Wisdom teeth are the third and final set of molars to develop, usually emerging in your late teens or early 20s. Not everyone has four; some people have fewer or none at all. These teeth are essentially an evolutionary relic – our ancestors needed them to grind tough diets, but modern diets and smaller jaws mean there’s often not enough room for wisdom teeth.
As a result, wisdom teeth frequently emerge at an angle or become impacted (trapped under the gum). If a wisdom tooth aligns properly and is easy to clean, it might not cause trouble. However, when there isn’t space to fit it in the mouth, or if it erupts improperly, it can lead to pain and other dental problems.
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What are Wisdom Teeth?
Wisdom teeth (third molars) are the last teeth in the back of the mouth to develop. There are normally four of them – two in the upper jaw and two in the lower – but numbers can vary. They usually appear in the late teens or early twenties.
Due to changes in diet over thousands of years, many people’s jaws are now too small to accommodate these extra molars. This lack of space often means wisdom teeth grow in at awkward angles or only partially emerge through the gums.
When a wisdom tooth can’t erupt normally (known as impaction), it may press against neighboring teeth or stay trapped under the gum. If fully erupted, a healthy wisdom tooth might coexist without issues. Otherwise, it can lead to complications that dentists monitor closely.
Signs of Problematic Wisdom Teeth
If wisdom teeth start causing trouble, you’ll usually notice symptoms in the surrounding area. Watch for signs like:
- Pain or tenderness at the very back of your mouth (behind the other molars).
- Swollen, red or bleeding gums near a wisdom tooth.
- Facial swelling or jaw stiffness, making it hard to open your mouth or chew.
- Pus, bad breath or an unpleasant taste – often from infection around the tooth.
- Difficulty opening your mouth fully (trismus) or swallowing easily.
These symptoms match the classic signs of wisdom-tooth infection or impaction. For example, gum infection from an impacted wisdom tooth can cause painful swelling, pus discharge, fever and a foul odour.
If you notice any of the above, it’s important to have a dentist check the tooth. Recurrent pain or infection (pericoronitis) is a common reason wisdom teeth are removed, because the problem often returns if the tooth remains in place.
Top 5 Reasons for Wisdom Teeth Removal
When dentists recommend extracting a wisdom tooth, it’s usually due to one or more of the following issues:
Overcrowding/Limited Space
A common problem is simply not enough room in the jaw. Wisdom teeth may grow at odd angles or “lean” against the adjacent molar when they erupt. This pressure can damage neighboring teeth and affect your bite.
In some cases, dentists remove wisdom teeth early to prevent crowding or misalignment of the other teeth.
Impaction
Wisdom teeth often become impacted, meaning they cannot fully emerge through the gum because they’re blocked by bone or other teeth. Impacted wisdom teeth can be painful and are prone to infections. Food and bacteria can collect around a partially erupted tooth, leading to decay of the wisdom tooth and even the tooth next to it.
For these reasons, an impacted tooth is a top candidate for removal to avoid ongoing pain, swelling or damage.
Decay and Gum Disease
Because wisdom teeth sit far back in the mouth, they’re hard to clean well. Partially erupted wisdom teeth create gaps where food and plaque accumulate. This makes them highly vulnerable to cavities and gum disease.
In fact, dentists often find that wisdom teeth or the second molars beside them have significant decay or infection. Removing the offending tooth eliminates the source of decay and helps protect overall oral health.
Cysts or Tumours
In rare situations, fluid-filled cysts can form around an unerupted wisdom tooth. These cysts develop in the sac that encloses a developing tooth and can slowly expand, damaging the jawbone, nearby teeth and nerves. Even benign tumours (osteomas) have been reported around retained wisdom teeth.
If a cyst or tumour is discovered in dental X-rays, the impacted tooth and associated lesion are usually surgically removed to prevent more serious complications.
Preventive and Orthodontic Reasons
Sometimes wisdom teeth are removed proactively. For instance, if you are having orthodontic work, an orthodontist may request removing wisdom teeth to make space and prevent future crowding.
Dentists might also advise removal of partially erupted teeth that look likely to cause trouble later – even if they aren’t currently painful. In essence, a “preventive” extraction may be done to avoid expected issues with the wisdom teeth down the road.
Each patient’s situation is unique. Dentists weigh these factors – overcrowding, impaction, decay, cysts/tumors and orthodontic needs – when deciding if extraction is the best option.
Pros and Cons: Early Removal vs. Waiting
| Aspect | Early Removal | Waiting |
|---|---|---|
| Pros | – Easier extraction: roots not fully developed – Softer jawbone allows smoother surgery – Faster healing in younger patients – Can prevent future problems | – Avoids unnecessary surgery if no symptoms – Can monitor healthy teeth over time – Suitable if teeth are fully erupted and easy to clean |
| Cons | – Surgical risks (e.g. nerve injury, bleeding, infection) – Some wisdom teeth may never cause issues – Potential removal of healthy teeth | – Roots fully developed and bone denser with age – Surgery more difficult and healing slower – Risk of future issues (infection, decay) – May require urgent removal later |
| Ideal For | Teenagers and young adults with developing or impacted teeth | Older adults with fully erupted, symptom-free teeth |
| Risks to Monitor | Standard surgical risks: – Nerve damage – Dry socket – Infection | Same surgical risks if extraction needed later – Risk of delayed complications like cysts or decay |
| Dentist’s Role | Assess risk vs. benefit and advise on best timing | Monitor tooth health regularly and act if changes occur |
Recovery Process After Removal
The recovery timeline for wisdom tooth extraction varies by person, but typically follows a predictable pattern:
- First 24 hours: After extraction, a blood clot forms at the site to stop bleeding. You’ll likely have some numbness from anaesthesia, and there may be mild bleeding initially. Bite gently on the provided gauze to help the clot form, and keep your head elevated to minimise swelling.
- Days 2–3: Swelling in the cheeks and jaw usually peaks around the second day and then starts to go down. You should continue taking prescribed pain relief and stick to soft foods. Apply ice packs as instructed to manage swelling. Continue to avoid rinsing vigorously or using straws (which could dislodge the clot).
- Days 7–10: By one week, most of the swelling and bruising will have significantly improved. Any stitches (dissolvable ones) will usually disappear on their own during this period. You should notice that jaw stiffness and soreness are much better by days 7–10.
- Up to 2 weeks: Full recovery may take about two weeks. By then, most pain and bruising have resolved. If you experience normal healing, you can slowly return to a more varied diet as recommended by your dentist.
Aftercare tips: Follow your dentist’s instructions carefully. Aside from taking pain medication as needed, it’s important to rinse your mouth gently with warm salt water (a teaspoon of salt in warm water) starting 24 hours after surgery. This helps keep the socket clean and promotes healing. Avoid smoking, alcohol and strenuous exercise for the first couple of days, as these can delay healing or dislodge the clot. Your dentist will schedule a follow-up if needed, to ensure recovery is on track.
When to Consult a Dentist
You should see a dentist about your wisdom teeth if you notice any of the warning signs above or have concerns about future problems. In particular, schedule an appointment if you experience:
- Persistent pain, swelling or infections around a wisdom tooth.
- Damage to nearby teeth. For example, if a wisdom tooth is decayed or pushing on its neighbour, it can harm the adjacent tooth’s root or bone.
- Gum disease or repeated pericoronitis (gum infection) at a wisdom tooth site.
- Difficulty cleaning. If your dentist notes that a partially erupted wisdom tooth is trapping food and plaque, it may be wiser to remove it to prevent future cavities.
- Orthodontic or prosthetic plans. If you’re getting braces or other dental work, your orthodontist or dentist may want to review your wisdom teeth. Often, orthodontists will recommend removal to ensure teeth have space to align properly.
As Better Health Victoria notes, any wisdom tooth “causing problems” should be evaluated by an oral health professional. Even asymptomatic wisdom teeth can be monitored with X-rays.
During routine check-ups, your dentist can watch for signs of impaction or pathology. If there’s risk of serious future issues, they might suggest extraction even before pain starts. In short, if you have concerns about your wisdom teeth at any age, a consultation can clarify whether removal is advisable.
Frequently Asked Questions
What are common symptoms of impacted wisdom teeth?
Impacted or troublesome wisdom teeth often cause pain at the back of the jaw, swelling of the surrounding gum, and difficulty opening the mouth. Other signs include redness, a bad taste or pus from the gum, and sometimes earache or headache. Any persistent ache or infection around the wisdom tooth should be checked by a dentist.
What are the main reasons to remove wisdom teeth?
Dentists remove wisdom teeth mainly due to lack of space, impaction, decay, cysts/tumours or orthodontic needs. For example, crowded jaws can cause a wisdom tooth to grow sideways against other teeth. Impacted teeth often cause infections or damage nearby teeth. Wisdom teeth also tend to decay more easily because they’re hard to clean.
In rare cases, fluid-filled cysts can form around a wisdom tooth. Orthodontists may also recommend removal to allow proper alignment of the other teeth. Each of these issues can threaten the health of your mouth, so extraction can be the safest solution.
Is it necessary to remove wisdom teeth if they aren’t causing pain?
Not always. If an exam and X-ray show a healthy wisdom tooth with enough room to function, some dentists choose to leave it alone. Major reviews (Cochrane, NICE) have found no strong evidence to remove completely disease-free wisdom teeth as a precaution. However, they will typically advise monitoring such teeth. If at any point the wisdom tooth begins to cause symptoms (or shows decay, cyst formation, etc.), extraction may then be recommended.
How long does recovery take after wisdom tooth extraction?
Most patients heal surprisingly quickly. Bleeding usually stops within a few hours as a protective blood clot forms. Swelling peaks around day two or three and then goes down. By about one week post-op, jaw stiffness and most discomfort have significantly improved. Full recovery of the surgical site is typically seen within two weeks. Following your dentist’s aftercare instructions (like gentle saltwater rinses after 24 hours) will help ensure smooth healing.
Ready to Speak with a Dentist?
If you’re experiencing pain or notice any of the signs described above, don’t wait – book a same-day consultation with our qualified dentist or oral surgeon. Early assessment of your wisdom teeth can prevent small issues from becoming big problems.
Richmond & Springvale Dental Group is here to help you understand your options and provide the care you need. Call us today (03) 9428 9102 or (03) 9558 5756 to schedule a wisdom-teeth evaluation and discuss the best plan for your dental health.
