What Are Wisdom Teeth?

Wisdom teeth, also called third molars, are the last set of permanent teeth to develop. They are located at the very back of the mouth, behind the second molars. Most people see their wisdom teeth begin developing during their mid-teen years, with full development typically completing between the late teens and early twenties.

What Does It Mean When a Wisdom Tooth Is Impacted?

Most adults develop 32 permanent teeth, but in many cases the jaw simply does not have enough room to accommodate all four wisdom teeth. When a tooth cannot fully erupt into its proper position, it is considered impacted. Impacted teeth are unable to emerge for chewing and are difficult to keep clean, which makes them more prone to complications over time.

Types of Impaction

An x-ray of the mouth and jaws, called a panorex, is used to determine whether wisdom teeth are impacted, how much room exists for eruption, and how involved the removal would be.

Soft Tissue Impaction The wisdom tooth has partially emerged, but there is not enough room around the gum tissue to allow for proper cleaning.

Partial Bony Impaction The tooth has partially erupted but cannot fully emerge or function properly in the bite. Cleaning around it is difficult, creating ongoing risk for complications.

Complete Bony Impaction The tooth has no space to erupt at all. It remains fully embedded in the jaw bone, or if partially visible, requires more complex surgical techniques to remove. Unusual positioning or jaw bone anatomy can make this situation more involved.

Risks of Keeping Impacted Wisdom Teeth

When wisdom teeth do not have room to come in properly, several problems can develop. Removal is generally recommended before the roots are fully formed, typically between ages 12 and the early 20s. Complications become more common after age 30.

Infection The most frequent issue associated with impacted wisdom teeth is pericoronitis, a localized gum infection. When there is not enough room for the tooth to fully erupt, the surrounding gum tissue can become irritated and infected. This can result in recurring pain, swelling, and difficulty chewing or swallowing.

Cyst Formation Cysts, which are fluid-filled sacs that develop inside the jaw bone, can form around impacted wisdom teeth. They expand slowly and can destroy surrounding jaw bone and, in some cases, adjacent teeth. Tumors, though rare, have also been associated with impacted wisdom teeth that are not removed.

Crowding Impacted wisdom teeth may contribute to crowding, particularly in the lower front teeth. This is most noticeable in patients who have had orthodontic treatment. While wisdom teeth are not the sole cause of crowding, they can be a contributing factor.

Damage to Adjacent Teeth When there is not enough room to clean around a wisdom tooth, the second molar directly in front of it can be affected. This can lead to gum disease, bone loss, or decay on that neighboring tooth.

Timing of Removal

Early evaluation, often during the mid-teen years, generally leads to better surgical outcomes. Younger patients tend to have shorter recovery times and a lower risk of complications. If wisdom teeth are fully impacted and not actively causing problems, a surgeon may recommend monitoring rather than immediate removal.

As patients age, surgery and recovery can become more involved. Roots become more established in the jaw bone, and healing can take longer.

What to Expect on the Day of Surgery

• Most patients choose sedation for comfort. Anesthesia options are discussed at the consultation.

• Do not eat or drink for at least 6 hours before surgery, with the exception of prescription medications taken with a small sip of water.

• A responsible adult must accompany you and remain available for the rest of the day following the procedure.

• The procedure itself typically takes 30 to 60 minutes. Plan to be at the office for approximately 90 minutes in total.

• Dissolvable stitches are used when needed.

• Start with clear liquids after surgery and gradually reintroduce foods as comfort allows.

• Avoid dairy products on the day of surgery to reduce the risk of nausea.

• Pain is typically managed with ibuprofen. Stronger medication may be prescribed depending on the case.

• If you are prescribed antibiotics and are also on birth control pills, use an alternative form of contraception during that time.

Cost and Insurance

The cost of wisdom tooth removal depends on the complexity of the case and the type of anesthesia used. Insurance coverage for wisdom teeth varies by plan. Staff can help clarify what your benefits cover based on your specific situation.