The removal of wisdom teeth, or third molars, is one of the most common procedures carried out in the UK.
The wisdom teeth grow at the back of your gums and are the last teeth to come through. Most people have 4 wisdom teeth – one in each corner.
Wisdom teeth usually grow through the gums during the late teens or early twenties. By this time, the other 28 adult teeth are usually in place, so there isn't always enough room in the mouth for the wisdom teeth to grow properly.
Because of the lack of space, the wisdom teeth can sometimes emerge at an angle or get stuck and only partially emerge. Wisdom teeth that grow through like this are known as impacted.
When to see a dentist
You should make an appointment to see your dentist if you're experiencing severe pain or discomfort from your wisdom teeth. Your dentist will check your teeth and advise you on whether they need to be removed.
If your dentist thinks you may need your wisdom teeth removed, they'll usually carry out an X-ray of your mouth. This gives them a clearer view of the position of your teeth.
As with any teeth problems, it's important to see your dentist as soon as possible, rather than waiting for your regular dental check-up.
Why are wisdom teeth removed?
Your wisdom teeth don't usually need to be removed if they're impacted but aren't causing any problems. This is because there's no proven benefit of doing this and it carries the risk of complications.
Sometimes, wisdom teeth that have become impacted or haven't fully broken through the surface of the gum can cause dental problems. Food and bacteria can get trapped around the edge of the wisdom teeth, causing a build-up of plaque, which can lead to:
- tooth decay (dental caries) – this develops when plaque begins to break down the surface of your tooth. When tooth decay becomes more advanced, it leaves holes (cavities) in the tooth, which can affect the surrounding teeth.
- gum disease (also called gingivitis or periodontal disease) – this occurs when plaque releases toxins that irritate your gums, making them red, swollen and painful. Gum disease can also affect the surrounding teeth and the bone around the wisdom teeth.
- pericoronitis – when plaque causes an infection of the soft tissue that surrounds the tooth.
- cellulitis – a bacterial infection in the cheek, tongue or throat.
- abscess – when pus collects in your wisdom teeth or the surrounding tissue due to a bacterial infection.
- cysts and benign growths – very rarely, a wisdom tooth that hasn't cut through the gum develops a cyst (a fluid-filled swelling).
Many of these problems can be treated with treatment such as antibiotics and antiseptic mouthwash, so removing your wisdom teeth is only recommended when other treatment hasn't worked.
How wisdom teeth are removed
Your dentist may remove your wisdom teeth or they may refer you to a specialist surgeon for hospital treatment.
Before the procedure, you'll usually be given a local anaesthetic injection to numb the area around the tooth. You'll feel some pressure just before the tooth is removed, as your dentist or oral surgeon needs to widen the tooth socket by rocking the tooth back and forth.
In some cases a cut may be needed in your gum, and the tooth may need to be cut into smaller pieces before it's removed.
The time it takes to remove the tooth will vary. Some procedures only take a few minutes, whereas others can take 20 minutes or longer.
After your wisdom teeth have been removed, you may experience swelling and discomfort, both on the inside and outside of your mouth. This is usually worse for the first 3 days, but it can last for up to 2 weeks.
As with all surgery, there are risks associated with removing a wisdom tooth. These include infection or delayed healing, both of which are more likely if you smoke during your recovery.
Another possible complication is "dry socket", which is a dull, aching sensation in your gum or jaw, and sometimes a bad smell or taste coming from the empty tooth socket. Dry socket is more likely if you don't follow the after-care instructions given by your dentist.
There's also a small risk of nerve damage, which can cause pain or a tingling sensation and numbness in the tongue, lower lip, chin, teeth and gums. This is usually temporary, but can be permanent in some cases.
Read more about the possible complications of wisdom tooth removal.
Dentists charge depending on the treatment required, unless you're under 18 or otherwise exempt from NHS charges.
If hospital treatment is required, it will be provided through the NHS free of charge.