For some people, wisdom teeth may grow in smoothly - or not at all. For others, wisdom teeth can feel a little like party crashers, showing up late and causing problems.

Wisdom teeth tend to grow in much later than other permanent teeth, usually during late adolescence or early adulthood. If there isn't enough room in your mouth for these new teeth or they erupt in a problematic way, you may experience infection, discomfort or other issues. In that case, there's a good chance a dental professional will recommend removing^ø some or all of your wisdom teeth.

At Bupa Dental, our dentists monitor kids' oral health for signs that their wisdom teeth might be poised to cause some trouble. You can find wisdom teeth removal at many of our clinics or get a referral for an oral surgeon who will handle more complex cases. Keep reading for further information about impacted wisdom teeth, wisdom tooth extraction, dry sockets and more.

What are "wisdom teeth"?

"Wisdom tooth" refers to a back molar that typically emerges after other permanent teeth have already erupted. Often, this happens between the ages of 17 to 25 years old (but not always). These teeth are usually located in the four back corners of your mouth.

When do wisdom teeth need removal?

While you usually have about 32 teeth in your mouth, sometimes your jaw can be too small to accommodate them all. If there’s not enough space for a wisdom tooth to come through properly, it may erupt at an angle. Before too long, it can start pushing against an adjacent tooth, causing pain and irritating the cheek and gums. The wisdom tooth will have become an impacted tooth.

Impacted teeth can lead to gum infection, tooth decay, damage to other teeth and even jaw cysts. Sometimes lymph glands under the jaw become swollen and sore as a result of recurring infections. Extraction of the wisdom tooth or teeth may be the best solution. Generally, upper wisdom teeth tend to be easier to remove than lower ones, and they are more likely to be impacted.

How does the dentist know if an extraction is needed?

Throughout your teens and twenties, your dentist will be observing and monitoring the situation with your wisdom teeth. If there’s no pain and no crowding, the wisdom teeth may settle in happily.

However, if there’s any discomfort or you find it difficult to open your mouth, a wisdom tooth may be impacted under the gums. A dentist can take an x-ray to find out if the impacted wisdom tooth needs to be extracted. Sometimes, all that’s needed is a small cut in the gums to help the wisdom tooth come through. A dentist can explain your options and recommend a full treatment plan based on your needs.

Does removal happen in a dental chair or at hospital?

This depends on your individual case. Your dentist can explain your circumstances, work with you to understand any other needs and recommend a full treatment plan.

If your dentist decides that a wisdom tooth needs to be extracted, they may use a local or general anaesthetic. Your dentist may be able to remove the wisdom tooth with the aid of a local anaesthetic while you’re sitting in the dental chair.

However, if it’s a complex case due to the position or shape of the roots, your dentist may refer you to a specialist oral surgeon. Surgeons perform these procedures while you're asleep under general anaesthetic in the hospital.

What other problems can wisdom teeth cause?

Some wisdom teeth grow through the gum, breaking the surface but not fully erupting. This can cause problems, including something called pericoronitis: swollen, irritated or infected gum tissue that surrounds the partially erupted tooth. Symptoms of pericoronitis can include pain, swelling or a bad taste in your mouth.

If your wisdom tooth has only partially erupted and is causing swelling or infection, you may need an antibiotic or even full removal.

Sometimes, wisdom teeth grow into spots that make them extraordinarily difficult to clean, heightening your risk of decay and gum disease. If that's the case, or if the tooth has already undergone decay, your dentist may recommend extraction.

Recovery time

Your dentist or surgeon can explain instructions for recovery and what you can expect based on your procedure and circumstances. They'll advise you on recovery and possible side effects - this should happen before removal.

Wisdom teeth tend to be large, so you may need stitches after they're removed. Removal may cause swelling or some bleeding for the first few days, but over-the-counter painkillers, such as paracetamol or ibuprofen, can help alleviate the pain. Your dentist or surgeon will provide instructions; don't hesitate to ask for take-home material like a pamphlet or print-out that explains recovery instructions, or ask for a number you can call if you have questions about your recovery.

Eating and drinking

In the first 24 hours after removal, it’s best to avoid applying pressure or suction to the wound. Try to be gentle if you need to rinse your mouth.

It’s best to stick to a soft diet such as soup or mashed potato - aim for soft dishes that minimise chewing. Your dentist or surgeon will recommend when you can start reincorporating foods from your regular diet; many people often wait about four days before trying to return to harder or chewier foods.

Minimising your risk of dry socket

Extracting an adult tooth leaves an empty socket, and a blood clot usually forms here. This blood clot functions almost as a kind of protective blanket, covering any bone or nerve endings that are exposed. If it doesn't develop or becomes dislodged, this can cause pain and may allow food debris to settle into the socket. Be on the lookout for any pain in the first few days after your extraction. Contact your dentist or surgeon if you start experiencing pain or discomfort in your teeth, jaws, face or neck.

Sometimes dry socket occurs for reasons outside of your control. However, using alcohol, tobacco or certain contraceptives during your recovery period may heighten your risk of dry socket. It's important to follow your dentist's or surgeon's instructions closely so that you can lower your chances of developing a problem like dry socket.

Brushing your teeth after wisdom teeth removal

Usually, you can resume brushing your teeth gently after the surgery. Just be extra cautious around the empty tooth sockets, and ask your dentist if they have any tips for keeping your teeth clean after extraction.