What are wisdom teeth? When and why do they need removal? Find answers to common questions about wisdom teeth removal.

Most people's wisdom teeth come through in their late teens or early 20s. For some lucky people, these teeth emerge without a hitch and live in harmony with the rest of their teeth. 

But problems can happen if a wisdom tooth isn’t able to fully break through (“erupt”), grows in at the wrong angle, or pushes against your other teeth. In those cases, a dentist might recommend wisdom teeth surgery* to remove one or all of your wisdom teeth. Your individual circumstances will determine whether this procedure is simple or complex.

Do wisdom teeth always need removal?

Not always. Plenty of wisdom teeth develop normally without causing problems, but you or your child should still visit a dentist so a professional can monitor how wisdom teeth are developing and whether they’re poised to cause any trouble.

Wisdom teeth might cause issues if they:

• get stuck in your gum tissue when they’re erupting (impacted wisdom teeth)
• come through too long or too short
• come through at the wrong angle
• push against your other teeth (crowding).

Teeth that erupt in problematic ways can make it harder to brush and floss, possibly increasing your risk of tooth decay or other oral health problems. They might also cause other teeth to shift position.

Impacted wisdom teeth may lead to gum infections. If you have symptoms of an infection (like a toothache, swelling or fever), make an emergency appointment with a dentist or doctor.

What are wisdom teeth anyway? 

They’re molars in the very back corners of your mouth. They usually appear after all or most of your permanent teeth have already emerged. For a lot of people, this happens around age 17-25, but some people’s wisdom teeth might erupt earlier or later.

What does wisdom teeth surgery involve?

Wisdom teeth removal is sometimes as straightforward as a general tooth extraction, but it can also be a more complex procedure. Generally, upper wisdom teeth are easier to remove than lower wisdom teeth. Your dentist will take x-rays of your mouth to see the tooth's position and recommend a treatment plan.

For a simple extraction, your dentist will loosen the wisdom tooth using forceps until it can be pulled out.

More complex extractions may require a referral to a specialist oral surgeon. If the tooth is impacted in the gum, a dentist or oral surgeon might need to cut a small flap to access the tooth, which they’ll close afterward using stitches. It’s possible they’ll need to remove the tooth in separate pieces and potentially some of the surrounding bone.

Like many dental procedures, dentists and surgeons might use local anaesthetic during your extraction. But if your procedure is more complicated, you may need general anaesthesia* in a hospital.

What to expect after wisdom teeth removal

Like any surgical procedure, wisdom teeth surgery involves risks. A dentist or surgeon should explain all of the potential risks to help you make an informed decision. 

If you feel pain or have bad breath a few days after your surgery, make an appointment to see your dentist so they can check for any signs of complications.

Dry sockets

One of the most common complications of wisdom teeth surgery is something called “dry socket.” When a dentist or surgeon extracts a tooth, a blood clot forms in the socket (hole) left behind.

This clot acts as a kind of protective blanket for your bone and nerve endings, helping the area heal. 

The blood clot might dislodge or fail to form. Without the clot to protect the underlying bone and nerve endings, you could be at risk of pain, infection and a delayed recovery period.  Common signs of a dry socket include: 

• fever
• pain that worsens instead of subsides after your procedure
• bad breath or a bad taste in your mouth

Dry sockets tend to be more common with wisdom teeth removal than other types of extraction, but you can lower your risk by following your dentist’s or surgeon’s instructions.

Post-removal care

Your dentist or surgeon should provide you with individualised advice based on your procedure and circumstances. But there are a few basic guidelines and tips you can follow.

• Try to rest for at least 24 hours and up to a week after wisdom tooth removal.
• Only eat soft foods.
• Don't smoke for at least 48 hours. This could affect healing and may increase your risk of developing dry socket.

It's normal to experience some pain and swelling after surgery, which you may be able to manage by taking over-the-counter medication. Your dentist may prescribe antibiotics if they think there's a higher risk of infection.

What are the alternatives to wisdom teeth removal?

If your wisdom tooth doesn't need removal, you can try to ease the pain or swelling by taking painkillers and anti-inflammatory medication.

If a tooth is only slightly impacted, your dentist might only need to remove part of the gum to help the tooth come through.

Questions about wisdom teeth? 

If you have questions about your wisdom teeth or want to speak with a dentist, find a dental clinic near you.

*Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.