Most people expect their wisdom teeth to emerge at some point during the late teens and early adult years. But while many people have one to four wisdom teeth, some people don’t have any at all. Wisdom teeth are the third set of molars in the back of your mouth. Although it’s common to get wisdom teeth, they can cause issues.
You can experience pain as the teeth break through the gums. And if there isn’t enough space in your mouth for your wisdom teeth, they can become impacted below the gum surface. In either case, you may need to have them removed.
Why don’t some people have wisdom teeth?
A dental X-ray can reveal whether you have third molars. Not having any wisdom teeth might come as a surprise, and you might think there’s something wrong with your oral health. But the reality is, it’s perfectly okay not to have these molars.
According to researches, it’s estimated that anywhere from 5 to 37 percent of people are missing one or more of their third molars. The reason is unknown, but lack of these teeth could involve genetics. So if one of your parents doesn’t have wisdom teeth, you may not have them either.
Other factors that might influence the lack of wisdom teeth include environment, diet, and chewing function.
Keep in mind, though, just because you can’t see your wisdom teeth doesn’t mean they don’t exist. Sometimes, wisdom teeth become impacted or stuck in the gums. And as a result, they don’t fully emerge.
When do wisdom teeth come in?
Wisdom teeth emerge at different ages. Typically, you can expect your third molars to come in around your late teens or early adult years, between the ages of 17 and 21. However, some people get their wisdom teeth earlier, and some people get them later.
If you need your wisdom teeth removed, it’s easier to do so when you’re younger. Not that you can’t schedule surgery later in life, but when you’re young, the bones around your gums are softer and the nerve roots in your mouth haven’t completely formed.
What is the purpose of wisdom teeth?
Wisdom teeth removal is a common procedure because there’s often only room for 28 teeth in the mouth. If all four of your wisdom teeth come in, resulting in 32 teeth, this may lead to overcrowding.
Since the mouth only has space for about 28 teeth, what is the purpose of wisdom teeth?
One belief is that wisdom teeth served as replacement teeth for our distant ancestors. Today, we eat foods that are soft or tender, and most people practice good oral hygiene. Both factors help reduce the likelihood of losing teeth.
Since our ancestors ate different types of foods — maybe not as soft — and didn’t have regular dental appointments, they might have dealt with gum and teeth problems like tooth decay or tooth loss. If so, wisdom teeth possibly provided extra teeth for chewing.
What are complications of wisdom teeth?
Of course, there’s no rule that says you have to remove a wisdom tooth that emerges — especially if you have space in your mouth. Some people choose removal even when their wisdom teeth don’t cause problems to avoid complications down the road. And some people don’t seek removal until they have pain.
If you put off removal because you’re not having any symptoms, you may need to eventually schedule oral surgery. Wisdom teeth tend to cause problems the longer they remain in the mouth.
Common complications associated with wisdom teeth include:
Pain in the back of the mouth is a common sign of emerging wisdom teeth. Tooth pain can start off as mild and intermittent. The gums in the back of your mouth may hurt for a few days, and then the pain subsides. This can happen on and off over several months or years. However, pain can gradually increase to the point where it becomes difficult to chew or talk. Pain is often due to the tooth pressing on the nerves in the mouth.
Swelling and redness
Along with pain, signs of an emerging wisdom tooth include redness or swelling in the gums around your third molars.
As your wisdom teeth emerge, bacteria can get trapped in your gums, leading to an oral infection. Signs of an infection include:
- tenderness in your jaw
- bad breath
- a foul taste in the mouth
Food may also get trapped in the gums around third molars, which can cause a cavity on your emerging third molar. Teeth in front of wisdom teeth can also get cavities because there isn’t enough space to brush or floss.
When there isn’t enough space in your mouth for wisdom teeth, other teeth can shift out of place as these teeth emerge. They may become misaligned or crooked.
Impacted wisdom teeth
Impacted wisdom teeth are third molars at the back of the mouth that don’t have enough room to emerge or develop normally.
Wisdom teeth are the last adult teeth to come into the mouth (erupt). Most people have four wisdom teeth at the back of the mouth — two on the top, two on the bottom.
Impacted wisdom teeth can result in pain, damage to other teeth and other dental problems. In some cases, impacted wisdom teeth may cause no apparent or immediate problems. But because they’re hard to clean, they may be more vulnerable to tooth decay and gum disease than other teeth are.
Impacted wisdom teeth don’t always cause symptoms. However, when an impacted wisdom tooth becomes infected, damages other teeth or causes other dental problems, you may experience some of these signs or symptoms:
- Red or swollen gums
- Tender or bleeding gums
- Jaw pain
- Swelling around the jaw
- Bad breath
- An unpleasant taste in your mouth
- Difficulty opening your mouth
Wisdom teeth (third molars) become impacted because they don’t have enough room to come in (erupt) or develop normally.
Wisdom teeth usually emerge sometime between the ages of 17 and 25. Some people have wisdom teeth that emerge without any problems and line up with the other teeth behind the second molars. In many cases, however, the mouth is too crowded for third molars to develop normally. These crowded third molars become trapped (impacted).
An impacted wisdom tooth may partially emerge so that some of the crown is visible (partially impacted), or it may never break through the gums (fully impacted). Whether partially or fully impacted, the tooth may:
- Grow at an angle toward the next tooth (second molar)
- Grow at an angle toward the back of the mouth
- Grow at a right angle to the other teeth, as if the wisdom tooth is “lying down” within the jawbone
- Grow straight up or down like other teeth but stay trapped within the jawbone
Impacted wisdom teeth can cause several problems in the mouth:
- Damage to other teeth.If the wisdom tooth pushes against the second molar, it may damage the second molar or increase the risk of infection in that area. This pressure can also cause problems with crowding of the other teeth or require orthodontic treatment to straighten other teeth.
- The wisdom tooth develops in a sac within the jawbone. The sac can fill with fluid, forming a cyst that can damage the jawbone, teeth and nerves. Rarely, a tumor — usually noncancerous (benign) — develops. This complication may require removal of tissue and bone.
- Partially impacted wisdom teeth appear to be at higher risk of tooth decay (caries) than other teeth. This probably occurs because wisdom teeth are harder to clean and because food and bacteria get easily trapped between the gum and a partially erupted tooth.
- Gum disease.The difficulty cleaning impacted, partially erupted wisdom teeth increases the risk of developing a painful, inflammatory gum condition called pericoronitis (per-ih-kor-o-NI-tis) in that area.
You can’t keep an impaction from occurring, but keeping regular six-month dental appointments for cleaning and checkups enables your dentist to monitor the growth and emergence of your wisdom teeth. Regularly updated dental X-rays may indicate impacted wisdom teeth before any symptoms develop.
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.
Wisdom Teeth Removal
Getting your wisdom teeth removed is a fairly common procedure. You might feel nervous about it, but you can relax. It’s not as bad as you might think.
If you’ve been told you need your wisdom teeth removed, you could feel a little concerned. There’s no need to be anxious. Your dentist makes getting your wisdom teeth removed as easy and stress-free as possible. And having your wisdom teeth removed will put an end to the pain and discomfort that you may have been experiencing.
How long it takes
This depends on the removal procedure and where it is done.
- In a general dental practice the extraction will usually take around 30 to 60 minutes
- At oral surgery clinics it will usually take around 45 to 90 minutes
- For extraction under general anaesthetic at the hospital you will usually be at the hospital for around 2 to 3 hours
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 minimize 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.
Will removal affect my brushing?
You may find it uncomfortable to brush shortly after having wisdom teeth removed, especially around any wounds. For this reason, your dentist might recommend that you use a mouthwash to help keep the area clean.
What is ‘dry socket’?
Dry socket, the informal name for alveolar osteitis, is when the blood clot helping the wound heal around your tooth socket becomes infected, causing severe pain which is not controlled with medicine. Dry socket requires immediate attention. This usually involves anti-inflammatories to ease the discomfort, a medicated antiseptic dressing to promote healing and possibly a course of antibiotics to control the infection.
Can I have wisdom teeth removed whilst pregnant?
There is no reason to believe that the procedure would have any impact on your pregnancy. However, dentists may opt not to use X-rays and you will most likely be put under local, rather than general, anaesthetic. In many cases your dentist is likely to wait and carry out the treatment after the birth, unless it was considered an emergency procedure.
Will I need time off to recover?
Most people need two or three days off work to recover from the effects of the anaesthetic after they have had wisdom teeth removed. Those with a more physical job may need an extra day or two. If your job involves driving you should be fine to return after 24-48 hours after having had anaesthetic, but you need to use your own judgement and seek advice from your dentist if you are unsure.