Wisdom teeth, also called the third molars, are the very last teeth to come in. The first set of molars typically grow in around age 6, and the second set around age 12. Wisdom teeth usually begin to erupt in the late teens or early twenties. They are the four teeth located farthest back in your mouth, top left and right, bottom left and right. Some people even develop more than four wisdom teeth!
Our prehistoric forebears had larger, stronger jaws—the better to chew the tough foods they ate, like raw meats and plants. Our modern diet doesn’t require such forceful chewing. Earlier humans also tended to lose more teeth, so extra teeth developing around young adulthood had more room to grow in. Today, our better dental health and smaller jaws mean that there’s less room for wisdom teeth, so they are more likely to cause problems.
Because they emerge so late, often after the jaw has stopped growing and other teeth have filled the mouth, many wisdom teeth are either impacted—meaning they have not grown in fully—or misaligned. About 90% of people have at least one impacted wisdom tooth, according to the American Association of Oral and Maxillofacial Surgeons. This can lead to decay, plaque buildup, and infection.
When they grow in normally and function well, without pain or cavities, wisdom teeth may never cause a problem. However, they often have insufficient room to erupt properly and need to be removed.
Impacted wisdom teeth, those that are growing in your jaw, or teeth that appear on X-ray to be likely to cause problems in the future, should definitely come out. Other reasons to consider having wisdom teeth extracted include:
- Inflamed gums and cavities. Tissue around wisdom teeth is harder to clean, and can more easily become swollen and inflamed, leading to bacterial growth and cavities.
- Misalignment, crowding, and damage to other teeth.
- Sinus problems. Wisdom teeth problems can cause sinus pain and congestion.
- Jaw damage. Fluid-filled balloons called cysts sometimes develop as a result of impacted teeth. They can damage or even destroy the jawbone as they expand.
If there is any hint that your wisdom teeth should be removed, it is better to do it early on. Wisdom teeth extraction as you get older (in your 30s, 40s and beyond) can be more difficult and painful, with a higher chance of complications and slower rate of healing.
Most wisdom teeth extractions are performed under some form of sedation. Your dentist or oral surgeon will discuss with you the type of anesthesia that is best for you. You will need to bring someone with you to your appointment who can bring you home and stay with you until the anesthesia has worn off. You should not have anything to eat or drink for at least six hours before your surgery, to avoid risking complications from the anesthesia.
Everyone is different, but most people have some pain and discomfort, along with minor bleeding and swelling, after wisdom teeth are removed. Your dentist will provide you with over-the-counter pain medication, as well as prescription pain medication. It’s a good idea to try any non-narcotic medications first and see if that relieves your pain sufficiently.
Take it easy for a few days after your surgery. You can put ice packs on your jaw for the first day to help keep swelling down, and then use moist heat to help relieve tightness and stiffness in order to make it easier to open your mouth. Be sure to follow all of your dentist’s post-operative instructions.