HealthInfo West Coast-Te Tai Poutini

Wisdom teeth

Ngā niho kōhari tuatoru

By the time they are 18, most people have 32 teeth. The third molars are the last teeth to come through, at around age 18 to 20. These 4 teeth are also known as wisdom teeth.

Most people only have enough space in their mouths for 28 teeth. Because the wisdom teeth are the last to come through, they often do not have enough space. In this case, they may be crooked, only come through partly or remain completely embedded within the jaw.

Wisdom teeth may have to be removed (extracted) to correct an actual problem or to prevent future problems. But if your wisdom teeth are aligned properly and you can reach them to clean them, they will probably not have to come out.

Possible problems with wisdom teeth

Some of these problems are:

• Your jaw may not be large enough to fit them and they may become impacted. This means they cannot break through your gums, as shown in the picture. Your wisdom teeth may break part way through your gums, causing a flap of gum tissue (called operculum) to grow over them. This can trap food and germs, causing an extremely painful infection, called pericoronitis. It might also cause an abscess.
• One or more of your wisdom teeth may come in at an awkward angle. The top of the tooth may face forward, backward or to either side.
• Growing wisdom teeth put pressure on the surrounding tissues, causing pain and discomfort.
• More serious problems can happen when impacted wisdom teeth cause a cyst to form or damage the roots of neighbouring teeth. If this happens, you may lose those teeth.

Deciding whether to have your wisdom teeth removed

If your wisdom teeth are not causing problems, it may be difficult to decide whether to have your wisdom teeth removed to prevent possible future problems. There are several things to consider.

• You may never have any problems with your wisdom teeth.
• It is rarely harmful to your health to have your wisdom teeth removed, but there are minor risks involved with any surgery.
• In younger people (late teens and early 20s), the wisdom teeth's roots are not fully developed, and the jawbone is not as dense. This means it is easier to take the teeth out than it is later in life. The easier it is to remove the teeth, the easier your recovery is likely to be.
• Most problems with wisdom teeth develop between the ages of 15 and 25.
• If you have a medical condition that may get worse over time and your teeth may cause problems, consider having your wisdom teeth removed while you are healthy.

Removing wisdom teeth

How easy it is to remove your wisdom teeth depends on where they are. A wisdom tooth that has fully come through your gum can be taken out the same way as any other tooth. But a wisdom tooth can be underneath your gum and embedded in your jawbone. If so, your gum will have to be lifted and a part of the bone lying over the tooth will have to be removed. A tooth embedded like this may have to be taken out in several small sections.

Easier cases can sometimes be done under a local anaesthetic in your local dental clinic. More complicated wisdom teeth can be removed in hospital or a dental clinic. You will probably be under a general anaesthetic or lighter "conscious sedation" for this. Your oral and maxillofacial surgeon or dentist will let you know which is best for you.

Complications of removing wisdom teeth

Swelling

Your face may swell around the area where the tooth was removed. To minimise the swelling, place an ice pack (or a small bag of frozen peas wrapped in a clean cloth) on the side of your face. Keep it there for 10 to 15 minutes every hour for the first 24 hours.

Bleeding

The space where your tooth was may bleed. To control the bleeding, put a piece of clean, moist gauze over the empty tooth socket and bite down firmly. Keep doing so for about 45 minutes. Repeat this if you continue to have light bleeding. If you have heavy bleeding that will not stop, contact your dentist or oral surgeon.

Dry socket

Dry socket is common. It happens when a blood clot has failed to form in the extracted tooth socket or when the blood clot that does form is dislodged. This delays healing.

Dry socket typically happens 3 or 4 days after the extraction. It causes pain (ranging from dull to severe) and a foul mouth smell. Your oral surgeon or dentist will treat this by placing a medicated dressing in the socket. You will need to replace the dressing every 24 hours until the symptoms go away.

Paraesthesia

Paraesthesia is less common. Wisdom teeth impacted in the jaw may be close to nerves. Sometimes these nerves can be bruised or damaged when the tooth is removed. This causes numbness (called a paraesthesia) of the tongue, lip or chin that can last a few days, weeks or months. Very rarely, it may be permanent.

Self-care after wisdom tooth removal

• Take the pain relief prescribed by your surgeon or dentist for the first 48 hours. It is better to prevent pain by taking it according to instructions rather than to wait for pain to develop.
• Chew food on the other side of your mouth. If you have had a difficult extraction, only consume soft foods and liquids for the first 24 hours.
• Try not to rinse or spit for 24 hours after your teeth come out.
• Avoid hot liquids (such as coffee or soup), hard food, alcohol, vigorous exercise and touching the wound. These things can dislodge the clot which helps you to heal.
• While your mouth is numb, be careful not to bite your tongue, lip or the inside of your cheek.
• Avoid smoking because it decreases the blood supply and can bring germs and contaminants into your mouth.
• After 24 hours, rinse your mouth with an antiseptic mouth rinse or warm salt water (half a teaspoon of salt in a cup of warm water) after meals and before bed.
• Keep your mouth clean. Brush your teeth with a soft toothbrush twice a day.

Written by HealthInfo clinical advisers. Last reviewed March 2025.

Sources

Page reference: 75198

Review key: HICPA-75368