Wisdom teeth: when is removal recommended?

Wisdom teeth, also known as third molars, are the last teeth to emerge in the mouth. They most commonly erupt between the ages of 17 and 25, although in some people they may appear later or may never erupt at all.

If there is enough space in the jaw, the teeth grow in the correct direction, and they can be cleaned properly, they may cause no problems. However, wisdom teeth often remain partially or completely trapped beneath the gum or within the jawbone, which may lead to pain, inflammation, or damage to the surrounding teeth.

The most common problems associated with wisdom teeth

Wisdom teeth may cause:

• insufficient space in the jaw;
• pain, pressure, or discomfort;
• recurring inflammation of the surrounding gum;
• swelling and tenderness;
• tooth decay affecting the wisdom tooth or the neighbouring tooth;
• difficulty cleaning the area and a build-up of plaque;
• damage to or resorption of the root of the adjacent tooth;
• the formation of a cyst around an unerupted tooth;
• an unfavourable or angled position.

Not every wisdom tooth needs to be removed automatically. If the tooth is healthy, fully erupted, functional, and easy to keep clean, it may remain in place without causing any difficulties.

When is wisdom tooth removal recommended?

A dentist may recommend removing a wisdom tooth if:

• it is growing in the wrong direction or is impacted in the jawbone;
• it causes recurring pain or inflammation;
• it is damaging the neighbouring tooth;
• it cannot be cleaned properly;
• it is significantly affected by tooth decay;
• it is only partially erupted and bacteria collect beneath the gum;
• a cyst or another pathological change has developed around it;
• there is a risk of future complications that may be more difficult to treat later.

The decision is always made individually based on the condition of the teeth, the position of the wisdom tooth, and the findings on an X-ray.

What happens during wisdom tooth removal?

Before the procedure, the dentist examines the area and assesses an X-ray. This helps determine the position of the tooth, the shape of its roots, and its relationship to the surrounding structures.

The procedure is usually performed under local anaesthesia. The patient may feel pressure or movement, but should not feel pain.

If the wisdom tooth is fully erupted and easily accessible, it can often be removed in a similar way to any other tooth. If it is partially or completely impacted, surgical removal may be necessary. During the procedure, the dentist or oral surgeon gently opens the gum, removes a small amount of bone if required, and may divide the tooth into smaller sections so that it can be removed as carefully as possible.

The wound may then be closed with stitches where necessary.

Recovery after the procedure

For several days after wisdom tooth removal, patients may experience:

• swelling;
• tenderness or pain;
• limited mouth opening;
• slight bleeding;
• discomfort when chewing or swallowing.

The healing process depends on the complexity of the procedure and the individual response of the body. After treatment, patients are usually advised to:

• rest;
• apply cold compresses;
• take the recommended pain medication;
• avoid smoking and alcohol;
• avoid strenuous physical activity;
• choose soft, lukewarm foods during the first few days;
• follow the dentist’s instructions carefully.

Most patients can return to their normal routine within a few days. After a more complex surgical procedure, however, swelling and tenderness may last longer.

If the pain becomes significantly worse after several days, or if you develop a fever, heavy bleeding, severe swelling, or an unpleasant smell from the wound, you should contact your dentist as soon as possible.

Do all wisdom teeth need to be removed?

No. Wisdom teeth should not be removed automatically without first assessing their condition. Every case needs to be considered individually.

Regular dental check-ups and X-rays can help identify whether a wisdom tooth is developing correctly or may cause complications in the future. Early treatment is usually simpler and gentler than removing the tooth during an acute infection or when severe pain is already present.