Do Wisdom Teeth Always Need To Be Removed? What You Should Know

By Author: sean20
Total Articles: 5
Comment this article

Wisdom teeth have a reputation for causing trouble.

Someone mentions that theirs are starting to come through, and almost immediately another person tells them about having all four removed. It is easy to come away with the impression that wisdom teeth are basically unwanted teeth that should always be taken out.

That is not actually the case.

Some wisdom teeth appear normally, remain healthy and never cause any significant problems. Others only partly emerge, grow at an awkward angle or become difficult to keep clean.

The important question is not simply whether you have wisdom teeth. It is whether they are healthy, correctly positioned and causing problems in your particular mouth.

What Are Wisdom Teeth?

Wisdom teeth are the final adult molars located right at the back of the mouth.

They generally begin appearing later than your other permanent teeth, which is why many people first notice them during their late teenage years or early adulthood.

Not everyone develops the same number.

Some people have all four wisdom teeth. Others have fewer, and some people may ...
... not develop them at all.

Having wisdom teeth by itself is not a dental problem.

Trouble usually starts when there is not enough room for a tooth to come through normally or when its position makes the surrounding area difficult to clean.

Why Do Wisdom Teeth Sometimes Cause Problems?

By the time wisdom teeth begin to appear, most of the other adult teeth are already in place.

Sometimes there is enough space at the back of the jaw and the wisdom tooth comes through without much drama.

Sometimes there is not.

A wisdom tooth may become trapped beneath the gum, emerge only partly or grow towards the tooth beside it. Dentists commonly describe a tooth that cannot erupt normally because of its position as impacted.

A partly erupted wisdom tooth can also leave an area of gum around it where food and bacteria become trapped.

Because this part of the mouth is so far back, keeping it clean can be difficult even for someone who normally brushes thoroughly.

That combination can lead to irritation and, in some cases, infection.

Does Wisdom Tooth Pain Mean It Has to Come Out?

Not necessarily.

This is one of the most useful things to understand about wisdom teeth.

Pain around the back of the mouth can occur for different reasons. Gum tissue around an erupting wisdom tooth may become irritated. Food may become trapped around a partly erupted tooth. Decay, infection or pressure from the position of the tooth may also contribute.

The appropriate treatment depends on what is actually causing the discomfort.

This is why having the area examined is more useful than assuming that pain automatically means extraction.

Tooth Heaven, for example, notes in its information about general and restorative dentistry in Kensington that wisdom-tooth discomfort does not necessarily mean the tooth must be removed.

Sometimes cleaning the area and monitoring the tooth may be appropriate. In other situations, repeated problems may make removal a more sensible option.

The decision comes after assessment, not before it.

Signs That a Wisdom Tooth May Need Attention

Wisdom-tooth problems do not feel the same for everyone.

One person may experience an obvious toothache, while another mainly notices soreness in the gum behind their last molar.

Things worth paying attention to include persistent pain at the back of the mouth, gum swelling, tenderness when chewing, an unpleasant taste, recurring bad breath or difficulty cleaning around the tooth.

You may also notice food repeatedly getting trapped in the same area.

Another warning sign is a problem that seems to settle and then keeps returning.

Occasional irritation can sometimes improve temporarily, but repeated episodes are worth discussing with a dentist.

Victorian health information about wisdom teeth explains that problem wisdom teeth can be associated with infection, impaction, tooth decay and damage to nearby teeth.

Why Does the Gum Around a Wisdom Tooth Become Sore?

A partially erupted wisdom tooth can sometimes have a flap of gum sitting over or around part of it.

Food and plaque can collect underneath this tissue.

Because the area is difficult to reach with a toothbrush, irritation can develop and the gum may become red, swollen or painful.

You might notice that chewing on that side feels uncomfortable.

Sometimes there is a bad taste or unpleasant breath as well.

Keeping the area clean may help with mild irritation, but recurring symptoms should not simply be ignored.

A dentist can determine whether the problem is temporary or whether the position of the wisdom tooth is likely to keep causing difficulties.

What Does an Impacted Wisdom Tooth Mean?

An impacted wisdom tooth is one that has not been able to come through normally.

It may remain underneath the gum, become trapped partly in the jawbone or sit against the tooth in front of it.

Interestingly, an impacted tooth does not always hurt.

Some are discovered during dental X-rays even though the person has no symptoms at all.

That is one reason dentists do not make decisions about wisdom teeth based solely on pain.

The position of the tooth, its effect on nearby structures and whether it can be kept healthy all matter.

Why Are Dental X-Rays Useful?

You can only see part of a wisdom tooth by looking inside the mouth.

An X-ray can provide more information about what is happening underneath the gum.

It may show how the tooth is positioned, whether it is impacted and how close it sits to neighbouring teeth and other structures.

This information can help the dentist decide whether the tooth can simply be monitored or whether treatment should be discussed.

If removal is being considered, imaging also helps with planning.

Not every wisdom-tooth examination requires exactly the same type of imaging. Your dentist will decide what is appropriate based on your individual situation.

When Might Removal Be Recommended?

There is no rule saying that every wisdom tooth should come out.

Removal may be considered when a tooth is repeatedly causing problems or is likely to damage oral health.

Examples can include repeated infections around the tooth, significant decay, damage to a neighbouring tooth or a position that makes adequate cleaning extremely difficult.

A dentist may also recommend treatment when other problems are identified during an examination or X-ray.

On the other hand, a healthy wisdom tooth that has erupted normally, can be cleaned properly and is not damaging surrounding structures may simply be monitored.

The presence of the tooth alone is not necessarily a reason to remove it.

What Happens If a Wisdom Tooth Needs to Be Removed?

The procedure depends on the position of the tooth.

A wisdom tooth that has fully erupted may be relatively straightforward to remove.

A tooth that remains underneath the gum or is deeply impacted can require a more involved procedure.

Before treatment, the dentist will examine the area and review relevant imaging.

Local anaesthetic is commonly used to numb the area. More complex cases may involve other forms of anaesthesia or referral depending on the circumstances.

Your dentist should explain the procedure, expected recovery and relevant risks before treatment takes place.

It is worth asking questions if anything is unclear.

What Is Recovery Like?

It is normal to expect some soreness after a wisdom tooth has been removed.

Swelling and tenderness may occur during the early part of healing, particularly after more complicated extractions.

Your dentist will provide instructions for looking after the area.

Following those instructions matters.

One of the most important parts of early healing is protecting the blood clot that forms in the socket where the tooth was removed.

That clot helps protect the area underneath while healing begins.

This is one reason patients are often advised not to vigorously rinse the mouth immediately after an extraction.

Smoking can also interfere with healing and increase the risk of complications.

What Is Dry Socket?

You may have heard someone describe severe pain after having a wisdom tooth removed and refer to it as dry socket.

Dry socket is a possible complication after a tooth extraction.

It occurs when the blood clot in the socket does not form properly or is lost before the area has had enough time to heal.

The pain can be significantly stronger than ordinary post-extraction soreness and may begin a few days after the tooth was removed.

If pain becomes severe rather than gradually improving, contact the dentist who performed the extraction.

Do not simply assume that intense pain is something you have to tolerate until it goes away.

Can You Look After Wisdom Teeth Instead of Removing Them?

In some cases, yes.

If a wisdom tooth is in a reasonable position and is not creating problems, good oral hygiene and regular monitoring may be all that is necessary.

The challenge is reaching it.

The very back of the mouth can be awkward to clean.

A small-headed toothbrush can sometimes make access easier. Your dentist or dental hygienist may also show you how to clean around the area more effectively.

The main goal is preventing plaque and food from repeatedly collecting around the tooth and nearby gum.

If you are struggling to clean the area despite your best efforts, mention that during your dental appointment.

Do Not Ignore Repeated Wisdom Tooth Problems

It can be tempting to manage recurring discomfort with pain relief and wait for it to disappear again.

The problem with that approach is that it does not tell you why the symptoms keep coming back.

If the area has become sore several times, having it examined makes sense.

Recurring inflammation or infection may indicate that the position of the tooth makes the problem difficult to prevent permanently.

A dentist can assess whether better cleaning, monitoring or another treatment approach is appropriate.

When Should You Seek More Urgent Help?

Mild tenderness around an erupting wisdom tooth is very different from a rapidly worsening infection.

Seek professional advice promptly if pain becomes severe, swelling is increasing or you develop symptoms that make you feel generally unwell.

Difficulty opening the mouth can also occur when the area around a wisdom tooth becomes significantly inflamed.

More serious symptoms such as difficulty swallowing or breathing require urgent medical attention.

Do not try to drain swollen gum tissue yourself or attempt to remove anything around the tooth with sharp objects.

What If Your Wisdom Teeth Do Not Hurt at All?

No pain is certainly a good sign, but it does not always tell the entire story.

Some impacted wisdom teeth produce very few noticeable symptoms.

Regular dental examinations allow the dentist to monitor the area and decide whether anything has changed.

If a wisdom tooth is healthy and stable, monitoring may continue for years without intervention.

That is very different from automatically removing a tooth simply because it exists.

Ask Questions Before Agreeing to Treatment

If a dentist recommends removing a wisdom tooth, you are allowed to ask why.

Ask what problem the tooth is causing.

Find out whether the issue is likely to continue if the tooth stays in place.

Ask about the complexity of removal, the expected recovery period and any risks that apply to your situation.

You can also ask whether monitoring is a reasonable alternative.

Understanding the reason behind a recommendation makes it much easier to make an informed decision.

Wisdom Teeth Should Be Treated Individually

There is a tendency to talk about wisdom teeth as though they always come as a package.

“All four have to come out.”

That is not necessarily how treatment decisions work.

One wisdom tooth may be healthy while another is impacted.

One side may be easy to clean while the other repeatedly becomes inflamed.

Your dentist should assess what is happening with each tooth rather than making assumptions based simply on how many wisdom teeth you have.

The Bottom Line

Wisdom teeth are not automatically bad teeth.

Some come through normally and cause little or no trouble. Others become impacted, difficult to clean or associated with repeated pain and infection.

The key is finding out which situation applies to you.

For people around Kensington, Flemington and Melbourne's inner west, Tooth Heaven provides general and restorative dental care, including assessment and treatment of wisdom-tooth concerns.

If a wisdom tooth has started causing recurring pain or swelling, having it examined can give you a much clearer idea of what is actually happening.

And if the tooth is healthy and causing no problems, you may discover that keeping an eye on it is all that is needed.