What Are Wisdom Teeth?
Wisdom teeth are the third and final set of molars that develop at the very back of your mouth. Most people have four wisdom teeth, one in each corner. However, it is completely normal to have fewer than four, and some people never develop wisdom teeth at all.
These teeth are called "wisdom teeth" because they typically appear during the late teenage years or early twenties, an age historically associated with gaining maturity and wisdom. They are the last permanent teeth to erupt, arriving well after the rest of your adult teeth are already in place.
Why Do Wisdom Teeth Cause Problems?
The human jaw has gradually become smaller over thousands of years of evolution. Our distant ancestors had larger jaws that could accommodate 32 teeth, including the third molars. Modern diets, which require less heavy chewing, have contributed to smaller jaw sizes. For most people today, there simply is not enough room at the back of the mouth for wisdom teeth to come in properly.
What Is an Impacted Wisdom Tooth?
A wisdom tooth is considered impacted when it cannot fully emerge through the gum because something is blocking it, usually the jawbone or the neighboring tooth. Impaction is the most common problem associated with wisdom teeth.
There are different degrees of impaction. A partially impacted wisdom tooth has broken through the gum surface but has not fully emerged. A fully impacted wisdom tooth remains completely embedded in the jawbone or gum tissue. The angle of impaction also varies. The tooth may be angled toward the next tooth (mesial impaction), angled toward the back of the mouth (distal impaction), tilted sideways (horizontal impaction), or positioned straight up but trapped below the gum (vertical impaction).
Common Complications from Wisdom Teeth
- Pericoronitis: An infection of the gum tissue around a partially erupted wisdom tooth. Food and bacteria get trapped under the gum flap, causing pain, swelling, and sometimes difficulty opening the mouth.
- Damage to adjacent teeth: A wisdom tooth pressing against the second molar can cause decay, root damage, or bone loss on the neighboring tooth.
- Crowding: While the degree to which wisdom teeth cause crowding of the front teeth is debated, impacted wisdom teeth can push against adjacent molars.
- Cysts: A fluid-filled sac (cyst) can form around an impacted wisdom tooth. If left untreated, a cyst can damage the surrounding bone, teeth, and nerves.
- Tooth decay: Wisdom teeth are hard to reach with a toothbrush and floss, making them more susceptible to cavities.
Signs Your Wisdom Teeth May Need Attention
Some wisdom teeth cause problems without obvious symptoms, which is why regular dental X-rays are important during your late teens and early twenties. However, these signs suggest your wisdom teeth may need evaluation.
Common Symptoms
- Pain or tenderness at the back of the mouth behind your last molars
- Swollen, red, or tender gums around the wisdom tooth area
- Jaw pain or stiffness
- Difficulty opening your mouth fully
- Bad breath or an unpleasant taste near the back of the mouth
- Swelling on the side of the face near the jaw angle
Do Wisdom Teeth Always Need to Be Removed?
No. Not all wisdom teeth need to come out. If your wisdom teeth have fully erupted, are positioned correctly, are not causing pain or damage to neighboring teeth, and can be reached with a toothbrush and floss, they may not need to be removed.
Your dentist will monitor your wisdom teeth with periodic X-rays to check their position and development. The decision to remove or keep wisdom teeth is based on your specific situation, including the angle of the teeth, the available space in your jaw, your age, and whether there are current or likely future problems.
That said, most people do not have enough room for their wisdom teeth to come in properly. Studies estimate that the majority of young adults have at least one impacted wisdom tooth. When impaction is present, the risk of future complications is higher, and many dental professionals recommend removal before problems develop.
Wisdom Tooth Removal: What to Expect
Wisdom tooth extraction is one of the most commonly performed oral surgery procedures. Here is what the process involves.
Before the Procedure
Your dentist or oral surgeon will take X-rays (or a panoramic radiograph) to evaluate the position of your wisdom teeth, their roots, and their proximity to nerves and other structures. You will discuss anesthesia options, which typically include local anesthesia, sedation (IV or oral), or general anesthesia. The choice depends on how many teeth are being removed, the complexity of the extractions, and your comfort level.
During the Procedure
For a simple extraction, where the tooth has fully erupted, the dentist or surgeon loosens the tooth and removes it with forceps. The process is similar to any other tooth extraction.
For an impacted wisdom tooth, the surgeon makes a small incision in the gum tissue to access the tooth. If bone is covering the tooth, a small amount of bone is removed. The tooth may be divided into sections to make removal easier and minimize bone removal. Once the tooth is out, the surgeon cleans the area and may place stitches to help the gum heal. The entire procedure typically takes 30 to 60 minutes for all four wisdom teeth.
Recovery After Wisdom Tooth Removal
Most people recover from wisdom tooth removal within 3 to 7 days, though the surgical sites continue to heal for several weeks. Swelling and mild discomfort are normal for the first 2 to 3 days and typically peak on the second day. Your surgeon will prescribe pain medication or recommend over-the-counter options.
During the first 24 hours, rest, apply ice packs to the outside of your face, and eat soft foods. Avoid using a straw, smoking, and vigorous rinsing, as these can dislodge the blood clot that forms in the extraction site. Losing this clot, a condition called dry socket, can cause significant pain and delay healing.
Recovery Timeline
- Day 1 to 2: Rest, ice packs, soft foods, prescribed pain medication. Swelling begins.
- Day 2 to 3: Swelling typically peaks. Begin gentle warm saltwater rinses (not vigorous swishing).
- Day 3 to 5: Swelling and discomfort gradually decrease. Most people begin returning to normal activities.
- Day 7 to 10: Stitches dissolve or are removed. Most surface healing is complete.
- Week 2 to 4: The extraction sites continue to fill in with new tissue. Avoid hard, crunchy foods near the surgical sites.
Wisdom Tooth Removal Cost
The cost of wisdom tooth removal depends on whether the extraction is simple or surgical, the type of anesthesia used, and where you live. Costs vary by location, provider, and case complexity.
A simple extraction of a fully erupted wisdom tooth typically costs $75 to $250 per tooth. A surgical extraction of an impacted wisdom tooth typically costs $225 to $600 per tooth. If all four wisdom teeth are removed at once, the total cost including anesthesia generally ranges from $1,000 to $3,000.
Most dental insurance plans cover a portion of wisdom tooth extraction, particularly when the procedure is deemed medically necessary. If you are having the procedure done by an oral surgeon with IV sedation or general anesthesia, medical insurance may also provide some coverage. Check with both your dental and medical insurance plans.
The Oral Surgeon's Role in Wisdom Tooth Removal
General dentists remove many wisdom teeth, particularly those that have fully erupted. However, impacted wisdom teeth, especially those that are deeply embedded in bone or positioned near the inferior alveolar nerve, are best handled by an oral and maxillofacial surgeon.
An oral surgeon is a dentist who completed 4 to 6 years of hospital-based surgical residency training after dental school. This training includes advanced techniques for surgical extractions, anesthesia administration (including IV sedation and general anesthesia), and management of complications. You can learn more about oral surgeons on our oral surgery specialty page at /specialties/oral-surgery.
Find an Oral Surgeon Near You
If you need your wisdom teeth evaluated or removed, an oral surgeon can help. Every oral surgeon on My Specialty Dentist has verified specialty credentials. Search by location to find oral surgeons in your area and schedule a consultation.
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