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Wisdom Tooth Extraction

Wisdom tooth extraction is a surgical procedure to remove one or more wisdom teeth — the four permanent adult teeth located at the back corners of your mouth on the top and bottom.

If a wisdom tooth doesn't have room to grow (impacted wisdom tooth), resulting in pain, infection or other dental problems, you'll likely need to have it pulled. Wisdom tooth extraction may be done by a dentist or an oral surgeon.

To prevent potential future problems, some dentists and oral surgeons recommend wisdom tooth extraction even if impacted teeth aren't currently causing problems.


Why it's done

Wisdom teeth, or third molars, are the last permanent teeth to appear (erupt) in the mouth. These teeth usually appear between the ages of 17 and 25. Some people never develop wisdom teeth. For others, wisdom teeth erupt normally — just as their other molars did — and cause no problems.

Many people develop impacted wisdom teeth — teeth that don't have enough room to erupt into the mouth or develop normally. Impacted wisdom teeth may erupt only partially or not at all.

An impacted wisdom tooth may:

  • Grow at an angle toward the next tooth (second molar)
  • Grow at an angle toward the back of the mouth
  • Grow at a right angle to the other teeth, as if the wisdom tooth is "lying down" within the jawbone
  • Grow straight up or down like other teeth but stay trapped within the jawbone

Problems with impacted wisdom teeth

You'll likely need your impacted wisdom tooth pulled if it results in problems such as:

  • Pain
  • Trapping food and debris behind the wisdom tooth
  • Infection or gum disease (periodontal disease)
  • Tooth decay in a partially erupted wisdom tooth
  • Damage to a nearby tooth or surrounding bone
  • Development of a fluid-filled sac (cyst) around the wisdom tooth
  • Complications with orthodontic treatments to straighten other teeth

Preventing future dental problems

Dental specialists disagree about the value of extracting impacted wisdom teeth that aren't causing problems (asymptomatic).

It's difficult to predict future problems with impacted wisdom teeth. However, here's the rationale for preventive extraction:

  • Symptom-free wisdom teeth could still harbor disease.
  • If there isn't enough space for the tooth to erupt, it's often hard to get to it and clean it properly.
  • Serious complications with wisdom teeth happen less often in younger adults.
  • Older adults may experience difficulty with surgery and complications after surgery.

Risks

Most wisdom tooth extractions don't result in long-term complications. However, removal of impacted wisdom teeth occasionally requires a surgical approach that involves making an incision in the gum tissue and removing bone. Rarely, complications can include:

  • Painful dry socket, or exposure of bone when the post-surgical blood clot is lost from the site of the surgical wound (socket)
  • Infection in the socket from bacteria or trapped food particles
  • Damage to nearby teeth, nerves, jawbone or sinuses



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