A Comprehensive Guide Focused on Bursa from Orthodontist Dr. Begüm Ulaşan and Oral Surgeon Dr. Ali Direnç Ulaşan

One of the most frequently asked questions when planning orthodontic treatment (braces, clear aligners, Invisalign, etc.) is:

“Should I get my wisdom teeth extracted before or after my orthodontic treatment?”

Many patients consult both the orthodontist and the oral surgeon with questions like:

1. “My wisdom teeth ruined my alignment; should I have them removed first?”
2. “Will wisdom teeth cause crowding again after orthodontics is finished?”
3. “I have impacted wisdom teeth; must they be extracted before getting clear aligners (Invisalign)?”

In Bursa, orthodontist Dr. Begüm Ulaşan and Oral and Maxillofacial Surgeon Dr. Ali Direnç Ulaşan, working together under the same clinic, answer this question multiple times a day as a team dedicated to collaborative ortho-surgical patient management. In this article, based on their approach, we will prepare a detailed, understandable, and SEO-friendly answer to this highly sought-after question.

1. What is a Wisdom Tooth and Why Does It Cause Problems?

Wisdom teeth are our third molars. They typically:

1. Attempt to erupt between the ages of 17 and 25.
2. Can total 4 teeth, one on the right and left in both the upper and lower jaws.
3. Some individuals may not develop them at all, or may be missing 1–2 of them.

As modern human jaw structure gradually shrinks due to genetic and environmental factors while our tooth count remains the same, it is very common for there to be insufficient space, especially for the wisdom teeth. This often results in:

1. Impacted wisdom teeth (fully or partially impacted).
2. Forward pushing of teeth.
3. Crowded anterior teeth.
4. Recurrent infections.
5. Jaw pain, cheek biting, and chewing problems.

Oral Surgeon Dr. Ali Direnç Ulaşan in Bursa evaluates the wisdom teeth using panoramic X-rays and, if necessary, 3D tomography (CBCT) to determine:

1. Their position within the bone.
2. Their relationship with the nerve canal.
3. The pressure they exert on adjacent teeth.
4. The risk of cysts or infection.

...and then decides which wisdom teeth need extraction.

2. What is Orthodontic Treatment and Its Relationship with Wisdom Teeth?

Orthodontic treatment aims to bring teeth and jaws into their ideal positions. Dr. Begüm Ulaşan, an orthodontist in Bursa, uses both traditional wires (braces) and clear aligners (Invisalign, clear aligner systems) to:

1. Straighten crowded teeth.
2. Correct bite irregularities (malocclusion).
3. Improve smile aesthetics and chewing function.

The role of wisdom teeth in this process includes:

1. The posterior wisdom tooth can crowd the more anterior teeth.
2. An impacted wisdom tooth can create pressure on roots, making orthodontic movements difficult.
3. An infected or frequently painful wisdom tooth can often disrupt the course of orthodontic treatment.
4. After orthodontics is complete, impacted or partially erupted wisdom teeth can negatively affect the stability of the aligned teeth, increasing the risk of relapse (crowding recurrence).

Therefore, Orthodontist Dr. Begüm Ulaşan always examines the panoramic X-ray when creating a treatment plan and refers the patient's wisdom teeth for surgical evaluation by Dr. Ali Direnç Ulaşan.

3. The Main Question: Should Wisdom Teeth Be Extracted Before or After Orthodontics?

There is no single, one-sentence answer that fits every patient.

The correct answer is provided through personalized planning.

However, to understand the general principles, we can categorize wisdom teeth into three main scenarios:

1. Wisdom teeth that absolutely need extraction.
2. Wisdom teeth that can be monitored but may be advantageous to extract in the medium term.
3. Wisdom teeth that cause no problems and show no radiological risk.

Based on these three main groups, the timing of extraction—whether before, during, or after orthodontics—is determined.

Let's detail this below, based on the combined approach of Dr. Begüm Ulaşan (Orthodontics) and Dr. Ali Direnç Ulaşan (Oral Surgery).

4. Situations Where Wisdom Teeth Must Be Extracted Before Orthodontics

In some cases, wisdom teeth are evaluated before starting orthodontic treatment and are most often recommended to be extracted first.

4.1. If there are frequent infections, pain, and abscess episodes

If your wisdom teeth:

1. Swell up frequently.
2. Cause pain when chewing or opening your mouth.
3. Cause redness, increased warmth in the gums, and bad breath.
4. You have had to use antibiotics several times due to pericoronitis (wisdom tooth gum infection).

...it is not healthy to start orthodontic treatment with this condition.

First:

1. Oral Surgeon Dr. Ali Direnç Ulaşan controls the infection.
2. He plans the extraction of the impacted or partially impacted wisdom teeth if necessary.
3. Orthodontist Dr. Begüm Ulaşan recommends starting treatment after the surgical site has healed.

This way, you avoid needing to constantly use antibiotics or painkillers during orthodontic treatment, and you avoid undergoing difficult surgery while wearing braces.

4.2. If it mechanically obstructs orthodontic movement

Some impacted wisdom teeth are positioned:

1. Very close to the tooth roots.
2. Directly behind the tooth intended for orthodontic movement.
3. In a forceful position, pushing the roots upward.

In this situation:

1. The orthodontist may not be able to achieve the desired eruption or movement of the teeth.
2. The risk of root resorption (erosion) in the teeth may increase.

In such cases, Dr. Begüm Ulaşan in Bursa views the wisdom tooth as a "mechanical obstacle" and refers the patient for extraction by Oral Surgeon Dr. Ali Direnç Ulaşan before orthodontics.

This approach increases both the speed and safety of the treatment.

4.3. If there is a cyst or serious radiological risk

If the panoramic X-ray or 3D tomography shows:

1. A large radiolucent area around the impacted wisdom tooth (suspected cyst).
2. Clear erosion on the adjacent tooth roots.
3. Risk of pressure on the nerve canal.

...the issue is no longer just about orthodontics. For your general oral and maxillofacial health, it is essential to:

1. Solve the surgical problem first.
2. Clean the cyst or lesion.
3. Remove the impacted wisdom tooth.

Dr. Ali Direnç Ulaşan resolves these risky cases with extraction and cyst operation. Dr. Begüm Ulaşan then revises the orthodontic plan accordingly.

In this scenario, the surgery first, then orthodontics approach applies.

5. Situations Where Wisdom Teeth Extraction is Appropriate During or After Orthodontics

Not every wisdom tooth must be extracted before orthodontics. In some situations, it may be more sensible to perform the extraction:

1. While orthodontics is ongoing.
2. Or even after orthodontics is completed.

5.1. Fully impacted wisdom teeth posing no immediate clinical risk

Some wisdom teeth:

1. Are completely within the bone.
2. Are a reasonable distance from the nerve.
3. Are not pressing on an adjacent tooth.
4. Appear "silent and stable" for the patient's age.

These are not teeth that need "urgent extraction" before orthodontics.

Orthodontist Dr. Begüm Ulaşan may do the following in such a situation:

1. Prepare the orthodontic plan.
2. Monitor these wisdom teeth with regular imaging during treatment.
3. Refer to Dr. Ali Direnç Ulaşan if any risk or complaint arises.

Sometimes, these wisdom teeth may be extracted after orthodontics is completely finished, simply to "reduce long-term risks" and "increase the stability of the teeth."

5.2. Wisdom teeth threatening stability after orthodontics

Behind the question, "Will my teeth relapse after orthodontics?" there are two main factors:

1. Natural physiological changes and muscle/tongue/lip force balance.
2. The posterior pushing force of the wisdom teeth.

Although scientific studies show that wisdom teeth are not the sole culprit for anterior tooth crowding, clinical experience reveals the following:

1. Wisdom teeth leaning on adjacent teeth.
2. Teeth positioned at an anterior angle.
3. Impacted teeth pressing on adjacent roots.

...can negatively affect the stability of the aligned teeth.

For this reason, orthodontists like Dr. Begüm Ulaşan may prefer to support the use of a retainer (plaque/bonding) with the extraction of risky wisdom teeth after treatment is finished.

In this scenario, the wisdom tooth extraction is most often planned by Dr. Ali Direnç Ulaşan after orthodontics.

5.3. If wisdom tooth root development is incomplete when orthodontics begins

In young patients:

1. Orthodontic treatment often starts between 14–16 years old.
2. The roots of the wisdom teeth may not be fully formed yet.

In this situation, trying to extract the wisdom tooth early may:

1. Be challenging due to nerve and root development.
2. Create unnecessary risk in some cases.

Dr. Begüm Ulaşan may follow this path in such cases:

1. Start the orthodontic treatment.
2. Monitor the wisdom teeth regularly with panoramic X-rays and, if necessary, CBCT.
3. Refer to Dr. Ali Direnç Ulaşan for extraction when root development is complete and the wisdom tooth position is clear.

Here, the approach is orthodontics first (or monitoring during orthodontics), then extraction.

6. Dr. Begüm Ulaşan's Perspective on Orthodontic Planning

When making decisions regarding wisdom teeth, Dr. Begüm Ulaşan, an orthodontist in Bursa, seeks answers to these questions:

1. Is this wisdom tooth currently causing an active problem?
2. Pain, infection, swelling, bad breath, decay, adjacent tooth loss, etc.
3. Does this wisdom tooth mechanically obstruct the orthodontic movements I plan?
4. Plan to move teeth backward, extraction/non-extraction orthodontics, upper-lower jaw harmony, etc.
5. Will this wisdom tooth threaten stability after treatment is finished?
6. A wisdom tooth angled forward, an impacted tooth pressing on an adjacent root, etc.
7. How suitable are the patient's age, jaw structure, and general condition for the timing of surgery?

Based on the answers to these questions, the options are laid out: extraction before orthodontics, during orthodontics, or after orthodontics.

In all cases, action is taken in coordination with Oral Surgeon Dr. Ali Direnç Ulaşan. This ensures the patient proceeds with a single, holistic plan, both orthodontically and surgically, avoiding surprise decisions later on.

7. Dr. Ali Direnç Ulaşan's Perspective on Oral Surgery

Oral Surgeon Dr. Ali Direnç Ulaşan bases the surgical decision regarding wisdom teeth on:

1. The tooth's position within the bone.
2. Its relationship with the nerve canal.
3. Whether there is a cyst, infection, or root erosion around it.
4. The patient's age and systemic condition.
5. Their ongoing or planned orthodontic treatment.

With information received from Orthodontist Dr. Begüm Ulaşan, he clarifies these decisions:

1. "This wisdom tooth must be removed before orthodontics because..."
2. "Let's monitor this tooth during orthodontics; let it stay for now."
3. "It is more advantageous for us to extract it after orthodontics is finished and the teeth are stabilized."

Points he pays particular attention to from a surgical perspective:

1. Age: The 18–25 age range is often the ideal period for impacted wisdom tooth extraction.
2. Nerve Proximity: In very close cases, he performs detailed planning with 3D tomography.
3. Presence of Orthodontic Brackets or Aligners: Sutures, elastics, and oral hygiene need to be managed in a way that is compatible with these.
4. Single session or both sides at once? Decided by considering patient comfort and the orthodontic plan.

8. Frequently Asked Practical Questions and Clear Answers

Let's summarize the common questions patients ask on this topic, tailored to the approach of Dr. Begüm Ulaşan and Dr. Ali Direnç Ulaşan in Bursa.

9. Summary: Should I Get Them Extracted Before or After Orthodontics?

Let's return to the main question with a clear framework at the end of this long discussion: “Should I get my wisdom teeth extracted before or after my orthodontic treatment?”

In short:

1. If your wisdom teeth are an active source of problems (infection, pain, cyst, adjacent tooth damage, obstruction to orthodontic movement)
2. ➜ It is usually more appropriate for them to be extracted by Oral Surgeon Dr. Ali Direnç Ulaşan before orthodontics.
3. If your wisdom teeth are silent for now but may pose a risk in the future
4. ➜ Orthodontist Dr. Begüm Ulaşan creates the treatment plan; extraction is planned during or after treatment at the appropriate time.
5. If your wisdom teeth are:
6. ➜ Fully impacted, show no risk factors, and have a safe bone-nerve relationship,
7. ➜ They may only be monitored during the orthodontic period and extracted later if necessary; in rare cases, they may not be extracted at all.

Thus, the answer is not singular; it is personalized.

The healthiest approach is:

1. To have your orthodontic evaluation done by Orthodontist Dr. Begüm Ulaşan in Bursa.
2. To have your wisdom teeth surgically analyzed by Oral Surgeon Dr. Ali Direnç Ulaşan within the same clinic.
3. To combine your orthodontic and surgical plans into a single roadmap.

By doing so, you neither undergo "unnecessary extraction" nor face risks that would make you say, "I wish I had extracted it earlier."

Final Word

While wisdom teeth may seem like a minor detail on their own, they are a significant factor that directly influences the:

1. Duration of orthodontic treatment.
2. Difficulty of the treatment.
3. Longevity (stability) and comfort after treatment.

Being evaluated by a team that works collaboratively, like Orthodontist Dr. Begüm Ulaşan and Oral Surgeon Dr. Ali Direnç Ulaşan in Bursa, means a treatment process that is both safer and more predictable for you.

If you still have the question, “Which path is right for my wisdom teeth?” the best way to get the most accurate answer is to schedule a personalized evaluation with such a team, bringing your panoramic X-ray with you.