Wisdom teeth are the last set of teeth to erupt in the back corners of your mouth. Most people will experience the eruption of these extra molars between the ages of 17 and 25. In a lucky few however, these teeth erupt in the right position, function correctly and cause no oral health problems. Unfortunately modern human jaws often do not have enough space to accommodate 4 extra large molars.

Sometimes due to a lack of space in your jaw, the wisdom teeth can erupt in awkward positions, get impacted underneath the gums or cause crowding of the neighboring teeth. By knowing when to remove a problematic wisdom tooth you can avoid severe pain, infections, damage to your teeth and complex jaw problems. In this ultimate guide we will explain when you need to remove your wisdom tooth, the main symptoms to look out for and the best time to do so.

Why Do Wisdom Teeth Cause Problems?

Wisdom teeth used to play an important role in our ancestors’ lives. Early humans ate a very coarse diet with little heating. This included raw meat, tough roots, nuts and fibrous leaves. This caused a lot of wear on their natural teeth so they needed extra power from their jaws.

  • Modern Cooking Methods: These days our food is cooked and processed making us no longer require large jaw bones and third molars.

  • Smaller Jaw Bones: Humans jaw bones have reduced in size over the years. However our bodies still try to produce 32 adult teeth.

  • Not Enough Space: Modern jaws are too small so the wisdom teeth often hit neighboring second molars or get stuck inside the bone.

Impacted Teeth:

1. Impacted Teeth

This is one of the most common reasons that a dentist would advise removing your wisdom tooth. Impacted wisdom teeth are unable to erupt into their correct position causing ongoing oral health problems.

  • Fully Impacted: The wisdom tooth is fully stuck inside the jaw bone. This means that it can’t erupt through the bone. This can cause the formation of cysts or damage to neighboring tooth roots.

  • Partially Impacted: The wisdom tooth has started to erupt but is still stuck under some soft tissue. This causes a flap of gum tissue which can trap food, saliva and bacteria.

  • Horizontally Impacted: The third molars are growing horizontally (90 degree angle) into the roots of the neighboring second molar. This causes damage to neighboring teeth.

  • Tilted: The new erupting teeth are growing awkwardly and leaning towards the back of your mouth or tongue causing irritation to the soft tissue.

2. Severe Pain

Constant pain in the back of your jaw is a clear sign that you need to see a clinician. If you ignore the pain you could cause complex dental problems.

  • Constant Pain: Constant dull pain in the joint of your jaw or your back molars. Often gets worse when eating.

  • Pressure: As the wisdom teeth erupt they can cause a lot of pressure on neighboring teeth causing aching throughout your whole arch.

  • Radiating Pain: Severe inflammation of your third molar can cause pain to radiate into your ears, temples, cheeks and neck.

  • Throbbing: Sharp pain which wakes you from sleep or doesn’t help with painkillers.

3. Reoccurring Gum Infection (Peritonitis)

A partially erupted wisdom tooth creates a perfect breeding ground for bacteria. The gum flap will make it almost impossible to clean underneath.

  • Bacteria Build Up: Food and plaque will build up underneath the inflamed flap of gum. This area will be difficult to reach with a toothbrush and floss.

  • Peritonitis: The trapped bacteria cause a painful infection in your gums. Your gums will become bright red, inflamed and very sensitive.

  • Pus: If the peritonitis gets severe it will form an abscess which will cause smelly acidic tasting pus to run into your mouth causing constant bad breath.

  • Mouth Opening Problems: Severe gum inflammation around your lower wisdom teeth can cause you to struggle to open your mouth fully. This is known as truisms.

4. Damage To Neighboring Second Molars

Often erupting wisdom teeth will not stay in their own space. If the third molar is pushing against your neighboring second molar it can cause damage to a perfectly healthy tooth.

  • Cavities: Due to the lack of space between your wisdom tooth and second molar food can get stuck causing bacteria to eat away at the enamel on both teeth.

  • Root Resorption: The pressure from the angled wisdom tooth can cause the neighboring second molar’s root to literally dissolve.

  • Bone Loss: Chronic inflammation between the crowded molars can cause the bone in between to dissolve causing neighboring healthy teeth to become loose.

  • Difficult Repairs: Often it is impossible to repair deep cavities or root damage on the second molar until the blocking wisdom tooth is removed by the surgeon.

5. Cysts And Tumors

If you ignore impacted wisdom teeth you may cause serious problems inside your jaw bone.

  • Cyst: If the impacted wisdom tooth stays stuck inside your jaw for years the sac can swell with fluid causing a benign cyst to form.

  • Bone Damage: The swelling can cause the inside of your jaw bone to hollow out causing weakness and increasing the risk of your jaw breaking.

  • Nerve Damage: The growing cyst puts a lot of pressure on the inferior alveolar nerve causing numbness or tingling on your lower lip, chin and tongue.

  • Benign Tumor: In rare cases non cancerous tumors can form in the tissues around chronically impacted third molars. These require extensive surgery to remove.

6. Severe Crowding

Many teenagers and young adults spend years having orthodontic treatment to get a straight and beautiful smile. However erupting wisdom teeth can cause problems.

  • Front Teeth Crowding: As the wisdom teeth erupt they will put constant pressure on your front incisors causing them to overlap and twist.

  • Relapse: The erupting third molars can cause relapse meaning you will need to go back to orthodontic treatment.

  • Misalignment: Awkwardly angled wisdom teeth can cause misalignment between your upper and lower teeth causing problems with your natural bite.

Orthodontists often advise removing non-erupted wisdom teeth before or during your orthodontic treatment to ensure you have a stable result.

7. Deep Cavities

Even if your wisdom teeth fully erupt in the correct upright position they can cause serious problems due to their position at the back of your mouth.

  • Difficult To Clean: Most people struggle to clean the back of their third molars without gagging.

  • Build Up Of Plaque: Due to the difficulty cleaning they will cause a build up of sticky plaque and calculus.

  • Difficult To Fill: If there is deep decay on your wisdom tooth dentists will often have trouble placing clean fillings or crowns.

Dentists often prefer to remove heavily decayed or difficult to reach wisdom teeth rather than carrying out complex and expensive root canal treatment on an unnecessary molar.

Best Time To Remove Wisdom Teeth

It is important to know when to remove your wisdom teeth to reduce risks, speed up your recovery and avoid any complications.

  • Best Age To Remove: It is highly advised by dental professionals to have any problem wisdom teeth assessed and removed between the ages of 16 and 22.

  • Short Roots: Teenagers and young adults will only have 2/3rd of the full length of roots formed. This makes the extraction much easier and safer.

  • Soft Bone: The younger the jaw bone the softer it will be. This means you will recover quicker.

  • Fewer Complications: Younger patients will suffer from less nerve damage, less infection and little dry socket.

  • Difficult To Remove: Once you are over the age of 30 the roots will be fully formed and will be tightly fused to the dense jaw bone. This can make them more difficult to remove and prolong your recovery.

When Can You Leave Your Wisdom Teeth?

Not all wisdom teeth will need to be removed. If your third molars are healthy your dentist will advise you leave them.

  • Fully Erupted: The wisdom teeth have fully erupted through the gums in their natural upright position.

  • Correct Bite: The teeth fit comfortably with the opposite upper/lower molars.

  • Enough Space: There is plenty of space in your jaw meaning your gums are pink, firm and easy to clean.

  • Easy To Clean: You can easily clean all surfaces of your wisdom teeth.

  • Healthy Bone: Digital x-rays will show that the bone around your wisdom teeth is healthy, neighboring roots are intact and there are no cysts or decay.

Key Symptoms To Look Out For

  • You are experiencing constant throbbing pain in the back corners of your upper or lower jaw.

  • Your gums at the back are inflamed, sore, bright red or bleed easily.

  • You notice smelly pus running from your gums at the back of your molars and suffer from bad breath.

  • You are struggling to open your mouth fully or are experiencing pain when eating.

  • Your front incisors are becoming crowded, twisted or sticking out.

  • Your lymph nodes in your neck are swollen and you have a mild temperature.

  • You are suffering from unexplained headaches, earache or pressure behind your cheeks.

  • Your dentist notices bone loss, deep cavities or growing cysts in your panoramic x-rays.

Frequently Asked Questions

Is it painful to remove a wisdom tooth?

No it isn’t! Powerful local anesthetic will be used to completely numb your teeth, gums and jaw bone. Many clinics offer sedation options such as laughing gas, oral or IV sedation to help you relax or even fall asleep during the appointment. You will only experience mild soreness after the procedure.

What happens if I don’t remove my impacted wisdom tooth?

If you don’t remove your impacted wisdom tooth problems will develop underneath your gums. Bacteria will become trapped causing reoccurring gum infections, painful abscesses and deep cavities on neighboring healthy teeth. Fluid filled sacs can grow causing cysts in your jaw. This can cause damage to your bone and facial nerves. You will also have to undergo far more complex procedures in the future.

How long will I be in pain after my wisdom teeth have been removed?

You will usually be in pain for 3-7 days. Most people will experience mild pain easily managed with anti inflammatory medication. You will be able to return to work/school after 2-3 days. Full healing will take a few weeks to a few months.

Can wisdom teeth cause headaches and sinus pressure?

Yes! Upper wisdom teeth can cause headaches and sinus problems. As the roots of your upper third molars grow upwards they will press against the floor of your sinuses. This can cause sinus problems, pressure behind your eyes and constant tension headaches.

Knowing when to remove your wisdom tooth is an important step in keeping your oral health healthy for life. If you notice any early symptoms such as constant jaw pain, inflamed gums, front teeth crowding or reoccurring infections you can take action. Having your third molars assessed between the ages of 16-22 will give you the safest, easiest and quickest recovery. Book in for a thorough examination and panoramic x-ray with your dentist today.