Wisdom teeth are the third molars at the very back of your mouth. They usually come through between the ages of about 17 and 25, if they come through at all. Some people have plenty of room and their wisdom teeth cause no trouble. For many others, there isn’t enough space, and the teeth grow in at an angle or stay partly trapped under the gum. This guide explains the signs that wisdom teeth may need to come out, and when it’s reasonable to leave them.
What is an impacted wisdom tooth?
A wisdom tooth is impacted when it can’t fully come through into a normal position. It might be tilted towards the tooth in front, lying sideways in the jaw, or only partly through the gum. Impacted teeth don’t always cause symptoms, but they’re harder to clean and more likely to lead to problems.
Common signs of trouble
Pain or pressure at the back of the mouth
Aching, throbbing or a feeling of pressure behind your last molar, sometimes spreading to the ear or jaw, can be a sign that a wisdom tooth is pushing against bone or the tooth in front.
Swollen, sore gums around the tooth
When a wisdom tooth is partly through, a flap of gum can cover part of it. Food and bacteria get trapped underneath, and the gum can become inflamed and infected. This is called pericoronitis. It can cause swelling, a bad taste, bad breath and pain when biting.
Difficulty opening your mouth
Infection around a wisdom tooth can make jaw muscles stiff, so it’s hard to open wide.
Decay in the wisdom tooth or the tooth in front
Because wisdom teeth are hard to reach, they often decay. An angled wisdom tooth can also trap food against the back of the second molar, causing decay in a tooth you want to keep.
Gum disease at the back of the mouth
Deep pockets can form between a wisdom tooth and the molar in front, leading to bone loss.
Cysts
Less commonly, a fluid-filled sac can form around an impacted tooth and damage the surrounding bone. These are usually found on x-rays.
When is it OK to leave wisdom teeth?
Wisdom teeth that are fully through, healthy, in a good position, part of a normal bite and easy to clean can often stay. Some impacted teeth that are fully covered by bone and causing no problems are monitored with periodic x-rays rather than removed. Your dentist will weigh the risks of removal against the risks of leaving the tooth.
How your dentist assesses wisdom teeth
Assessment includes an examination and usually an OPG x-ray, which shows the whole jaw, the angle of the teeth and how close the roots are to the nerve in the lower jaw. Sometimes a 3D scan is recommended to see the nerve position more clearly.
What removal involves
Many wisdom teeth can be removed in the dental chair under local anaesthetic, sometimes with sedation for anxious patients. More complex cases, such as deeply impacted teeth close to the nerve, may be referred to an oral surgeon and done under general anaesthetic. Read more on our wisdom teeth removal page.
Cost
Tooth extractions at Parramatta Dentistry, including wisdom teeth, range from $200 to $600, depending on how complex the removal is. Your dentist will give you a written quote after assessing your x-rays. Conditions apply.
Risks of removal
Wisdom tooth removal is a common procedure, but it is surgery and it carries risks. These include pain, swelling and bruising, infection, dry socket (where the blood clot is lost from the socket, causing pain a few days later), damage to nearby teeth or fillings, and, for lower wisdom teeth, nerve injury that can cause temporary or, rarely, lasting numbness of the lip, chin or tongue. For upper teeth, there’s a small risk of an opening into the sinus. Your dentist will explain your individual risks before you decide.
Is there a best age?
Recovery is often easier in younger adults because the roots aren’t fully formed and the bone is less dense. That said, removal isn’t recommended just because of age. The decision should be based on the position of the tooth and whether it’s causing, or likely to cause, problems.
When to see a dentist urgently
Call us promptly if you have swelling in your face or jaw, a fever, difficulty opening your mouth or pain that’s getting worse. If swelling affects your breathing or swallowing, go to your nearest emergency department or call 000.
You can also read about the cost of wisdom teeth removal.
Frequently asked questions
Should I have all four wisdom teeth removed at once?
Sometimes it makes sense to remove more than one at a time, so you only go through recovery once. In other cases only the teeth causing problems are removed. Your dentist will advise based on the position of each tooth and your x-rays.
Can antibiotics fix wisdom tooth pain?
Antibiotics may help settle an acute infection around a wisdom tooth, but they don’t fix the underlying problem. If the tooth keeps getting infected, removal is often recommended.
How long does wisdom tooth removal take?
A simple extraction can take a few minutes, while a more complex impacted tooth may take longer. Your dentist will give you an estimate at your consultation.
Do I need time off work?
Many people take two or three days off to rest. If your procedure is more complex or under general anaesthetic, you may need longer. Your dentist will give you an idea of the recovery to expect.
What if my wisdom teeth don’t hurt?
Painless wisdom teeth can still cause problems such as decay or gum disease around the tooth in front. If x-rays show a risk, your dentist may recommend monitoring or removal. If they’re healthy and in a good position, they may be fine to keep.
Is wisdom tooth removal covered by health funds?
Many extras policies include a benefit towards extractions, sometimes under major dental with a waiting period. If treatment is done in hospital, hospital cover may also apply. Check your policy with the item numbers on your treatment plan.
Book at Parramatta Dentistry
Parramatta Dentistry is at Suite 25, Level 3, 27 Hunter Street, Parramatta, a short walk from Parramatta Station. We’re open Monday to Friday, 9am to 6pm, and HICAPS is on site, so you can claim from your health fund on the day and pay only the gap, if there is one. Call (02) 8090 1109 or book online.
This article is general information only and isn’t a substitute for personalised advice from your dentist. Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.