Wisdom teeth, or that final set of molars that usually grows in during your late teen and early adult years, are a throwback to bygone days where our chewing teeth would wear out over time, thus creating a need for a new set. Today, with modern dental hygiene techniques, these teeth are no longer strictly necessary, but they continue to grow in nonetheless.

While these leftover teeth can be problematic for some people, do you really need to get them removed if they come in correctly? We’ve taken a look at wisdom teeth removal to help you decide when to have your wisdom teeth taken out and when they can be left alone.

Remove If: You Develop an Infection or Abscess

One of the most common side effects of a new wisdom tooth erupting is an infection or abscess of the tooth or gums. As the gum tissue swells and tears, it can create pockets that allow bacteria to grow and flourish, leading to infection. This infection can spread to the surrounding jaw and teeth, creating a painful and sometimes dangerous situation.

If your wisdom tooth is abscessed or infected, chances are it will need to be taken out. Depending on the severity of the infection, your dentist may put you on antibiotics first to bring down the infection so it is safe to extract the tooth. Once the infection is gone, or at least under control, removing your wisdom tooth is no different than any other tooth extractions.

Remove If: You Suffer From Sinus Problems

This might sound like we’re talking about apples and oranges, but hear us out. Sinus infections can often occur as a side effect of wisdom tooth problems — and vice versa. Studies have found a link between sinus infections and tooth health — sinus infections can cause tooth pain, and untreated tooth problems like cavities, wisdom teeth and crown fractures can cause sinus infections.

Sinus infection treatment will require a trip to your family doctor, rather than a trip to the dentist unless it’s been determined that a dental problem is the cause of your infection. Sometimes, the two will need to be treated in tandem to ensure the best outcome. If you’re experiencing sinus infections caused by your wisdom teeth, it’s definitely time to have them removed.

Remove If: Your Teeth Have Improper Alignment

If you’ve got a small mouth or already crowded teeth, adding 4 more wisdom teeth to the mix can make matters worse — and more painful as well. If you had some natural gaps, your teeth could move slightly to make room for the new wisdom teeth, but if you don’t have any extra room your teeth could be painfully forced together. In addition to the aesthetic damage this might cause, the overcrowded teeth could also be damaged by the additional pressure.

This can also occur if the wisdom teeth come in at an odd angle. Called impacting, this happens when the new molars come in sideways or at some other odd angle. This can also hurt your other existing teeth by pressing against them, damaging the enamel and even potentially causing the teeth to crack

Remove If: You Experience Tooth Damage

We’ve mentioned improperly aligned wisdom teeth can cause damage to other molars by pressing them together. The wisdom teeth themselves can also be damaged by overcrowding. If the teeth are cracked or worse by the overcrowding of the jaw, it can lead to intense pain and expensive but necessary interventions.

See Dentist If: You Get New Cavities

It can be painful for wisdom teeth to erupt, especially in adulthood, but the irritation and swelling of the gum tissue while the teeth make their appearance can also lead to another problem — cavities. The swollen tissue allows bacteria to reach otherwise untouchable surfaces, creating cavities below the gum line.

This alone doesn’t necessarily mean your wisdom teeth need to be removed. Make sure to confer with your dentist to see if the removal of the wisdom teeth is required to maintain the health of your teeth. If the cavities can be repaired and the wisdom teeth aren’t affecting the rest of your mouth negatively, then there is no reason to take out the extra molars.

Leave Alone If: You Undergo a Healthy Eruption

For some people, wisdom teeth are just another set of molars. They hurt for a bit while they erupt, but once they fully grow into place, they don’t cause any other problems. In those cases, feel free to leave them alone. Treat them like any other teeth — make sure you brush and floss. You won’t require any dental intervention.

If you’re concerned after your wisdom teeth have arrived, go talk to your dentist. They’ll most likely perform a panoramic X-ray of your jaw to ensure the teeth have come in correctly, and they aren’t causing any problems with any of your existing teeth. If you get the A-OK from your dentist, you’re good to go.

Wisdom teeth are often a painful and expensive problem for many people. They may be leftover teeth we really don’t need anymore, but that doesn’t stop them from making themselves a nuisance. If they’re bothering you, make an appointment with your dentist today to discuss your options. You may be able to get away with a good cleaning and an improved dental hygiene regimen, but if your wisdom teeth are getting infected or are coming in improperly, then you will definitely need to get them removed.