When does a wisdom tooth need to be removed?
A wisdom tooth generally needs removing when it is causing repeated infection, decay that cannot be restored, damage to the tooth in front of it, or pain that keeps returning.
Repeated swelling of the gum over a partly erupted wisdom tooth is one of the commonest reasons. So is decay on the back of the second molar, which is often caused by the wisdom tooth trapping food against it and is easy to miss without an X-ray.
When can a wisdom tooth be left alone?
A wisdom tooth that has come through fully, sits in a normal position, can be cleaned properly and has never caused symptoms does not need removing simply because it exists.
Removing healthy, symptom-free wisdom teeth as a matter of routine is not the standard approach. If a tooth is doing no harm and can be kept clean, leaving it alone and keeping an eye on it is a legitimate plan.
What does impacted mean?
Impacted means the tooth has not been able to come through into its normal position, usually because there is not enough room, so it stays partly or fully buried in the jaw.
Impaction on its own is not automatically a reason to remove a tooth. A fully buried wisdom tooth with no symptoms and nothing developing around it is often watched rather than removed. A partly erupted one is different, because the flap of gum over it traps bacteria and tends to cause repeated infection.
What is the recovery like?
Expect swelling and discomfort for two to three days, easing over about a week. A straightforward upper wisdom tooth is usually easier than a lower one.
A lower tooth that is deeply impacted or close to the nerve is a more involved procedure and the recovery reflects that. This is worth asking about specifically before the day, so the plan for time off is realistic.
Who should take out a difficult wisdom tooth?
A tooth that is deeply impacted, close to the nerve, or has awkward roots is a surgical case, and it is reasonable to ask who will actually be doing it.
There is nothing wrong with asking that question. Difficult anatomy is exactly where experience shows.
Common questions
Do all wisdom teeth need to be removed?
No. A wisdom tooth that has come through fully, sits normally, can be cleaned and has never caused symptoms does not need removing just because it is there.
What does an impacted wisdom tooth mean?
It means the tooth could not come through into its normal position, usually for lack of room, so it stays partly or fully buried in the jaw.
How long does recovery take after wisdom tooth removal?
Swelling and discomfort are usual for two to three days and generally settle over about a week. Lower and deeply impacted teeth take longer than upper ones.
Is wisdom tooth removal done under general anaesthetic?
Most are done under local anaesthetic in the clinic. Complex or multiple removals are sometimes handled differently, which is a decision made case by case.