Wisdom teeth are the last teeth to arrive, usually between 17 and 25. By then the jaw is often full, and that is where the trouble starts.
Why they cause problems
When there is not enough room, a wisdom tooth can come through only part of the way, or grow in at an angle against the tooth in front. This is called an impacted tooth. Some never break through the gum at all and cause no trouble; others cause repeated problems.
The signs to watch for
- Swollen, sore gum at the back of the mouth, sometimes with a bad taste. Food and bacteria get trapped under the flap of gum over a half-erupted tooth. This is called pericoronitis, and it tends to come back.
- Pain when you open wide or chew, or a stiff jaw.
- Decay in the tooth in front. A tilted wisdom tooth creates a gap that no brush can reach, and the molar in front, a tooth you need, can decay there.
- Swelling of the face or a temperature. This needs care the same day. See tooth pain.
Leave it, or take it out?
A wisdom tooth that is fully through, upright, in use and easy to clean can stay. So can one that is buried deep and causing nothing.
We usually advise removal when there is repeated infection, decay in it or the tooth in front, damage to neighbouring teeth, or, rarely, a cyst around it. Removing a troublesome wisdom tooth in your twenties is usually easier than later, as the roots are not yet fully formed and the bone is softer.
How we plan it
An X-ray shows the tooth’s position. For lower wisdom teeth whose roots sit close to the nerve that supplies feeling to the lip and chin, a 3D CBCT scan shows exactly how close, which shapes how the tooth is removed.
What removal involves
The area is numbed. A tooth that is fully through may come out much like any other. An impacted one needs a small cut in the gum, and sometimes the tooth is divided so it comes out in pieces with less pressure on the bone. Stitches close the gum. Most people need a day or two at home and a week of soft food.
Expect swelling and a stiff jaw for a few days. Our aftercare for tooth removal explains what is normal and when to call us. Read more about tooth removal.