Should Impacted Wisdom Tooth Be Pulled Before Invisalign?

I have one wisdom tooth that is fully grown sideways underneath my gums on the bottom left. I have some crowding on the bottom center. I would like to find out how the impacted tooth will affect the treatment.

If I decide to have the wisdom tooth removed after the Invisalign treatment, will there be any shifting of teeth to its original position?

Doctor Answers 6

Pulling out wisdom tooth before Invisalign will have no effect

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The wisdom tooth or 3rd molar can be removed before or after treatment. It is really your choice. As far as any affect from removing the 3rd molar after invisalign treatment there will be none. The only shifting you may have will be a direct result from not following the retention guidelines your orthodontist prescribes after treatment is completed.

Atlanta Orthodontist

Before or after treatment is OK for extractions

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Impacted wisdom teeth can be removed before or after treatment with Invisalign. If, however, any of the wisdom teeth have erupted or come through the gum, they could in some cases adversely affect your bite or treatment with Invisalign. In this situation it may be prudent to have these wisdom teeth removed.

Matt T. Walton, DMD
Suwanee Orthodontist

When to remove wisdom teeth before Invisalign

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If the teeth are completely impacted (not coming through the gums at all), you may wait. If they are growing in at all, I prefer my patients have them out first. They could cause the teeth to move more slowly, and, more importantly, the gums around them could get infected during treatment, thereby causing you pain. It's not absolutely necessary, though.

Depends on the degree of the impaction

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If the tooth is impacted and not wrapped around the nerve, it may be taken out before Invisalign. In most correctly treated Invisalign cases, the tooth movement is not that significant so before or after may not make a difference. It would be a cleaner way to extract it before. However, if it is sitting or is wrapped around a very important nerve in the mandible (inferior alveolar nerve), it may be contraindicated to ever take it out due to post extraction complications. Any periodontist or surgeon will be able to make that diagnosis.

Thank you.

Anca Bazile, DDS
New York Dentist

Don't need to be concerned

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Its been proven over time that the lower wisdom teeth don contribute much to the crookedness of your lower front teeth. I usually leave them in if they are not infected and challenging the molar in front of them. do Invisalign first and then wear retainers. The teeth cannot push thru the retainers back to their original position.

Michael J. Thomas, DDS
Los Angeles Dentist

Timing of extraction should be no problem

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Whether extracting before or after Invisalign is a personal choice.  There is no right or wrong, and extracting afterwards likely won't have any affect on the outcome.  However, nothing is 100%, so if you are very concerned, then simply have the tooth out now and put the odds in your favor.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.