Quick answer: Wisdom teeth only need removing when they cause problems or are likely to, such as repeated gum infection, decay, damage to the neighbouring tooth, or a cyst. Healthy, fully erupted wisdom teeth that can be cleaned well can often be kept. An examination with an X-ray shows the tooth’s position and helps decide.
Wisdom teeth are the third molars at the very back of the mouth. They usually appear in the late teens or early twenties, and because they are the last teeth to arrive there is often not enough room for them to come through properly.
Key takeaways
- An impacted wisdom tooth is one that cannot fully erupt because it is blocked by bone, gum or another tooth.
- Pain, swelling, bad taste and difficulty opening the mouth can signal infection around a wisdom tooth.
- Removal is recommended for problems, not automatically for every wisdom tooth.
- Most extractions are done under local anaesthesia, with recovery over several days.
What does an impacted wisdom tooth mean?
A wisdom tooth is “impacted” when it is trapped and cannot erupt into a normal position. It may be tilted towards the tooth in front, lying horizontally, or partly covered by gum. Partly erupted teeth can be difficult to clean, which allows food and bacteria to collect.
What are the signs of wisdom tooth problems?
- Pain or tenderness at the back of the jaw
- Swollen, red or bleeding gum around a back tooth
- A bad taste or bad breath that does not go away
- Difficulty opening the mouth fully or discomfort when swallowing
- Food repeatedly getting trapped behind the last molar
Infection of the gum flap over a partly erupted wisdom tooth (pericoronitis) is a common cause of these symptoms.
When is wisdom tooth removal recommended?
Your dentist or oral surgeon may recommend removal when a wisdom tooth:
- causes repeated episodes of gum infection or pain
- has decay that cannot be reasonably restored
- is damaging or causing decay in the neighbouring molar
- is associated with a cyst or other changes seen on X-ray
- is interfering with other planned dental treatment
If a wisdom tooth is healthy, fully erupted, in a functional position and easy to clean, it can often be monitored instead.
What happens during a wisdom tooth extraction?
After examining the tooth and reviewing an X-ray, the area is numbed with local anaesthesia. A straightforward erupted tooth may be removed much like any other tooth. An impacted tooth may need a small opening in the gum and, sometimes, sectioning of the tooth to remove it gently. Stitches may be placed. Learn more on our oral & maxillofacial surgery page.
How long is the recovery?
Some swelling and discomfort are normal for the first few days and usually improve steadily. To help healing:
- Bite gently on the gauze provided to control bleeding.
- Avoid rinsing vigorously, smoking and drinking through a straw for the first day, to protect the blood clot.
- Eat soft, cool foods at first and chew on the other side.
- Use cold compresses on the cheek during the first day to reduce swelling.
- Take medication as advised and keep the rest of your mouth clean.
Contact the clinic if pain gets worse after a few days, swelling increases, or you develop a fever.
Should you wait for pain before getting checked?
No. Problems can develop without symptoms, so it is worth having your wisdom teeth reviewed during routine check-ups. If you are experiencing pain or swelling, book a surgical consultation at CADIL.
