Do impacted wisdom teeth always have to be extracted?

Not every impacted wisdom tooth has to be removed, but if problems are expected, it is better to extract it in advance. Impacted wisdom teeth can damage the roots of the neighboring molar, cause cavities, and rarely develop into a cyst. We recommend extraction when 1) there is recurring swelling or pain, 2) the adjacent tooth is developing cavities or damage, or 3) a lesion is visible on the X-ray. On the other hand, if the tooth is completely buried in bone with no symptoms and is very close to the nerve canal, we may choose to monitor it regularly instead of extracting.