Wisdom teeth, also called third molars, usually do not push through the gum until 17 – 21 years of age.

Most people have four wisdom teeth, however it is very common to have less.  Some wisdom teeth either erupt easily or remain buried and cause no problem, however others may cause severe problems and require removal.

Problems caused by wisdom teeth

Impaction

If the jaw does not have enough room for the wisdom teeth to come through the bone and gums, it may become “impacted”.  The wisdom tooth can also push nearby teeth out of their correct position.

 

Infection

This is one of the most common and significant problems associated with wisdom teeth. Infection may develop when wisdom teeth only partially erupt. Food and bacteria may get caught underneath a flap of gum around the tooth, causing infection. If this remains, the gum becomes irritated, leading to “pericoronitis”. If the pericoronitis is severe, the swelling and infection may cause jaw stiffness and extend beyond the jaw to the cheeks and neck.

Pain

Pressure form the wisdom tooth may cause pain from the tooth next to it. Pain may also be caused from infection or stiffness in the jaw.

Cyst

If a wisdom tooth in not removed, a fluid filled sac, or cyst, can form around the tooth and may displace the tooth.  The cyst can destroy teeth, gum and bone and is fairly common around unerupted teeth of adults.

Resorption cavity

An impacted wisdom tooth can push against the tooth in front of it for many years.  This may cause a resorption cavity where the wisdom tooth contacts the next molar. This often leads to serious damage to both teeth and may result in removal of both teeth.

Ulcers

Incorrectly positioned wisdom teeth and upper wisdom teeth often rub against the cheek or lead to cheek biting, resulting in ulcers.

Treatment of infection

  • Your dentist may gently clean the area. Warm salt water or an antibacterial mouth rinse may also be used at home.
  • Antibiotics may be required to suppress infection before the tooth can safely be removed.
  • Infection of a lower wisdom tooth may be made worse by the top wisdom tooth biting down on the overlying gum.
  • After clinical and x-ray assessment, your dentist will discuss with you options for extraction and sedation, including local anaesthesia, intra-venous sedation or general anaesthetic.
  • Depending on the complexity of removal and the anatomy of your teeth and jaw, this may be able to be done in the surgery, or referred to a specialist oral surgeon for removal in hospital.
  • For all tooth extractions, risks and complications of treatment will be explained thoroughly, as well as post-operative care.

 

Your dentists will assess the presence and position of your wisdom teeth, and may need a special x-ray to aid diagnosis.
If you suffer recurrent gum infection, or the teeth are difficult to access to keep clean, then it is usually advised to have them removed.

Wisdom Teeth Extractions FAQ’s

Below is a list of commonly asked questions about wisdom teeth and their removal.

Wisdom teeth, or third molars, are the last permanent teeth to appear in the mouth.

These teeth usually appear between the ages of 17 and 25. Some people never develop wisdom teeth. For others, wisdom teeth erupt normally — just as their other molars did — and cause no problems.

However many people develop impacted wisdom teeth. Essentially means that the teeth don’t have enough room to erupt into the mouth or develop normally. Impacted wisdom teeth may erupt only partially or not at all.

An impacted wisdom tooth may:

  • Grow at an angle toward the next tooth (second molar)
  • Grow at an angle toward the back of the mouth
  • Grow at a right angle to the other teeth, as if the wisdom tooth is “lying down” within the jawbone
  • Grow straight up or down like other teeth but stay trapped within the jawbone

You’ll likely need your wisdom tooth or teeth pulled if it results in problems such as:

  • Pain
  • Trapping food and debris behind the wisdom tooth
  • Infection or gum disease
  • Tooth decay in a partially erupted wisdom tooth
  • Damage to a nearby tooth or surrounding bone
  • Development of a fluid-filled sac (cyst) around the wisdom tooth
  • Complications with orthodontic treatments to straighten other teeth

A wisdom tooth extraction is almost always a same-day procedure meaning you are able to go home after the surgery.

You’ll receive instructions from the hospital or dental clinic staff on what to do before the surgery and the day of your scheduled surgery. Ask these questions:

  • Will I need to make arrangements for someone to drive me home after the procedure?
  • When do I need to arrive at the dental clinic or hospital?
  • Do I need to avoid eating food or drinking fluids or both (fast)? If so, when do I begin?
  • Can I take my prescription medications before the surgery? If so, how soon before the surgery can I take a dose?
  • Should I avoid any nonprescription drugs before the surgery?

If you receive sedation anesthesia or general anesthesia, you’re taken to a recovery room after the procedure. If you have local anesthesia, your brief recovery time is likely in the dental chair.

As you heal from your surgery, follow your dentist’s instructions on:

  • There may be some oozing of blood which may occur the first day after wisdom tooth removal. Try to avoid excessive spitting so that you don’t dislodge the blood clot from the socket. Replace gauze over the extraction site as directed by your dentist.
  • Pain management. You may be able to manage pain with an over-the-counter pain reliever, such Nurofen or a prescription pain medication from your dentist. Prescription pain medication may be especially helpful if bone has been removed during the procedure.

Holding a cold pack against your jaw also may relieve pain. Along with anit-inflammatory drugs like Voltaren.

  • Swelling and bruising. Use an ice pack as directed by your dentist. The swelling of your cheeks usually improves in two or three days. Bruising may take several more days to fade.
  • After your surgery, plan to rest for the remainder of the day. Resume normal activities the next day, but for at least a week, avoid strenuous activity that might result in losing the blood clot from the socket.

Most people take a week of just to make life easier, but not always possible with work commitments.

  • Drink lots of water after the surgery. Don’t drink the following:
    • alcoholic,
    • caffeinated,
    • carbonated or
    • hot beverages in the first 24 hours.

Don’t drink with a straw for at least a week because the sucking action can dislodge the blood clot from the socket.

  • Eat only soft foods, such as yogurt or applesauce, for the first 24 hours. Start eating semisoft foods when you can tolerate them. Avoid hard, chewy, hot or spicy foods that might get stuck in the socket or irritate the wound.
  • Cleaning your mouth. Don’t brush your teeth, rinse your mouth, spit or use mouthwash during the first 24 hours after surgery. Typically you’ll be told to resume brushing your teeth after the first 24 hours. Be particularly gentle near the surgical wound when brushing and gently rinse your mouth with warm salt water every two hours and after meals for a week.
  • Tobacco use. If you smoke, don’t do so for at least 72 hours after surgery — and wait longer than that if possible. If you chew tobacco, don’t use it for at least a week. Using tobacco products after oral surgery can delay healing and increase the risk of complications.
  • You may have stitches that dissolve within a few weeks or no stitches at all. If your stitches need to be removed, schedule an appointment to have them taken out.

Call your dentist if you experience any of the following signs or symptoms, which could indicate an infection, nerve damage or other serious complication:

  • Difficulty swallowing or breathing
  • Excessive bleeding
  • Fever
  • Severe pain not relieved by prescribed pain medications
  • Swelling that worsens after two or three days
  • A bad taste in your mouth not removed with saltwater rinsing
  • Pus in or oozing from the socket
  • Persistent numbness or loss of feeling
  • Blood or pus in nasal discharge