FAQ: Do I need my wisdom teeth out?

The thing about wisdom teeth, is that they’re not a problem until they are. Yet because of the location and size of wisdom teeth, they’re more likely to play up than other teeth. If they cause pain, swelling or the dentist tells us they’re impacted, then its better to have those wisdom teeth removed rather than leave them in.

What are wisdom teeth?

Our wisdom teeth are at the very back of our mouth, and are our third and final set of molars. Most people get two on the top, and two on the bottom. They are the toughest, widest teeth we get so they’re the best for grinding food. It’s just that with evolution our food choices and face shapes have changed so sometimes there’s just not room for them.

They got their name because they usually come in when we’re older, typically between the ages of 17 and 21. Wisdom teeth are the last of our adult teeth.

How do I know if I have them?

Usually, it becomes quite obvious when our wisdom teeth are coming in. When they do, we may experience some minor pain as the tooth erupts. Your jaw may even ache. Depending on the angle the tooth is coming in at, you may feel it rubbing against your cheek or tongue.

During a routine check, our dentist examines the whole of our mouth and will know if we have healthy wisdom teeth in place. If the teeth have not erupted, an x-ray shows their position and whether they are impacted or not.

• Are dental x-rays safe?

What sort of problems do wisdom teeth cause?

While some people experience no problems when their wisdom teeth come in, sometimes they can cause discomfort, pain or swelling.

A particular problem with our wisdom teeth is that they are so far back in our mouth. This means it’s hard to reach them effectively with a normal toothbrush. Consequently, tooth decay can set in, then gum disease and abscesses. To prevent this, it is best to invest in a slim, long-handled toothbrush and brush your wisdom teeth on all the exposed surfaces. Use floss too, as you would on your normal teeth.

What’s an impacted wisdom tooth?

An impacted tooth is one that isn’t able to grow into the correct place. It’s alignment means that it grows sideways and pushes against other teeth. Our dentist checks for impacted wisdom teeth and may take x-rays to examine the position.

Symptoms may include:

• red, swollen or bleeding gums,
• jaw pain; swelling around the jaw,
• bad breath, or
• difficulty opening our mouth.

Swelling associated with wisdom teeth is unpredictable and can be sudden. It can be upsetting too, especially for teenagers, because one side of the face may swell dramatically.

Because of these issues, dentist’s regularly suggest extraction. Often our own dentist can do the extraction, but sometimes a referral to a specialist is necessary.

If I need them extracted, what happens?

The ease with which a dentist can remove our wisdom teeth depends on their position and stage of development. A wisdom tooth that has erupted through our gum can be extracted as any other tooth would be. If it is impacted, the dentist has to remove it surgically, making an incision into the gum.

When all four wisdom teeth need to be extracted, usually the dentist or oral surgeon will do the upper and lower tooth on one side first, and when that’s healed up, will do the extractions on the other side. This makes it easier for the patient to eat and drink afterwards.

In some cases, to avoid nerve damage in the lower jaw, the dentist may recommend a coronectomy. This is when the crown of the tooth is removed and the root remains in the jawbone.

What happens after surgery?

The dentist will give you advice about aftercare, and may prescribe or suggest antimicrobials and pain management.

As with any minor surgery, there are some expected after effects. Patients may experience:

• some discomfort from the wound and gums as the anaesthetic wears off
• swelling of the jaw and cheek over the site
• sensitivity to hot and cold food and drinks

Patients should contact their dentist if symptoms persist or worsen, such as:

• increased pain in the jaw, a symptom of dry socket
• excessive tiredness
• any unusual symptoms that progress rather than lessening

Swelling that threatens to block airways or bleeding that won’t stop, should be treated as an emergency.

• Read more about emergency and urgent care here

A final thought

Wisdom teeth usually erupt around the time teenagers and young adults are taking significant exams, preparing to deliver presentations, performing or playing in front of audiences or just being regular teenagers. There’s never a good time to have toothache or a swollen face.

If a teenager is about to take exams, dentists recommend a dental examination well in advance. This means any problem can be handled, so there’s no chance of pain or swelling during exams. Nothing lowers grades as quickly as toothache.

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