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Sage: If they're not causing a problem then it's ok to keep them. It sounds like yours are starting to cause a problem, crowding. These kinds of things generally get worse over time and the teeth get more difficult to extract as you get older. If you are under 25, I'd get them out.
Nayzo: It sounds like while you may have had great teeth until 17/18, you haven't kept up with it since then. The "permanent grime" isn't permanent but it needs to be removed by a hygienist or you may need periodontal surgery to get it all off. I strongly doubt that the bad teeth have anything to do with the fact that they are close to where your wisdom teeth were, it's just that they are now the teeth furthest back and most difficult to clean. Smoking does not exactly help the situation. It alters your body's ability to fight off disease.
In short, yes go to Tufts or BU. Expect to pay ~25-50% of a dental office price (overpriced is a very relative term my friend....).
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