Wisdom Teeth: When They Need Removing, Impaction Symptoms and Recovery Tips

No, wisdom teeth do not always need to be removed. Wisdom teeth that have fully erupted, sit in the correct position, can be cleaned properly and cause no pain or infection can stay; removal is usually recommended when a tooth is impacted or causes problems such as repeated infection, decay or damage to neighbouring teeth.

Wisdom teeth, the third molars, usually come through between the late teens and early twenties. When there is not enough room in the jaw, they may erupt only partially or stay trapped under the gum or bone. Any decision about removal should be made individually after an examination and X-ray.

Symptoms of impacted wisdom teeth

Impacted wisdom teeth can cause no symptoms for years and are often spotted on a routine X-ray. When they do cause trouble, you may notice:

• Pain or pressure at the back of the mouth
• Swollen, red, tender gum over the tooth (pericoronitis)
• A bad taste or bad breath
• Difficulty opening your mouth or jaw ache
• Swelling of the cheek or under the jaw
• Sensitivity or decay in the neighbouring molar

When should wisdom teeth be removed?

Experts differ on whether symptom-free, healthy-looking impacted wisdom teeth should be removed as a precaution. The decision therefore depends on the tooth's position, your age, general health and the potential risks. Teeth that are left in place should be monitored at regular check-ups.

Removal is generally advised in situations such as:

• Repeated episodes of pericoronitis
• Decay in the wisdom tooth or the adjacent tooth that cannot be treated
• Damage to the root of the neighbouring tooth or bone loss
• A cyst or other pathology around the tooth
• When an orthodontic or restorative treatment plan requires it

What happens during wisdom tooth extraction?

A fully erupted wisdom tooth is removed under local anaesthetic, much like any other extraction. For impacted teeth, the gum may need to be opened, a small amount of bone removed and the tooth sectioned into pieces, so the procedure can take a little longer.

The roots of lower wisdom teeth can lie close to a nerve in the jaw. Your dentist will assess this with an X-ray, and 3D imaging if needed, and explain any risks beforehand. More complex cases may be referred to an oral surgeon.

Wisdom tooth extraction recovery tips

Swelling and discomfort are usually most noticeable for the first two to three days and then gradually ease. The key is to protect the blood clot that forms in the socket; losing it too early can lead to a painful condition called dry socket (alveolar osteitis).

• Bite on the gauze for as long as advised and use a cold compress on the first day.
• Avoid vigorous rinsing, spitting and straws for the first 24 hours.
• Do not smoke, as it significantly increases the risk of dry socket.
• Eat soft, lukewarm foods and chew on the other side.
• Keep brushing your other teeth from the next day, taking care around the socket.
• Take any medicines only as your dentist recommends.

When to contact your dentist

Seek advice promptly if pain gets worse rather than better after a few days, or if you have bleeding that will not stop, a fever, increasing swelling, or difficulty swallowing or breathing. If your wisdom teeth are bothering you, you can book an examination with Dr. Merve Hakan in Baku to have them assessed.