TL;DR
Wisdom teeth are third molars that usually arrive between the late teens and mid-twenties. When there isn’t room, they can stay trapped in the jaw or come in partway, which can lead to infection, decay, damage to the neighboring molar or cysts. Healthy, fully erupted wisdom teeth you can clean well may never need removal. We decide with an exam and X-rays, and explain the procedure and recovery before anything is scheduled. New patients wanting a second opinion on a removal recommendation have been offered a free consultation; ask whether it’s current.
What are wisdom teeth, and why do they cause trouble?
Wisdom teeth are the third and last set of molars, one at the back of each side of the upper and lower jaw. They usually start coming in between the late teens and the mid-twenties, long after the other adult teeth have settled. By then, many jaws simply don’t have room left.
A wisdom tooth without room becomes impacted, meaning it’s stuck. It may stay buried in the bone, push against the molar in front of it at an angle, or break through the gum only partway. A partly erupted tooth leaves a flap of gum where food and bacteria collect, and that pocket is very hard to clean.
Do all wisdom teeth need to come out?
No. A wisdom tooth that has come in fully, sits upright, meets the tooth above or below it and can be brushed and flossed may stay for life, as long as it’s checked at regular visits. Removal makes sense when a wisdom tooth is causing a problem or clearly heading toward one, such as:
Teeth that show none of these may simply be watched with periodic X-rays.
- Repeated infection and swelling of the gum flap over a partly erupted tooth
- Decay in the wisdom tooth, or in the second molar it leans against
- Bone loss or gum disease around the neighboring molar
- A cyst forming around a buried tooth
- Pain that keeps returning at the back of the jaw
How do we decide whether to remove them?
The decision comes from an exam and X-rays, weighed against your symptoms and age. X-rays show the position of each wisdom tooth, how its roots are forming, how close it sits to the nerve in the lower jaw or the sinus above, and whether it’s harming the tooth in front.
Age matters because roots keep growing and bone grows denser over time. Removal in the late teens or early twenties, when the roots are shorter, is generally easier and heals faster than the same procedure later. That’s a reason to have them evaluated early, though not a reason to remove healthy teeth. If another office has already recommended removal, the free consultation or second opinion the practice has offered new patients is one way to talk it through.
What happens on the day wisdom teeth are removed?
Removing a wisdom tooth that has fully come in is much like any other extraction: the area is numbed and the tooth is loosened and lifted out. An impacted tooth needs more. The gum is opened, a little bone may be removed, and the tooth is often divided into sections so it comes out through a smaller opening. Stitches close the site.
You’ll feel pressure but should not feel sharp pain; tell us if you do. If your treatment involves general anesthesia, read our page on getting ready for general anesthesia ahead of time, since it includes fasting and bringing someone to drive you home. Either way, we explain the plan for each tooth before the day comes.
What is recovery like after wisdom teeth removal?
Expect swelling and soreness that peak around the second or third day and then ease. Cold packs on the cheek in short spells during the first day help limit swelling, and keeping your head raised helps too. Many people are back to normal routines within a few days, with full healing of the gum over a couple of weeks.
Stick to soft, cool foods at first and protect the blood clot: no straws, no smoking, no forceful spitting. Call us for fever, swelling that gets worse after day three, pus, or numbness that doesn’t wear off. Our post-extraction care page has the day-by-day details.