They call them wisdom teeth because they tend to appear during a person’s late teens to early twenties, a time of life when people are said to become wise. Although the “wisdom” part may be debatable, the teeth are real — and often they’re a problem.
Wisdom teeth don’t need to be removed unless they’re causing trouble. This trouble can include pain, infection, decay, damage to nearby teeth, or crowding of existing teeth. In many cases your dentist might recommend preemptive removal of wisdom teeth before these problems start.
Some people have no issues with their wisdom teeth. Either these teeth never arrive or they grow in normally. But the majority of people — 90% of Americans — have had wisdom teeth removed.
What’s the problem with wisdom teeth?
There was a time when our ancestors made good use of this extra set of late-arriving molars. They ate tougher foods with stronger jaws, and wisdom teeth were an easy way to replace damaged teeth that had been lost without the benefit of modern dental care.
Today, however, our jaws are smaller and our teeth last longer. So we have less available space inside our mouths. There’s not as much room for wisdom teeth as there used to be, so they can become impacted when they start to grow in.
Impaction happens when the new, growing wisdom tooth gets blocked by an existing tooth. The new tooth can’t rise up fully to take its place, and it often forms at a wonky angle. This puts pressure on existing molars, leading to pain and swelling. Impacted molars are also more difficult to clean, and are therefore more likely to suffer from cavities and infection.
Complications related to wisdom teeth can include:
- Pain and irritation
- Swelling and jaw stiffness
- Tender or bleeding gums
- Difficulty eating or chewing
- A cyst around the tooth
- Crowded, crooked, or misaligned teeth
- Sinus issues
- Cavities
So is it really necessary to remove wisdom teeth?
Honestly, this is something that needs to be decided on a case by case basis. The structure and state of your existing teeth need to be taken into account. Radiographs of your incoming wisdom teeth will help with the decision.
Some dental professionals believe that wisdom teeth are removed too frequently and unnecessarily, and that the surgery shouldn’t be performed in the absence of a legitimate problem.
On the other hand, wisdom teeth are easier to remove when patients are younger and the roots are not fully formed. Waiting for problems to arise could make for a more complicated surgery when the patient is older.
What is wisdom tooth extraction like?
Removal of wisdom teeth can be performed by a dentist or oral surgeon. Depending on the location and state of the teeth, they might be simply pulled or possibly cut apart and removed in pieces. A small incision in the gums may be required. But don’t worry, you’ll be given a local anesthetic before the procedure — general sedation might also be an option — and the most you’ll feel is some pressure as the tooth is rocked back and forth to loosen it.
Often the removal only takes a few minutes per tooth, but it could take twenty minutes or more if your teeth are stubborn.
If you’re having all four wisdom teeth removed — aka “four on the floor” — you might have the option to take them out in two separate surgeries or to do them all at once. Unless you really love visiting your dentist, it’s probably easiest for you to just get it over with.
Aftercare following wisdom tooth extraction
In the days following extraction of wisdom teeth, you will likely experience some swelling and mild discomfort. Antibiotic and anti-inflammatory medications will be prescribed, and it’s important to follow through on the complete course of your antibiotics. If you experience any adverse reaction to the antibiotics, let your dentist know immediately for a revision to your prescription.
Be sure to carefully follow all post-op instructions provided by your dentist. These are important to allow for proper formation of blood clots and successful healing.
You’ll want to avoid any stressful activities such as exercise that might disturb the blood clots as they heal. You’ll also need to follow a soft diet of room temperature foods, and you need to avoid drinking through a straw — seriously, you’ll also be pulling blood clots right up through the “straw” of the holes where your tooth used to be. And if you’re a smoker? DO NOT SMOKE until the wounds are fully healed.
Stages of healing after wisdom tooth removal
| Blood clots form and bleeding stops | 24–48 hours |
| Gums heal | 2–6 weeks |
| New bone forms | 4–6 months |
Potential complications of wisdom tooth extraction
As with any surgery, there are potential risks. While wisdom tooth extraction is generally a very successful surgery, potential side effects to be aware of include:
- Dry socket — Dry socket happens when a blood clot fails to form after removal of the tooth. You might feel an intense throbbing pain like a toothache. You might also experience an unpleasant smell, and if you were to look into the empty tooth socket you would see exposed bone rather than a blood clot. You’re at higher risk of developing dry socket if you smoke or otherwise don’t follow your post-op instructions. Older patients are also at higher risk. Dry socket can be treated with a medicated dressing until it heals.
- Nerve injury — A less common complication is damage to the trigeminal nerve, which can leave you with numbness or tingling in the tongue, lip, teeth, and gums. This injury is temporary in most cases.
- Bleeding and infection — Let your dentist know if you’re experiencing discharge or persistent pain and swelling at the extraction site.
