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:
- 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:
March 31, 2015
- 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.
- Wisdom teeth. American Association of Oral and Maxillofacial Surgeons. http://myoms.org/procedures/wisdom-teeth-management. Accessed March 9, 2015.
- Mettes TG, et al. Surgical removal versus retention for the management of asymptomatic impacted wisdom teeth. Cochrane Database of Systematic Reviews. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD003879.pub3/abstract. Accessed March 9, 2015.
- Wisdom teeth. MouthHealthy.org. http://www.mouthhealthy.org/en/az-topics/w/wisdom-teeth. Accessed March 9, 2015.
- Coulthard P, et al. Surgical techniques for the removal of mandibular wisdom teeth. Cochrane Database of Systematic Reviews. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004345.pub2/abstract. Accessed March 9, 2015.
- Postextraction problems. The Merck Manual Professional Edition. http://www.merckmanuals.com/professional/dental_disorders/dental_emergencies/postextraction_problems.html. Accessed March 9, 2015.
- What to do following an extraction. British Dental Health Foundation. https://www.dentalhealth.org/tell-me-about/topic/routine-treatment/what-to-do-following-an-extraction. Accessed March 9, 2015.
- Bouloux GF, et al. What is the risk of future extraction of asymptomatic third molars? A systematic review. Journal of Oral and Maxillofacial Surgery. In press. Accessed March 9, 2015.
- Wisdom tooth removal. NHS Choices. http://www.nhs.uk/conditions/Wisdom-tooth-removal/Pages/Introduction.aspx. Accessed March 9, 2015.
- Salinas TJ (expert opinion). Mayo Clinic, Rochester, Minn. March 17, 2015.