Wisdom Teeth

Wisdom teeth, or third molars, are the last teeth to develop and appear in the mouth. They are called “wisdom teeth” because they usually appear during a person’s late teens or early twenties, which has been called the “age of wisdom” The normal position of wisdom teeth is behind the upper and lower second, or 12-year molars. Many times, the jaws are not large enough to accommodate the four wisdom teeth. Therefore, wisdom teeth cause more problems than any other teeth in the mouth. In fact, for nine out of ten people at least one wisdom tooth remains underneath the gum due to lack of space in the mouth.


When a wisdom tooth is blocked from erupting or coming into the mouth normally, it is termed “impacted”. A tooth may be only partially impacted, meaning it grows in crooked and breaks through the gum only partially, or it may fail to break through at all and thus remains totally impacted. Serious problems can develop from partially impacted teeth, such as pain, infection, and crowding of, or damage to, adjacent teeth. For totally impacted teeth, more serious problems can occur if the sac that surrounds the impacted tooth fills with fluid and enlarges to form a cyst. This enlargement can hollow out the jaw and result in permanent damage to the adjacent teeth, jawbone and nerves. If the cyst is not treated, a tumor may develop from the walls of the cyst and a more involved surgical procedure may be required for removal.

Mesioangular impaction
U&L impactions
Lower impaction

Many problems with wisdom teeth can occur with few or no symptoms, so there can be damage without your knowing it. It is important to know that as wisdom teeth develop, their roots become longer and the jawbone denser. Thus, as a person grows older, it becomes more difficult to remove wisdom teeth and complications can become more severe. In addition, as people age there is an increased chance of the symptoms mentioned above. For these reasons, the dental or oral surgeon may recommend the removal of wisdom teeth even if they are not yet causing obvious problems, particularly for young adults.

Impacted wisdom teeth often grow at an awkward angle making their removal more difficult. As a person grows older the tooth becomes longer and the jawbone denser. Partially or fully impacted wisdom teeth are more likely to pose serious problems in older individuals.

Distoangular impaction
Horiz & Vertical impactions


Wisdom teeth, or third molars, do not always erupt properly when they decide to make an appearance. It is wise to get an early opinion from your dentist on getting wisdom teeth pulled before they become impacted, causing pain, swelling, infection, cavities or gum disease.

Why don’t wisdom teeth grow in right?

The shape of the modern human mouth is often too small to accommodate wisdom teeth which make their first appearance in young adults between the ages of 15 to 25. Over the course of time in the evolutionary process, humans learned to harness fire for cooking foods and developed blade tools to better process food before consumption, they reduced the need for strong jaws to chew food.

What does impacted mean?

When wisdom teeth do not have room to grow or they have not reached their final position by age 25, they are considered impacted. Third molar impaction is the most prevalent medical developmental disorder.

What are the problems caused by impacted third molars?

Partially erupted wisdom teeth are breeding grounds for bacteria and germs that may cause infection, and cysts and tumours may grow on a trapped wisdom tooth. Jaw pain and gum disease may occur. Not all wisdom teeth cause problems, however.

Isn’t antibiotic therapy enough to suppress the infection?

Antibiotics only soothe infected wisdom teeth for a short time. Since people frequently use a wide variety of antibiotics, the infection may be resistant to such medication and does not solve the real problem: The tooth cannot fit in your mouth.

When is removal necessary?

It is not wise to wait until wisdom teeth bother you. Early removal, as advised by your dentist, is generally recommended to avoid problems, such as an impacted tooth that destroys the second molar. People younger than 16 heal easier too. At an early age, people should be evaluated by their dentist who can track third molar development with the help of X-rays. Second molars should be visible to lessen the chance of damaging them during surgery. This occurs at age 11 or 12, so wisdom teeth should be removed when the decision has been made that they cannot erupt into an acceptable position.

What if there are no symptoms?

People with symptoms of impaction, such as pain, swelling and infection should have their wisdom teeth removed immediately. However, those with no symptoms can avoid the chance of ever suffering from the pain of impacted wisdom teeth or achieve better orthodontic treatment results by having them removed. Asymptomatic impacted wisdom teeth also should be removed to reduce the chance of unexplained pain, accommodate prosthetic appliances, or avoid cavities, periodontal disease, bone shrinkage and tumour development.

How is the tooth removed?

Surgery for impacted wisdom teeth consists of removing of the gum tissue over the tooth, gently stripping connective tissue away from the tooth and bone, removing the tooth and sewing the gum back up.