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How will I know if I need my wisdom teeth removed?

Wisdom tooth removal is something that most people experience at some point in their lives. Knowing what to expect after surgery and what is involved in the recovery can ease some anxiety and can help with planning.

Why do I need my wisdom teeth removed?

Most of us have four wisdom teeth, but sometimes there can be fewer or none at all. Wisdom teeth (otherwise known as “third molars”) can start to cause problems as we reach our late teens or early twenties. Many people find that there isn’t enough room for their wisdom teeth to push through, which can cause the teeth to grow sideways, or become “impacted”. Also, as these teeth are situated so far back in the mouth, they can be uncomfortable to reach with a toothbrush, especially for those of us with a strong gag reflex. That’s when they can become decayed and cause toothache.

There are many other reasons why dentists would recommend removal of wisdom teeth, such as the damage it’s causing to adjacent teeth or planning for orthodontic treatment. If the extractions are likely to be complicated, your dentist will probably refer you to an oral & maxillofacial surgeon for the procedure. In this instance, you will also have the option to be put to sleep for the surgery, rather than have it done in-chair with local anaesthesia only.

Here are some of the more serious reasons why you would require your wisdom teeth to be removed.


This is a mild to moderate inflammatory response of the gum surrounding a partially erupted wisdom tooth. If this happens, part of the tooth may be covered by a flap of gum. Bits of food and bacteria can become trapped under the flap and this can cause swelling and low-grade infection. Pericoronitis is most common with lower wisdom teeth. If a wisdom tooth has had acute or recurrent pericoronitis then it is normally indicated for wisdom tooth removal.

Dental caries

Dental caries (tooth decay) is often present on wisdom teeth due to the difficulty in reaching the region to clean it adequately. If a wisdom tooth has extensive caries and is difficult to restore, we normally advise the patient to have the wisdom tooth extracted


Pericoronitis or caries that has caused the living pulp in the centre of the tooth to die can result in infection, either localised or spreading into the fascial spaces. In this case, an extraction would also be indicated because if the infection spreads rapidly it can be life threatening in the form of a malignant cyst or tumour.

Other common reasons for wisdom tooth extraction

  • Fractured tooth
  • Gum infection which causes difficulty to chew and open your mouth
  • Tooth decay
  • An impacted tooth can push against other teeth, causing pressure and lead to erosion of the other teeth.
  • Cyst around the wisdom teeth which if left unresolved cab destroy bone and result in a fractured jaw
  • They are ‘impacted’ and block from coming down by bone or other teeth.
  • As part of your orthodontic/orthognathic treatment plan
  • Prophylactic removal in the “at-risk” patient (for example, bacterial endocarditis)
  • As an aid to denture provision.

Circumstances in which removal is not suggested

  • There is a high risk of injury to the nerve during extraction of the wisdom tooth
  • The wisdom teeth and their neighbouring teeth are healthy with no signs of decay or cavities
  • They are fully functional and easy to clean.
  • They are not impacting neighbouring teeth or crowding the rest of the teeth.

How do I know if I need to get my wisdom teeth checked?

You may or may not experience symptoms associated with your wisdom teeth, which is why up-to-date X-rays and a six-monthly check-up and clean are the best ways to keep on top of your wisdom teeth.

Some of the symptoms you may experience are:

  • Tenderness and/or pain in the back of your mouth
  • Difficulty chewing
  • Red, swollen or uncomfortable gums
  • Sore lymph nodes and/or a fever
  • Persistent bad taste in your mouth
  • Unpleasant odour on your breath
  • Difficulty opening your mouth
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