Wisdom teeth can cause all kinds of problems. But just what are they, why do they cause such trouble and what issues surround their removal? Here's a handy guide.

Why do we call them "wisdom teeth"?

Originally called "teeth of wisdom" in the 1600s and later "wisdom teeth" by 1848, our third molars don’t usually grow in until we’re between 17 and 24 years old, when we're a little older and wiser than our formative years. They're our only teeth that don’t develop until after birth. Our primary and permanent teeth form prenatally as buds.

Why do we even have wisdom teeth anyway?

Wisdom teeth are a remnant from our primitive ancestors who needed those four extra molars to help chew their hunter-gatherer diet of sinewy, raw meat and tree bark, nuts, roots and leaves. The advent of cooking and meal preparation created cuisine that was softer and easier to chew, thus eliminating the need for those third molars. Our brain size has also increased from that of the caveman, so our modern jaws simply don’t have room for a third set of back chompers.

While most of us have anywhere from one to four third molars growing in those narrow gaps at the back of our mouths, a lucky 35 percent of Americans are born without any wisdom teeth at all. 

If I opt to have my wisdom teeth taken out, will I be awake and how long and painful can I expect my recovery period to be?

A patient's anxiety about the degree of pain and length of recovery can drive a real reluctance to undergo wisdom tooth extraction.

Depending on your comfort level and how impacted your teeth are, a dental professional will administer either a local anesthetic or a general anesthetic. The local numbs the mouth area, but you'll be awake during the procedure. The general can knock you out or put you under mild sedation, so be sure to have someone drive you to and from the office.

Most procedures take up to an hour and half, and you should expect two to three days of discomfort and swelling. Your post-operative healing time will vary, usually ranging from a couple of days to a week, and yes, the older you are, the longer you should expect to be sidelined.

Is this kind of surgery risky?

“The surgery is very safe,” asserts Dr. Christy Cranfill, a dentist at the highly rated Marketplace Dental Care in Indianapolis. “Dentists and, especially oral surgeons, do this exact same procedure all day, every day. It is very routine in the field of dentistry. Like any surgery, complications may occur, but for the most part they are rare and relatively benign.”

Some possible post-extraction complications can include nerve damage, which can be temporary or permanent. You may also encounter a painful condition known as dry socket. This occurs when the blot clot that forms after removal in the vacant space dissipates or becomes dislodged for some reason, leaving the bone and nerves exposed.

Make sure your dentist or oral surgeon explains all the risks and complications before consenting to an extraction of your molars.

How much does wisdom teeth removal cost, and how much does insurance typically pay?

For many people, the root of the issue of wisdom tooth removal can come down to money.

According to the Healthcare Blue Book, a free online guide that lists fair prices for healthcare services, the nationwide average for a simple tooth removal can cost $134, whereas removal of an impacted tooth in the bone with unexpected complications can run up to $481. The fair price is what a health service provider typically allows from insurance companies as full payment, which is substantially less than the billed amount.

Source: healthcarebluebook.com, based on national averages

Some dental insurance plans categorize simple tooth extraction as “routine corrective treatment,” whereas they may classify removal of an impacted wisdom tooth as “major dental care.” According to the California Dental Association, most dental plans cover 70 to 80 percent of routine procedures but less than 50 percent of major ones.

So given these estimates, waiting to have your wisdom teeth pulled may cost you ten times more if the tooth becomes impacted.

To an insurer, what constitutes a routine procedure rather than a major surgery can vary depending on the plan or the company.

If I'm already having one wisdom tooth taken out, shouldn't my dentist just remove them all out at once?

Ultimately, that’s really your decision. Many patients prefer the relative convenience of undergoing one general session with anesthetic and surgery to remove all of their wisdom teeth. This way, they pay for only one administration of anesthetic and are sidelined once with recovery. Surgeries that involve removing multiple teeth generally have the same recovery time as those involving just a single tooth. Whether you plan on removing a single wisdom tooth or multiple teeth, the same advice applies: Check with your insurance carrier to determine the exact out-of-pocket costs involved with your coverage.