When Should Wisdom Teeth Be Removed? Symptoms and Process

Wisdom teeth (the third molars) are the last teeth to erupt, usually between the ages of 17 and 25. When they find enough space in the jaw and erupt in the correct position, they cause no problems and do not need to be removed. Problems arise when a mismatch between jaw and tooth size causes the tooth to remain impacted or erupt at the wrong angle.

Which Symptoms Might Be Caused by Wisdom Teeth?

• Recurrent pain, pressure and swelling at the back of the jaw
• Gum tissue covering a partially erupted tooth, causing inflammation in the area (pericoronitis)
• Difficulty opening the mouth and pain when swallowing
• Pain, decay or a feeling of pressure in the neighbouring tooth
• Bad breath and an unpleasant taste in the mouth

Some of these symptoms can also occur for other reasons; a definitive assessment is made through examination and a panoramic X-ray.

In Which Cases Is Extraction Recommended?

• Partially impacted teeth that cause recurrent episodes of gum inflammation
• A position that causes decay, resorption or crowding in the neighbouring tooth
• Teeth that decay because their position makes them impossible to clean, where repair is no longer worthwhile
• Impacted teeth associated with cysts or similar pathologies
• Selected cases required by an orthodontic treatment plan

By contrast, a wisdom tooth that has fully erupted, can be cleaned and is functional is left in place; the belief that "wisdom teeth must always be removed" is not correct. For impacted teeth that show no symptoms, the decision is made on an individual basis through a risk-benefit assessment, and regular monitoring may be recommended instead.

What Happens During and After Extraction?

Erupted wisdom teeth are usually removed with a simple extraction, while impacted ones are removed through a minor surgical procedure under local anaesthetic. Mild swelling and sensitivity for a few days afterwards is normal. In the first few days, cold compresses, soft foods, avoiding smoking and not using a straw all speed up healing; when you follow your dentist's advice, the process is generally comfortable. You should contact your clinic if you experience worsening pain, bleeding that does not stop, or fever.