Pulling impacted wisdom teeth may be recommended when a wisdom tooth is causing pain, repeated infections, damage to neighbouring teeth or other dental problems. However, not every impacted wisdom tooth needs to be removed.
An assessment is needed to establish the position of the tooth, whether it is causing disease and how close it is to surrounding structures. Dental X-rays can help a dentist or oral surgeon plan the safest approach.
What Is an Impacted Wisdom Tooth?
If you are wondering what is an impacted wisdom tooth, it is a wisdom tooth that cannot emerge into the mouth normally. Wisdom teeth are the final molars to develop. They usually appear during the late teenage years or early twenties, although this varies. If there is insufficient room for the tooth, it may become trapped against another tooth, beneath the gum or within the jawbone.
A tooth may be fully covered or partially visible in the mouth. The exact wisdom teeth position can influence whether it causes problems and how straightforward removal may be. Some impacted wisdom teeth remain symptom-free for many years. Others can contribute to inflammation, infection or damage to the tooth immediately in front of them.
Do All Impacted Wisdom Teeth Need to Be Removed?
No. An impacted wisdom tooth does not automatically need to be removed simply because it has not erupted normally. Current NICE guidance states that healthy impacted wisdom teeth that are free from disease should not be removed routinely. Monitoring may be appropriate when the tooth is not causing problems, and there is no evidence of disease. Removal may be considered when an impacted tooth is associated with problems such as:
- Recurrent infection around the tooth
- Significant pain or swelling
- Tooth decay that cannot be effectively managed
- Gum disease affecting the area
- Damage to the neighbouring tooth
- A cyst or other disease associated with the tooth
- A dental abscess
The decision should be based on an individual assessment rather than the presence of impaction alone. To understand how the position of an impacted tooth can affect treatment planning, read our guide to Types of Impacted Wisdom Teeth.
Why Are Wisdom Teeth Sometimes Removed?
Wisdom teeth can be difficult to clean because of their position at the back of the mouth. A partially emerged wisdom tooth can be particularly prone to problems. When part of the tooth remains covered by gum tissue, food and bacteria may collect beneath the gum flap. This can lead to inflammation and repeated infection, often called pericoronitis.
An impacted tooth can also affect the second molar immediately in front of it. Decay, gum problems or damage to the neighbouring tooth may develop when the area is difficult to clean. In some cases, a decayed impacted wisdom tooth cannot be predictably restored, making extraction a more appropriate option.
Wisdom Teeth Pushing Other Teeth: What Can Happen?
Many people worry about wisdom teeth pushing other teeth and causing crowding. There is not strong evidence that erupting wisdom teeth alone are responsible for pushing the front teeth forward and causing general crowding. However, an impacted wisdom tooth can place pressure directly against the neighbouring molar in certain positions.
How Is an Impacted Wisdom Tooth Assessed?
An examination usually begins with a discussion of your symptoms and a clinical assessment of the back of the mouth. The dentist will consider whether the tooth has erupted partially, whether the surrounding gums are inflamed and whether there is enough space for the tooth. An impacted wisdom tooth Xray is usually an important part of treatment planning. Imaging can show:
- The depth of the tooth
- Its angle and position
- The shape and development of its roots
- Its relationship with the neighbouring molar
- Its relationship with important nerves and surrounding bone
Impacted Wisdom Teeth Surgery: What Happens?
Impacted wisdom teeth surgery varies according to the position and depth of the tooth. Some teeth can be removed relatively simply. Others require a surgical approach because they are covered by gum or bone, positioned at an angle or difficult to access. The procedure may involve making an incision in the gum to reach the tooth. A small amount of bone may need to be removed, and the tooth may sometimes be divided into smaller sections before extraction.
The procedure is commonly carried out using local anaesthetic, which numbs the treatment area. Depending on the complexity of the extraction and the individual circumstances, dental sedation may also be considered where appropriate.
How Long Does Impacted Wisdom Tooth Removal Take?
The length of the procedure depends on several factors. A relatively accessible tooth may take only a short time to remove. A deeply positioned tooth or one close to important anatomical structures may require more careful surgical planning. According to NHS guidance, wisdom tooth removal itself often takes a relatively short period, although more complex procedures can take longer. The appointment also includes preparation, anaesthesia and post-treatment instructions.
Impacted Wisdom Tooth Pain
Impacted wisdom tooth pain can vary from mild discomfort to significant inflammation. Pain may develop when the tooth presses against surrounding tissues, when the gum around a partially erupted tooth becomes inflamed or when infection develops. Symptoms can include:
- Pain at the back of the mouth
- Swollen or tender gums
- Discomfort when chewing
- Jaw stiffness
- Difficulty opening the mouth fully
- A bad taste in the mouth
- Pain that spreads towards the jaw or ear
Pain that repeatedly returns should be assessed rather than managed indefinitely with home remedies. Recurrent symptoms may indicate an underlying problem requiring treatment.
Impacted Wisdom Teeth Pain Relief
Temporary impacted wisdom teeth pain relief may help while waiting for a dental assessment or planned treatment. A dentist may recommend appropriate pain relief based on your individual circumstances. Keeping the area as clean as possible can also help reduce bacterial accumulation around a partially erupted tooth.
When Is an Impacted Wisdom Tooth Abscess an Emergency?
An impacted wisdom tooth abscess or spreading dental infection requires prompt professional attention. Warning signs can include increasing facial swelling, a high temperature, difficulty swallowing, difficulty breathing or severe pain that is getting worse. Do not rely on pain relief alone if symptoms are severe or rapidly worsening. Urgent dental or medical care may be necessary.
Recovery After Pulling Impacted Wisdom Teeth
After the procedure, some swelling and discomfort are common. Recovery varies depending on the complexity of the extraction. Many people experience the greatest swelling during the first few days, with gradual improvement afterwards. Aftercare commonly involves:
- Eating softer foods initially
- Keeping the area clean as instructed
- Avoiding vigorous rinsing immediately after surgery
- Avoiding smoking
- Taking prescribed or recommended pain relief as directed
- Following the individual aftercare advice provided by the dental team
The blood clot that forms in the extraction socket is important for healing. If it becomes dislodged, a painful complication known as dry socket can occur.
Possible Risks of Impacted Wisdom Teeth Surgery
Wisdom tooth removal is a common procedure, but every surgical treatment carries some risks. Possible complications can include:
- Pain and swelling during recovery
- Bleeding
- Infection
- Dry socket
- Temporary numbness or tingling where a tooth is close to important nerves
- Damage to nearby structures
The level of risk depends partly on the position of the tooth and the complexity of the extraction. Your dentist or surgeon should explain the relevant risks before treatment and discuss why removal is being recommended in your individual case.
Impacted Wisdom Tooth Removal Cost
The impacted wisdom tooth removal cost can vary depending on where the treatment is carried out and how complex the procedure is. Factors that can affect private treatment costs include the position of the tooth, whether surgical extraction is required, the type of imaging needed and whether treatment involves sedation or specialist care.
Pulling Impacted Wisdom Teeth: The Next Step
Pulling impacted wisdom teeth is not automatically necessary for every impacted tooth. The decision should follow a proper assessment of the tooth’s position, current symptoms and potential effect on surrounding oral health.
When removal is appropriate, the procedure is planned around the individual position of the tooth and the structures around it. X-rays play an important role in determining the safest approach. If you are experiencing pain, swelling or repeated infections around a wisdom tooth, a dental assessment can establish whether monitoring or removal is the most appropriate next step.
