Short answer: Wisdom teeth are the third molars that erupt at the very back of the mouth. Not every wisdom tooth needs to be removed. Extraction may be recommended for teeth that cause problems, decay, lead to recurrent gum infection or damage the neighbouring tooth. If there is enough space and the tooth is healthy, it can be monitored. The decision is made with a panoramic X-ray and an examination.
What is a wisdom tooth?
Wisdom teeth usually begin to erupt between the ages of 17 and 25. If there is not enough room in the jaw, they may not erupt fully; they may come through partially (semi-impacted) or remain inside the bone (impacted). In some people they may not develop at all.
When is extraction recommended?
- Recurrent gum infection: Food and bacteria can accumulate under the flap of gum over a partially erupted tooth. This can cause swelling, pain and difficulty opening the mouth.
- Decay: Because it is hard to clean, both the tooth itself and the neighbouring tooth can decay.
- Pressure on or damage to the neighbouring tooth: It can cause wear or decay on the root of the molar next to it.
- Cyst or pathological changes in the surrounding bone: If detected on the X-ray, extraction may be needed.
- Orthodontic or prosthetic planning: In some treatments, extraction may be considered to create space or because of the likelihood of continuing problems.
When can you wait?
- If the tooth has fully erupted, has enough space and can be cleaned
- If there are no complaints and no complications are seen on the X-ray
- If it is impacted but not harming the surrounding tissues, it can be monitored with regular check-ups
Even in these cases, a yearly check-up with an X-ray ensures that changes are noticed in time.
Relationship with orthodontics
It is a common belief that wisdom teeth cause crowding in the front teeth; however, scientific data do not show a clear result on this. The shifting of teeth can also be related to other factors. When orthodontic treatment is planned, the state of the wisdom teeth is assessed with a panoramic X-ray. For crowding, you can look at our page on treatment of crowded teeth.
How is extraction done?
- The position of the tooth and the nerve is assessed with a panoramic X-ray.
- Local anaesthesia is applied.
- For impacted teeth, the gum is opened, the bone is reshaped if necessary and the tooth is removed in sections.
- Stitches are placed if needed.
What to look out for after extraction
- For the first 24 hours, do not spit, do not use a straw and stay away from smoking.
- On the first day, a cold compress can be applied from the outside for swelling.
- Avoid hot and hard foods; prefer lukewarm, soft foods.
- Use the medicines prescribed by the clinician according to the instructions.
- If you have a fever, increasing swelling, a bad smell or bleeding that does not stop, contact the clinic.
For general oral care, you can have a look at our article on why oral health declines.
Which symptoms need assessment?
- Recurrent swelling or redness at the very back of the mouth
- Pain when opening the mouth and swallowing
- A bad smell or a discharge with an unpleasant taste
- Decay or sensitivity in the neighbouring molar
- Pain spreading to the jawbone or around the ear
These symptoms may come from the wisdom tooth, but they can also be due to other causes; the exact cause is determined by examination and X-ray.
Why is a panoramic X-ray important?
The direction of the wisdom tooth, its root structure, its relationship with the neighbouring tooth and its closeness to the nerve canal in the lower jaw are assessed on the panoramic X-ray. In some complex cases, three-dimensional imaging may also be requested. This allows the risks of extraction and who should perform the procedure to be planned more accurately.
What to tell your clinician before extraction
- Medicines you take regularly, especially blood thinners
- Allergies and previous operations
- Pregnancy or breastfeeding
- Chronic conditions (diabetes, heart disease, etc.)
Who performs the extraction?
Wisdom teeth that have erupted simply can be extracted by a dentist. In impacted cases, cases close to the nerve or cases that require surgery, a referral to an oral and maxillofacial surgeon may be made. Which path is followed is determined by the X-ray findings.
Eating and daily life after extraction
- In the first days, prefer soft foods such as lukewarm soup, yoghurt and purée.
- Be gentle when brushing around the extraction site; continue cleaning the other teeth.
- Gentle rinsing of the mouth is enough; avoid strong mouthwash and vigorous rinsing.
- It is a good idea to avoid intense sport and heavy exercise in the first days.
Possible risks
As with every surgical procedure, swelling, bruising, temporary difficulty opening the mouth and healing problems of the extraction wound can be seen after wisdom tooth extraction. With lower wisdom teeth, temporary changes in sensation related to closeness to the nerve may rarely occur. Information is provided before the procedure so that the risks can be assessed for each individual.
Frequently asked questions
Is pain normal while a wisdom tooth is erupting?
Mild discomfort can occur during eruption; if there is swelling, fever or difficulty opening the mouth, an examination is needed.
How long does healing take after wisdom tooth extraction?
Soft tissue healing mostly progresses over a few days to a week; complete bone healing takes longer.
Does a wisdom tooth that has not erupted have to be removed?
If there are no complaints or complications, it often does not need to be removed right away; it is monitored with regular check-ups, and the decision rests with the clinician.
How can you find out what suits you?
The information here is general; the right plan for you is determined by examination and clinical assessment. For appointments and directions, you can look at our contact page. At our clinic in Oran, Çankaya, Ankara, we go through your questions together.
