Wisdom teeth are the last teeth to come through at the back of the mouth. For many people they arrive quietly and cause no trouble at all. For others they bring pain, swelling or repeated gum infections. Knowing the common signs can help you decide when to book a dental check.
This guide covers what wisdom teeth are and why they sometimes get stuck. It also looks at the signs of a problem and when removal may be suggested. Finally, it outlines what recovery usually involves and how to look after the area while it heals.
What wisdom teeth are
Most people have four wisdom teeth, with two in the upper jaw and two in the lower jaw. Some people have more, some have fewer and some have none at all. They usually come through in the late teens or early twenties. Because they arrive last, there is not always enough room left for them.
They sit right at the back, behind the other molars. That position makes them harder to reach with a toothbrush. Food and bacteria can build up around them more easily than around front teeth. This is one reason they are more likely to cause trouble than other teeth.
Why wisdom teeth become impacted
An impacted wisdom tooth is one that cannot come through properly. It may grow at an angle and push into the gum or the tooth beside it. It can also get stuck against bone, with only part of the tooth showing. A flap of gum is often left sitting over the top of a partly erupted tooth.
Lower wisdom teeth take longer to come through than upper ones. According to healthdirect’s guide to removing wisdom teeth, they are also more likely to become impacted. That makes repeated infections more likely in the lower jaw. Some wisdom teeth do the opposite and grow too far out of the gum.
Crowded wisdom teeth often lean sideways and rub against the cheek. This can lead to ulcers inside the cheek and make chewing uncomfortable. Food can also collect between the wisdom tooth and its neighbour. Over time this can cause decay in either tooth.
Signs your wisdom teeth may be causing problems
An infection of the gum around a partly erupted wisdom tooth is called pericoronitis. It is one of the most common wisdom tooth problems. The Victorian Government’s Better Health Channel page on wisdom teeth lists the signs to watch for. These include:
- red, inflamed gum near the tooth
- pain and sensitivity at the back of the mouth
- swelling of the face
- pus coming from the gum
- swollen, sore lymph nodes under the jaw
- difficulty opening the mouth or swallowing
- fever
- food getting stuck and being hard to clean out
- bad breath
Any of these signs is a good reason to see your dentist. Decay is another concern, because the back of the mouth is hard to keep clean. If you want to understand how decay starts, these facts about tooth decay explain the basics. Early checks make problems easier to manage.
Does every wisdom tooth need to come out?
No. Some wisdom teeth never cause problems and can stay where they are. A dentist may suggest watching a tooth over time rather than removing it. X-rays help show whether a wisdom tooth is likely to cause trouble later. Your dentist will look at the position of the tooth and the space around it.
Removal may be suggested if there is not enough room, or if there is pain, infection or damage to nearby teeth. Healthdirect lists other reasons too. These include repeated or serious gum infection, a cyst near the tooth and a position that makes cleaning very difficult. Removal can also be part of planning for jaw surgery or orthodontic work.
There are sometimes other options for mild problems. Pain relief, improved cleaning and rinsing with warm salty water may help settle a flare. Antibiotics are sometimes used for infection. However, infection may keep coming back if a problem tooth stays in place.
Timing matters
Better Health notes that the longer removal is delayed, the more problems can happen. In the teenage years the roots are still forming, so removal is usually easier. Younger bone also tends to heal faster. This is one reason timing is worth raising with your dentist early.
Delaying removal of a tooth that is already causing trouble has its own risks. Symptoms may get worse or return. Healthdirect warns that a serious infection can develop. If your pain is getting worse, contact your dentist rather than waiting it out.
What happens during removal
Many wisdom teeth can be removed with a local anaesthetic, which numbs the area. Upper wisdom teeth are usually simpler to remove than lower ones. For difficult or deeply impacted teeth, a sedative or general anaesthetic may be offered. Some people are referred to an oral and maxillofacial surgeon for more complex cases.
The procedure may involve a small cut in the gum. Some bone may need to be removed, and the tooth may be cut into pieces to lift it out. The area may then be stitched. Most people go home the same day.
Feeling nervous before any procedure is normal. Simple ways to settle your thoughts, like those in these tips for preparing your mind for a big challenge, can help on the day. Ask your dentist to explain each step if that makes you feel calmer. Writing your questions down beforehand also helps.
Recovery and aftercare
It is normal for the jaw and gum to be sore, swollen and to bleed a little for a few days. You may need up to a week off work. Most people are back to normal activities within a week. Most people make a full recovery.
Better Health suggests some simple aftercare steps. Bite on gauze as instructed to control bleeding. Avoid excessive rinsing, spitting or sucking through a straw. Eat soft, easy foods for the next few days.
After the first 24 hours, hold warm salty water in your mouth after meals. Do not smoke for 48 hours after surgery. Avoid alcohol and strenuous exercise while you heal. Take pain relief only as advised by your oral health professional.
Possible complications
Like any procedure, wisdom tooth removal carries some risks. Dry socket happens when the socket does not heal properly, causing severe pain and a bad smell. It is more common in smokers and people who have trouble healing. A dentist can treat it successfully.
Other possible problems include bruising, infection, jaw stiffness and damage to nearby teeth. Removing lower teeth can sometimes affect a nerve, causing numbness in the lip, chin or tongue. This is usually temporary, but healthdirect notes it can take up to 18 months to recover. Tell your dentist if you take or have taken bisphosphonates or cancer medicines, as these raise the risk of a rare jawbone problem.
Keeping the rest of your mouth healthy
Good daily care helps every tooth, not just the ones at the back. Better Health notes that wisdom teeth can be hard to brush, and better cleaning in the area can help with gum infection. The same habits matter after any dental work. This article on oral hygiene after dental implant surgery explains why.
Sometimes a damaged tooth elsewhere in the mouth cannot be saved. If that happens, your dentist can talk you through replacement options. You can read about the benefits of dental implants if that is something you are weighing up. Regular checks remain the simplest way to spot problems early.
Frequently asked questions
At what age do wisdom teeth come through?
Wisdom teeth usually come through in the late teens or early twenties. Some people never get them at all. Others have teeth that stay under the gum. An X-ray can show what is happening below the surface.
Can an infected wisdom tooth go away on its own?
Better cleaning, a professional clean or antibiotics may settle an infection for a while. However, infection may keep returning if the tooth stays in place. People with other health problems or lower immunity may face complications. See your dentist rather than relying on home care alone.
How long does recovery take after wisdom tooth removal?
Soreness, swelling and some bleeding are normal for a few days. Most people are back to normal activities within a week. You may need up to a week off work. Follow the aftercare advice your dentist gives you.
What is dry socket?
Dry socket is when the socket does not heal properly after a tooth is removed. It causes severe pain and a bad smell. It is more common in people who smoke. A dentist can treat it, so contact them if you notice these signs.
This article is general information only and is not medical or dental advice. Please speak with your dentist, doctor or a qualified health professional about your own situation.