Wondering if you can get braces while your wisdom teeth are present? The short answer is yes, you can often get braces without removing your wisdom teeth first. However, this decision depends on several factors unique to your dental situation. Whether your wisdom teeth need to come out before, during, or after orthodontic treatment varies based on your specific case.
Let’s explore the relationship between wisdom teeth and braces to help you understand your options and make the best decision for your orthodontic journey.
How Wisdom Teeth Affect Orthodontic Treatment
Wisdom teeth and braces have a complicated relationship that often raises questions during treatment planning. Understanding this relationship can help you better navigate your orthodontic journey.
What Are Wisdom Teeth and Why They Matter for Braces
Wisdom teeth, or third molars, are the final set of molars that typically emerge between the ages of 17 and 25. These late bloomers arrive long after your other permanent teeth have established their positions. They’re called “wisdom teeth” because they appear during what’s traditionally considered the “Age of Wisdom.”
These teeth matter for braces because of their timing and position. Since orthodontic treatment often occurs during adolescence (ages 12-16), wisdom teeth frequently begin developing or erupting during or after braces treatment. Their emergence can potentially influence your treatment in several ways:
- They may create pressure against other teeth
- They could affect your final bite alignment
- They might contribute to overcrowding in some cases
Your orthodontist will evaluate your wisdom teeth development through dental X-rays to determine if they pose any risk to your treatment outcomes.
Common Problems When Wisdom Teeth and Braces Coexist
When wisdom teeth and braces share your mouth, several challenges can arise:
Space limitations – Most modern jaws have limited space for wisdom teeth. When they try to emerge in a crowded mouth that’s already undergoing orthodontic treatment, they can create pressure against neighboring teeth.
Hygiene difficulties – Braces already make oral hygiene more challenging. Add partially erupted wisdom teeth to the mix, and you’ve got hard-to-reach areas that can trap food and bacteria, potentially leading to inflammation, infection, or decay.
Treatment interference – In some cases, erupting wisdom teeth can work against the tooth movement your braces are trying to achieve, potentially extending treatment time or affecting results.
Pain and discomfort – The combination of pressure from braces and erupting wisdom teeth can sometimes create more discomfort than either condition alone.
However, these problems don’t always occur. Many patients successfully complete orthodontic treatment without wisdom teeth complications, which leads us to our next important question.
Does Everyone Need Their Wisdom Teeth Removed Before Braces?
Contrary to popular belief, not everyone needs their wisdom teeth removed before getting braces. This decision should be based on individual assessment rather than following a one-size-fits-all approach.
When Wisdom Teeth Removal Is Necessary Before Treatment
Wisdom teeth extraction before braces is typically recommended in these scenarios:
Active interference – If your wisdom teeth are already causing crowding or misalignment of your other teeth, removing them before starting orthodontic treatment makes sense.
Severe impaction – When wisdom teeth are severely impacted (trapped beneath the gumline) and positioned to create problems, early removal prevents complications during treatment.
Limited jaw space – X-rays showing insufficient space for wisdom teeth to emerge properly may indicate a need for extraction to prevent future crowding after braces.
Infection or pathology – If your wisdom teeth have developed cysts, infections, or other pathological conditions, they should be addressed before orthodontic treatment begins.
Planned treatment timing – For younger patients whose treatment will be completed before wisdom teeth typically emerge, orthodontists may recommend preventative removal to protect the results.
An oral surgeon working with your orthodontist will help determine if extraction is necessary based on your specific dental structure and treatment goals.
When Braces Can Proceed Without Wisdom Teeth Extraction
Many patients can get braces without removing their wisdom teeth when:
Adequate jaw space exists – Some patients naturally have sufficient jaw space to accommodate wisdom teeth without crowding.
Wisdom teeth are growing in properly – If dental X-rays show your wisdom teeth emerging at the correct angle without impacting other teeth, extraction may be unnecessary.
No symptoms are present – Absence of pain, infection, or other wisdom teeth-related issues suggests they may not interfere with treatment.
Wisdom teeth have fully erupted – Already fully emerged wisdom teeth that function well in your bite may not require removal.
Your orthodontic issues are unrelated – If your orthodontic concerns (like gaps, overbite, or crossbite) aren’t connected to your wisdom teeth, treatment can often proceed without extraction.
The key is proper assessment. Your orthodontist will use panoramic X-rays and possibly 3D imaging to evaluate how your wisdom teeth might interact with your planned orthodontic treatment.
Timing Options: Before, During, or After Orthodontic Treatment
The timing of wisdom teeth removal relative to your braces treatment is an important consideration that depends on your specific situation and treatment plan.
Getting Wisdom Teeth Removed Before Starting Braces
Removing wisdom teeth before beginning orthodontic treatment offers several advantages:
Clear path for tooth movement – With wisdom teeth already gone, your orthodontist can plan treatment without accounting for their potential interference.
Single recovery period – You’ll only need to heal from one procedure before starting your orthodontic journey.
Prevention of future complications – Early removal eliminates the risk of wisdom teeth disrupting treatment progress later.
If you choose this route, you’ll typically need to wait 4-6 weeks after extraction before having braces applied. This allows for proper healing of the extraction sites and ensures comfort when brackets are placed.
Remember that this approach requires planning ahead and potentially delaying your orthodontic treatment start date.
Managing Wisdom Teeth Extraction During Orthodontic Treatment
Sometimes, wisdom teeth become problematic while you’re already wearing braces. In these cases:
Temporary adjustment may be needed – Your orthodontist might need to remove brackets near the extraction sites to facilitate the procedure.
Treatment pause – A brief pause in active treatment may be recommended while you heal from the extraction.
Coordinated care – Your orthodontist and oral surgeon will need to coordinate their approach to ensure minimal disruption to your treatment.
Potential treatment extension – Depending on the timing and complexity of the extraction, your overall treatment timeline might be extended slightly.
While not ideal, mid-treatment extraction is sometimes unavoidable, especially when wisdom teeth cause sudden pain or infection.
When Waiting Until After Braces Is the Better Option
In some situations, it makes more sense to complete your orthodontic treatment before addressing wisdom teeth:
Asymptomatic wisdom teeth – If your wisdom teeth aren’t causing problems during treatment, your orthodontist may recommend completing braces first.
Uncertain eruption pattern – When it’s unclear how wisdom teeth will emerge, waiting allows for better assessment once teeth are properly aligned.
Treatment efficiency – Avoiding interruptions to your orthodontic treatment can help maintain momentum and possibly shorten overall treatment time.
Final alignment considerations – Sometimes the final position of teeth after braces helps determine whether wisdom teeth will have adequate space.
If you choose this approach, be prepared to monitor your wisdom teeth closely after braces are removed, as they could potentially affect your newly aligned teeth if they begin to cause problems.
Different Types of Wisdom Teeth Impaction and Their Impact on Treatment
Not all wisdom teeth grow in the same way, and the type of impaction significantly influences treatment decisions.
Mesial and Horizontal Impactions: The Most Problematic for Braces
Mesial and horizontal impactions tend to create the most complications for orthodontic treatment:
Mesial impactions (angled toward adjacent teeth) can create pressure against the second molars, potentially causing:
– Crowding in the back of your mouth
– Movement of the second molars
– Disruption of carefully aligned teeth
– Increased risk of damage to adjacent teeth
Horizontal impactions (teeth growing sideways) present even greater challenges:
– They can directly push against the roots of adjacent teeth
– They rarely if ever erupt properly on their own
– They frequently cause pain and inflammation
– They create high risk for damage to neighboring teeth
These types of impactions typically warrant removal before orthodontic treatment begins, as they pose significant risks to both your dental health and treatment outcomes.
Vertical and Distal Impactions: When Treatment Can Continue
Other impaction types may allow for more flexibility in your treatment approach:
Vertical impactions occur when the wisdom tooth is growing in the right direction but cannot fully emerge. These may not require immediate extraction if:
– There’s no active pressure on adjacent teeth
– No infection or inflammation is present
– The tooth isn’t causing pain
– Monitoring shows no progression toward problems
Distal impactions (angled away from adjacent teeth) often pose the least risk to orthodontic treatment because:
– They’re not directly pushing against other teeth
– They may have room to partially emerge without complications
– They typically cause fewer symptoms
Your orthodontist will use dental imaging to classify your impaction type and determine whether treatment can safely proceed without extraction.
Braces vs. Clear Aligners With Wisdom Teeth Present
Different orthodontic treatment methods handle wisdom teeth situations in distinct ways, which might influence your treatment choice.
How Traditional Braces Handle Wisdom Teeth Complications
Traditional braces offer certain advantages when dealing with wisdom teeth:
Adaptability – Metal brackets and wires can be adjusted or temporarily removed near extraction sites if needed.
Full mouth correction – Braces can address alignment issues throughout your entire mouth, including accommodating or working around emerging wisdom teeth.
Force distribution – The continuous arch wire distributes forces across all teeth, which can sometimes help manage pressure from emerging wisdom teeth.
Treatment modification options – Your orthodontist can use techniques like power chains or springs to create space or manage wisdom teeth pressure.
If your wisdom teeth have fully erupted and have enough space, your orthodontist may even place brackets on them to include them in your alignment plan.
Clear Aligner Treatment Considerations With Wisdom Teeth
Clear aligners like Invisalign® work differently with wisdom teeth present:
Limited coverage – Clear aligners typically don’t cover wisdom teeth, focusing instead on the more visible teeth.
Impaction concerns – If wisdom teeth begin erupting during treatment, they might affect how your aligners fit.
Mid-treatment adaptations – If extraction becomes necessary during treatment, your orthodontist will need to take new impressions and order revised aligners.
Monitoring requirements – More frequent check-ups might be needed to ensure wisdom teeth aren’t interfering with aligner fit or tooth movement.
For some patients, especially adults whose wisdom teeth have already fully emerged or been removed, clear aligners can be an excellent option. For others, especially adolescents whose wisdom teeth may emerge during treatment, traditional braces might provide more flexibility.
What to Expect During Your Orthodontic Consultation
Your initial consultation sets the stage for your entire treatment plan, including how to handle your wisdom teeth situation.
Questions Your Orthodontist Will Ask About Your Wisdom Teeth
Be prepared to discuss:
Previous dental history – Have you had any wisdom teeth symptoms, consultations, or previous extraction recommendations?
Family dental patterns – Did your parents or siblings have wisdom teeth complications? Some impaction patterns run in families.
Current symptoms – Are you experiencing any pain, pressure, or discomfort in the back of your mouth?
Future dental plans – What are your treatment timeline expectations? Any upcoming major life events that could affect treatment scheduling?
Concerns about extraction – Do you have specific concerns about wisdom teeth removal that might influence your treatment decisions?
Honest answers help your orthodontist develop the most appropriate treatment approach for your specific situation.
Dental Imaging and How It Guides Treatment Decisions
Modern dental imaging plays a crucial role in wisdom teeth evaluation:
Panoramic X-rays provide a comprehensive view of all teeth, including developing wisdom teeth, showing their position and angle of eruption.
Cone Beam CT scans (CBCT) offer detailed 3D images that reveal:
– Exact tooth positions and impaction types
– Proximity to nerves and sinuses
– Root structure and development
– Available jaw space
– Potential complications
Digital models help simulate treatment outcomes with and without wisdom teeth present.
These imaging tools allow your orthodontist to make evidence-based recommendations rather than guesswork. They can show you exactly what’s happening beneath your gums and explain how wisdom teeth might affect your treatment.
Based on this information, your orthodontist may refer you to an oral surgeon for consultation or proceed directly with orthodontic planning.
Long-Term Considerations and Follow-Up Care
The relationship between wisdom teeth and orthodontic treatment extends beyond active treatment into your long-term dental health.
Preventing Tooth Movement After Braces Completion
After investing in orthodontic treatment, you’ll want to protect your results:
Consistent retainer use is essential, especially if you’ve kept your wisdom teeth. Retainers help maintain your new alignment even if wisdom teeth shift slightly.
Regular dental monitoring allows your dentist to track wisdom teeth development after braces. Sometimes wisdom teeth that seemed fine during treatment may become problematic years later.
Proactive intervention may be recommended if post-treatment X-rays show wisdom teeth beginning to cause problems.
Customized retention plan – Your orthodontist might recommend a more robust retention strategy if you’ve kept wisdom teeth that could potentially affect alignment.
Remember that your teeth naturally shift throughout life, and wisdom teeth can sometimes accelerate these changes if not properly monitored.
When to Seek Professional Advice for Post-Treatment Concerns
Contact your orthodontist or dentist if you notice:
New pressure or pain in the back of your mouth after braces removal
Changes in your bite or how your teeth come together
Difficulty wearing or fitting retainers that previously fit well
Visible shifting of teeth that were previously straight
Swelling, redness, or infection symptoms near wisdom teeth
Early intervention for wisdom teeth problems after orthodontic treatment can prevent more serious complications and protect your investment in your smile.
Your orthodontist and dentist should work together to monitor your wisdom teeth situation throughout your life, especially in the years immediately following braces removal.
Remember that the wisdom teeth and braces decision isn’t a one-time choice but rather an ongoing conversation throughout your orthodontic journey. The right approach depends on your unique dental structure, treatment goals, and wisdom teeth development pattern.
By understanding your options and working closely with your dental care team, you can achieve the beautiful, healthy smile you desire—with or without your wisdom teeth.
