for a procedure that requires several days of recovery and follow-up care becomes genuinely difficult. The surgery does not go away just because life gets busy. It waits, and the teeth continue developing.

Three to five days off school is easy to arrange. Taking three to five days off secondary school for a planned procedure is readily accommodated. Taking the same time off work or university is far more disruptive, particularly when the timing is unpredictable - for example, when a pericoronitis episode forces an emergency extraction at a clinically inopportune moment.

The social timing argument is not trivial. Dr Kia describes it as a window of convenience that, once closed, does not reopen at a better time.

13. The Financial Argument: Simplicity Has a Price Advantage

The final argument is financial, and it is significant. Wisdom tooth extraction at 16 to 17 is, in most cases, a simpler procedure than the same extraction at 22 or 27. Simpler procedures cost less.

At 16 to 17, roots are shorter, bone is less dense, and impaction is typically less severe. Many extractions at this age can be performed by an experienced general dentist under local anaesthetic, without hospital admission.

By the time a patient is 25, wisdom teeth may have roots embedded in dense bone, in close proximity to the inferior alveolar nerve, and possibly with significant surrounding infection or bone loss. These cases require specialist oral and maxillofacial surgeons, often under general anaesthesia in a private hospital. The surgical fees for a complex extraction are substantially higher than for a straightforward one.

There is also the private health insurance consideration. Children are typically on their parents' private health insurance until their mid-20s, but for many families, the most comprehensive hospital cover is maintained while children are still at home. Wisdom tooth extraction under general anaesthesia in a private hospital attracts a hospital fee, which is substantially reduced by private health insurance with hospital cover. Timing the procedure while the child is still under the family's PHI maximises the financial benefit.

The total cost difference between a simple extraction at 16 and a complex surgical extraction at 25 can be substantial. The clinical outcome is also better. Earlier extraction is superior on every measure that matters: safety, complexity, recovery, and cost.

When Wisdom Teeth Should Be Kept

Dr Kia is clear that not all wisdom teeth need to be removed. In some circumstances, wisdom teeth are valuable and should be deliberately retained. The decision is always clinical and individual - which is why proper assessment matters before any recommendation is made.

Adequate space for full eruption. On one or both sides of the mouth, there may be sufficient room for the wisdom tooth to erupt fully and establish itself as a functional part of the natural bite. When this is the case, the wisdom teeth are welcomed into the arch as genuine chewing teeth. They require no different care than any other molar - regular cleaning, check-ups, and monitoring.

Patients who have had extraction orthodontics. Some orthodontic treatment plans involve removing premolar teeth (bicuspids) to create space for alignment. Patients who have had premolars extracted may have more room at the back of their dental arch than average. In these cases, the wisdom teeth may have sufficient space to erupt and function usefully - and retaining them is often the preferred outcome.

Potential replacement for damaged molars. In younger patients with serious decay or structural compromise of their first or second molars, the clinical decision may be made to retain wisdom teeth strategically. If a heavily damaged molar is eventually lost, the wisdom tooth - if retained and healthy - can move forward naturally or be guided into the space, effectively serving as a replacement. This is a nuanced clinical judgment that requires careful planning, but in appropriate cases it is genuinely worthwhile.

The principle underlying all three scenarios is the same: wisdom teeth that can serve a functional purpose in the mouth, that have space to erupt cleanly, and that can be adequately cleaned and maintained, should be retained. Extraction is appropriate only when the evidence indicates the tooth cannot fulfil this purpose - and when it is indicated, earlier is better.

The Key Is Collaborative Consultation

The decision to extract or retain wisdom teeth is not one that should be made by a general dentist alone, or based on a single examination without appropriate radiographs. Dr Kia emphasises that optimal wisdom teeth management requires a consultation involving both the general dentist and an orthodontist.

The general dentist evaluates the immediate clinical picture: the position of the wisdom teeth on OPG, the degree of impaction, the proximity to adjacent structures, the presence of decay or infection, and the patient's symptoms and history.

The orthodontist contributes a different and essential perspective: the overall arch form, the history of any previous orthodontic treatment, the presence of extraction spaces, the relationship between the dental arches, and the long-term stability considerations for the bite.

Together, these two perspectives allow a complete picture to emerge. Only once both clinicians agree that the wisdom teeth serve no functional purpose and are likely to cause problems is extraction recommended.

At Smile Solutions, both general dentists and a full team of specialist orthodontists are available under one roof at 220 Collins Street. A wisdom teeth assessment at Smile Solutions means the complete clinical picture is reviewed - and the recommendation you receive reflects all of it.

When extraction is the agreed conclusion: sooner is unequivocally better than later.

At Smile Solutions: Wisdom Teeth Assessment and Extraction

Smile Solutions is Melbourne's most comprehensive dental practice, located in the Manchester Unity Building at 220 Collins Street, Melbourne CBD. With 40 dental suites and more than 20 board-registered specialists, Smile Solutions is equipped to manage wisdom teeth cases of every level of complexity under one roof.

Assessment. An OPG radiograph is the starting point for any wisdom teeth assessment. Collins Street Imaging, located on Level 9 of the Manchester Unity Building, provides OPG and CBCT imaging on-site. Results are available promptly for your dentist to review in the same visit. A complimentary wisdom teeth consultation is available - call 13 13 96 to arrange yours.

Simple and moderate extractions. Wisdom teeth that can be extracted under local anaesthetic are managed by experienced general dentists Dr Jaclyn Wong, Dr Paul Aulakh, and Dr Avi Aggarwal. These clinicians have extensive experience in wisdom tooth removal and manage the majority of cases presenting to Smile Solutions with excellent outcomes.

Complex and surgical cases. Wisdom teeth with complex impaction, deep root anatomy, proximity to the inferior alveolar nerve, or other factors requiring specialist management are referred directly to our specialist oral and maxillofacial surgeons: A/Prof Patrishia Bordbar and Dr Ricky Kumar. Both surgeons have extensive hospital-based training and manage all levels of surgical complexity. General anaesthesia is available in a private hospital for patients requiring or preferring full sedation.

Pricing:

• Single tooth extraction (general dentist, local anaesthetic): from $475 to $725
• All four wisdom teeth (general dentist, local anaesthetic): from $1,950 to $2,950
• Complex surgical extractions by specialist oral and maxillofacial surgeon: pricing varies by complexity; a detailed itemised quote is provided at consultation

Payment plans are available through Payright, Humm, and MyDentaPlan.

Frequently Asked Questions

Q: How do I know if my child needs their wisdom teeth out? A: The key investigation is an OPG radiograph - a panoramic jaw x-ray that shows all teeth, roots, and available space. At Smile Solutions, this can be done on-site at Collins Street Imaging on Level 9. If the space available in the jaw is smaller than the width of the wisdom tooth crown, impaction is likely and early extraction is indicated. Call 13 13 96 to arrange a wisdom teeth assessment.

Q: Is it safe to remove wisdom teeth at 16? A: Yes - in fact, it is safer than waiting. At 16, the jaw bone is less dense and more responsive to healing, the tooth roots are shorter and less likely to be associated with the inferior alveolar nerve, the teeth themselves are less brittle and less prone to fracture during surgery, and recovery is quicker and more complete. The risks associated with wisdom tooth extraction increase with age, not decrease.

Q: Will my child need a general anaesthetic? A: Not necessarily. Simple and moderately complex extractions are commonly performed under local anaesthetic by experienced general dentists. The procedure typically takes less than an hour and is well-tolerated. General anaesthesia in a private hospital is available for more complex cases - such as deeply impacted teeth in close proximity to the inferior alveolar nerve - and for patients who prefer to be fully sedated. Your dentist will recommend the most appropriate option after reviewing the OPG.

Q: How long is the recovery? A: For a straightforward extraction at 16 to 17, most patients experience three to five days of swelling and discomfort, managed with over-the-counter pain relief and a soft diet. By day five, the majority are comfortable enough to return to normal activity. Recovery at this age is substantially faster than recovery from the same procedure at 25 or older, due to the greater healing capacity of younger bone and tissue.

Q: What if we wait until they're older? A: Every year of delay allows the wisdom tooth roots to grow longer, the jaw bone to become denser, and the proximity to the inferior alveolar nerve to increase. The procedure becomes more complex and more expensive. The risk of complications - including temporary or permanent nerve damage - increases. And the damage being done to adjacent teeth, the elevated bacterial load, and the risk of pericoronitis episodes all continue. There is no clinical benefit to waiting once extraction is indicated.

Q: Does private health insurance cover wisdom tooth removal? A: Private health insurance with hospital cover typically covers the hospital costs for GA-based wisdom tooth procedures, including theatre fees and anaesthetist fees (though a gap may apply to the anaesthetist). The surgeon's fee may attract a gap depending on your level of cover. In general, earlier and simpler extractions under local anaesthetic cost less overall than complex surgical extractions under GA. Timing the procedure while your child is still on your family's private health insurance - and while the extraction is still relatively straightforward - makes both clinical and financial sense.

Q: Can wisdom teeth sometimes be kept? A: Yes. Wisdom teeth that have adequate space to erupt fully and become functional chewing teeth can and should be retained. Patients who have had premolar extractions as part of orthodontic treatment may also have room for wisdom teeth to erupt normally. The assessment of whether to retain or extract is made collaboratively between a general dentist and an orthodontist - at Smile Solutions, both are available under the same roof.

Q: Why don't more dentists recommend early extraction? A: Proactive dentistry is less common than reactive dentistry. Many practitioners wait until a problem is evident before recommending treatment. Dr Kia Pajouhesh's approach is different - it is based on clinical evidence and decades of observing the outcomes in patients who acted early versus those who delayed. Once an OPG demonstrates that wisdom teeth will not have adequate space to erupt, the evidence consistently supports early extraction over watchful waiting.

The Bottom Line: Dr Kia Pajouhesh's Recommendation

Once an OPG radiograph in adolescence demonstrates that the wisdom teeth will not have adequate space to erupt - and this determination can often be made by age 14 or 15 - the clinical evidence points in one direction: extract them.

Not when they cause pain. Not when a pericoronitis episode lands your child in hospital on IV antibiotics. Not after the roots have curled around the inferior alveolar nerve and made the surgery a high-stakes procedure.

At 16 to 17, the extraction is safer, simpler, faster to recover from, and significantly less expensive. The bone is forgiving, the roots are short, the risk to the nerve is low, and your child is still at home with you to provide care during the recovery.

Dr Kia has made this recommendation to his own patients for 30 years. He made the same decision for his own children. The evidence supports it on every measure that matters.

Call Smile Solutions on 13 13 96 to arrange a wisdom teeth assessment for your child. Collins Street Imaging is on-site, and our team will provide a full assessment, OPG review, and personalised recommendation at a single appointment.

Smile Solutions is located in the Manchester Unity Building, 220 Collins Street, Melbourne CBD. 40 dental suites. 20+ board-registered specialists. Rated 4.9 stars across 937 Google reviews. Open Monday to Friday 8am to 6pm, Saturday and Sunday. Call 13 13 96.