Top 10 Things to Know About Wisdom Teeth

How this list is ordered

The points move from the basics, such as what wisdom teeth are and when they appear, through the problems they can cause, to treatment, recovery and the link with braces, and end with the option of leaving them alone. This is an editorial ordering and not a ranking by importance, and the right path depends on your own teeth, which only a dentist can assess with an examination and X-ray. We keep the guidance general and based on NHS and professional sources. If you have pain, swelling or difficulty opening your mouth, contact a dentist or NHS 111 rather than relying on this guide.

A short background

Wisdom teeth are the third molars, the furthest back on each side of the upper and lower jaws, so most adults can have up to four. They are the last teeth to develop, and the jaw may not have enough room for them. Some people have wisdom teeth that come through without trouble, some have them partly come through or stay hidden under the gum and bone, and some never develop them at all. Dentists often learn what is happening from a panoramic or similar X-ray. Many people only need advice, monitoring and good cleaning, and not all wisdom teeth need to be removed.

1. What wisdom teeth are

Wisdom teeth are the third and last set of molars, sitting at the very back of the mouth. They are larger teeth designed for grinding, and because they are so far back they are harder to clean than other teeth. People often call them wisdom teeth because they appear when people are older. They are normal teeth, and whether they cause problems depends on whether they have space and come through in a good position. If they are healthy, well positioned and cleanable, they can be used for chewing like any other molar. It matters because knowing what they are removes some of the worry. Watch out for confusing wisdom tooth pain with other causes of pain at the back of the mouth, and ask a dentist to check.

2. When they appear

Wisdom teeth commonly start to come through in the late teens or early twenties, though the timing varies, and some appear later in adult life. The process can take months or years, and may cause tenderness at the back of the jaw as the tooth pushes through. A dentist may notice them on a routine X-ray before they appear, and may recommend monitoring. It matters because pain in the late teens or twenties may be wisdom teeth, but a dentist should check, since other problems can look similar. Watch out for sudden severe pain, swelling or fever, which are not normal teething, and for a bad taste or discharge around a back tooth. Eruption itself is not a reason to remove a tooth.

3. Not everyone has them

A number of people have fewer than four wisdom teeth, and some have none, because the teeth never formed. This is a normal variation, and an X-ray can show what is present. Some people have extra teeth or wisdom teeth that look very different in size and shape. It matters because you cannot tell from the front of the mouth, and because a plan for orthodontic or other dental care may depend on what is there. Watch out for assuming you have none because you cannot see them, and for assuming you will definitely need them removed. A dentist can explain what an X-ray shows and what, if anything, needs to be done.

4. Why they can cause trouble

The jaw often has limited space at the back, so wisdom teeth may come through at an angle, only partly or not at all. A partly erupted tooth leaves a flap of gum where food and bacteria collect, and the tooth is hard to clean, so decay, gum disease and infection are more likely in that area and in the tooth in front. Problems are not guaranteed, and many people have no trouble. It matters because pain, swelling, a bad taste and bad breath at the back of the mouth are common signs. Watch out for repeated episodes, which suggest the problem will recur, and for decay in the second molar next to a wisdom tooth.

5. Impacted wisdom teeth

An impacted wisdom tooth is stuck under the gum or against the tooth in front or the jaw bone and cannot come through properly. Many impacted teeth cause no symptoms and are found on X-rays, and may be left and monitored. Others can cause pain, infection, decay in the neighbouring tooth or, rarely, cysts. The NHS notes that wisdom teeth that are impacted but cause no problems usually do not need to be removed. It matters because the word impacted sounds worse than it often is. Watch out for new pain, swelling, a bad taste or difficulty opening your mouth, and for any change on later X-rays that your dentist wants to discuss.

6. Pericoronitis

Pericoronitis is inflammation or infection of the gum around a partly erupted wisdom tooth, usually in the lower jaw. Symptoms include a sore, swollen gum, a bad taste, bad breath, pain on biting or swallowing, difficulty opening the mouth and sometimes fever. The NHS suggests keeping the area clean, rinsing gently with warm salt water and using painkillers as directed, while seeing a dentist, who may clean under the flap, prescribe antibiotics if needed and discuss removal if it keeps returning. It matters because it can flare repeatedly. Watch out for swelling that spreads, a high temperature, difficulty swallowing or breathing, which need urgent help, and do not put tablets on the gum.

7. When removal is advised

Removal is generally considered when wisdom teeth cause repeated infection, decay that cannot be treated, damage to neighbouring teeth, gum disease, cysts or other pathology. UK guidance has advised against removing wisdom teeth that are healthy and symptom-free simply to prevent possible future problems. A dentist will weigh the benefits against the risks of surgery, which depend on how the tooth lies and its relationship to nerves and the sinus. Treatment may be done by a dentist or an oral surgeon, sometimes with sedation. It matters because the decision is individual. Watch out for pressure to remove healthy teeth without a clear reason, and ask about the reasons, risks and alternatives.

8. Removal and recovery

Removing a wisdom tooth can be straightforward or can involve cutting the gum and removing bone, and it is usually done under local anaesthetic, with sedation or general anaesthetic for complex cases. Swelling, soreness and difficulty opening the mouth are common for several days. The NHS suggests following the dentist's aftercare instructions, such as avoiding rinsing hard for the first day, eating soft food, avoiding hot drinks, smoking and alcohol, and using painkillers as directed. A dry socket, where the clot is lost, causes severe pain a few days later and needs a dentist. Watch out for bleeding that does not stop, spreading swelling, fever, numbness that persists and signs of infection, and contact the dentist or NHS 111.

9. Wisdom teeth and braces

A common belief is that wisdom teeth push the front teeth and cause crowding after braces. The evidence for this is limited, and orthodontic bodies have not found strong proof that wisdom teeth are a main cause of late crowding, so removal is not usually recommended only to protect a straight smile. Your orthodontist may nevertheless want to know about your wisdom teeth, because they can affect planning, for example if there is not enough room for movement of back teeth. Our guides on wisdom teeth and braces and on impacted molars explain more. Watch out for being told that removal will guarantee stable teeth, and for stopping retainers because you had wisdom teeth out.

10. Leaving them alone

If wisdom teeth are healthy, well positioned and clean, leaving them is a perfectly good option. The dentist will keep an eye on them at check-ups and may recommend an X-ray from time to time. Good cleaning, including a small brush for the back of the mouth, helps to keep them healthy. If problems develop, you can revisit the decision. It matters because unnecessary surgery carries risks and cost. Watch out for neglecting the back of the mouth, for ignoring early signs of infection and for skipping check-ups. If you are unsure, ask your dentist for the reasons for their advice and whether a second opinion would be reasonable.

Cleaning around wisdom teeth

Because they sit so far back, wisdom teeth are easy to miss when brushing. Use a small-headed toothbrush, angle it towards the back of the last tooth and spend time on the biting and cheek surfaces. A small interdental brush or a single-tufted brush can help reach behind the last tooth. A fluoride mouthwash at a different time of day may be advised if you are at risk of decay. Cleaning gently with warm salt water can ease a sore flap temporarily. If food keeps catching, or gum bleeds in that area, tell your dentist, because it may mean the tooth needs attention.

Costs and where treatment is done

NHS treatment for a wisdom tooth that needs removal falls within the usual NHS dental charge bands in England, and different charges and arrangements apply in Scotland, Wales and Northern Ireland. Complex cases may be referred to a hospital or an oral surgery service, where waiting times can be long. Private removal is charged by the practice, and fees vary with complexity and the type of anaesthetic. Ask for a written plan and cost, and ask what is involved, including follow-up. If you are waiting for an appointment and develop swelling, fever or trouble swallowing, seek urgent care.

Questions to ask your dentist

Useful questions include how many wisdom teeth you have and where they are, whether they are coming through well or are impacted, whether an X-ray is needed and why, whether they are likely to cause problems, what the benefits and risks of removal are, whether you can keep them and be monitored, who would carry out any surgery and what type of anaesthetic would be used, how long recovery is likely to take and what it will cost. If you are having orthodontic treatment, ask whether your wisdom teeth affect the plan. Writing the answers down helps you to decide calmly and compare opinions.

Coping while you wait for treatment

If you are waiting for an appointment and have mild discomfort, the NHS suggests painkillers taken by mouth as directed on the pack, if they are suitable for you, and gentle warm salt-water rinses, with careful cleaning of the area. Avoid very hot or cold food on that side and do not put anything on the gum. Eating softer food can help. This does not treat the cause, so keep your appointment. Seek urgent help for swelling, a high temperature, difficulty opening your mouth fully or swallowing, or a bad taste with discharge. Never try to pull or cut a wisdom tooth or the gum yourself.

Common wisdom tooth myths

Several beliefs are worth checking. One is that everyone must have their wisdom teeth out, when many people keep theirs without trouble. Another is that wisdom teeth always cause crowding, for which the evidence is limited. A third is that removal is always painful and risky, when most are routine and recover within days, although complex cases carry more risk. A fourth is that you can tell if you need removal by looking in the mirror, when an X-ray is needed. A fifth is that you cannot have your wisdom teeth removed once you are older, when treatment is possible, though the risks and healing differ. A dentist can give personal advice.

Anxiety and sedation

Many people feel anxious about wisdom tooth surgery. Tell the practice about your worries so that they can plan, for example with longer appointments, a clear explanation of each step, a signal to pause or, where appropriate, sedation. Sedation and general anaesthetic carry their own risks and need preparation, such as fasting and arranging for someone to take you home, so follow instructions carefully. Ask what pain relief and aftercare to expect. Understanding the process often reduces fear. If cost or anxiety is delaying care for a painful tooth, speak to a dentist or NHS 111 about options.

Key takeaways

Wisdom teeth are the last molars, and many people have no trouble with them. They can cause problems when there is not enough room, and removal is generally advised for repeated infection, decay or damage and not for healthy teeth. Recovery takes days, and the link with crowding after braces is unproven. This is general information, not personal medical advice, so ask your dentist what is right for your teeth.

Useful related pages

This guide is for general information only. It is not a diagnosis, treatment plan, or substitute for advice from a registered dentist or orthodontist.