Common wisdom teeth symptoms include pain or pressure at the back of the jaw, swollen or tender gum over a partly erupted tooth, a bad taste or bad breath, difficulty opening your mouth, and food getting trapped behind your back teeth. Not every wisdom tooth causes problems, and not every wisdom tooth needs to come out, but symptoms like these are worth having checked.
What are wisdom teeth?
Wisdom teeth are the third molars, the last teeth to develop at the very back of the mouth. Most people have four, although some have fewer or none. They usually come through between the late teens and mid-twenties, but timing varies a lot.
Because they arrive last, there is often not enough room for them. A wisdom tooth that cannot come through fully into a normal position is called impacted. It may be tilted forward into the tooth in front, lying sideways, or sitting partly under the gum.
Common wisdom teeth symptoms
Pain and pressure
A dull ache or pressure at the back of the jaw is common when a wisdom tooth is coming through. The discomfort may come and go over weeks or months. Pain can sometimes spread to the ear, the side of the head or the neck, which can make it hard to pinpoint.
Swollen, sore gum over the tooth (pericoronitis)
When a wisdom tooth is partly through, a flap of gum often covers part of it. Food and bacteria get trapped underneath, and the gum can become inflamed or infected. This is called pericoronitis and is one of the most common wisdom tooth problems. Signs include:
- Red, swollen and tender gum behind the last molar
- Pain when biting, especially if the upper tooth bites on the swollen gum
- A bad taste, bad breath or pus
- Difficulty opening your mouth fully
- In more severe cases, swelling in the cheek or jaw, swollen glands in the neck and fever
Decay in the wisdom tooth or the tooth in front
Wisdom teeth are hard to reach with a toothbrush, so they are prone to decay. An impacted wisdom tooth tilted against the second molar can also trap food and cause decay on the back of that tooth, which is often not noticed until it is quite large.
Gum problems around the back teeth
Partly erupted wisdom teeth can create deep pockets of gum around the second molar, increasing the risk of gum disease in that area.
Cysts and other changes
Less commonly, a cyst can form around an impacted wisdom tooth, which may damage the surrounding bone or teeth. These are often found on X-rays rather than through symptoms.
Do wisdom teeth cause crowding of front teeth?
This is a common belief, but the evidence does not strongly support it. Front teeth tend to shift slightly with age whether or not wisdom teeth are present, which is one reason retainers are recommended after orthodontic treatment. Wisdom teeth are not usually removed solely to prevent crowding.
What you can do at home for mild symptoms
If you have mild discomfort or gum soreness around a wisdom tooth, these measures may help in the short term:
- Rinse gently with warm salty water (half a teaspoon of salt in a glass of warm water) after meals
- Brush carefully around the back teeth with a soft brush, even if the area is tender
- Use over-the-counter pain relief as directed on the packet, if it is suitable for you
- Eat softer foods and chew on the other side
A few things are worth avoiding. Do not place aspirin or other tablets directly against the gum, as this can cause a chemical burn. Avoid picking at the gum flap with toothpicks or sharp objects, and do not take leftover antibiotics from a previous illness; if antibiotics are needed, your dentist or doctor will prescribe the right ones.
These steps can ease symptoms but do not fix the underlying problem. Pericoronitis often comes back, so it is worth having the tooth assessed even if it settles.
Do wisdom teeth always need to be removed?
No. Current mainstream guidance is that wisdom teeth that are healthy, fully through, functional and easy to clean, or that are fully buried and causing no problems, can often be left and monitored with regular check-ups and X-rays.
Removal is more likely to be recommended when a wisdom tooth:
- Causes repeated episodes of pericoronitis or infection
- Has decay that cannot reasonably be restored
- Is causing decay or gum problems in the tooth in front
- Is associated with a cyst or other changes
- Is in the way of other planned dental treatment
Your dentist will weigh up the benefits and risks of removing versus monitoring each tooth.
How wisdom teeth are assessed and removed
Assessment includes an examination and X-rays, usually a panoramic X-ray showing all the teeth and jaws. If a lower wisdom tooth appears close to the nerve that supplies feeling to the lip and chin, a 3D CBCT scan can show their relationship more clearly. CBCT imaging is available on site at our Macquarie Park practice.
Many wisdom teeth can be removed in the chair under local anaesthetic, and happy gas (nitrous oxide) is available to help you relax, with the fee on request. More complex cases may be referred to a specialist oral surgeon. You can read more on our wisdom teeth removal page and our general tooth extractions page. The fee depends on how many teeth are involved, their position and how complex the removal is, and a written estimate is given after assessment.
Risks of wisdom tooth removal
Like any surgery, wisdom tooth removal carries risks. Swelling, bruising, stiffness and discomfort for several days are common. Other possible complications include dry socket (a painful condition when the blood clot is lost from the socket), infection, bleeding, and numbness or tingling of the lip, chin or tongue if a nerve is affected. Nerve changes are usually temporary but in rare cases can be long-lasting. Removing upper wisdom teeth can occasionally involve the sinus. Your dentist will discuss your individual risks before any treatment.
When to see a dentist
Book an appointment if you have pain, swelling or a bad taste around a wisdom tooth, if symptoms keep coming back, or if food is regularly trapped at the back of your mouth. Seek prompt care if you have swelling in your face or jaw, difficulty opening your mouth, fever or swollen glands. If swelling is spreading, or you have difficulty swallowing or breathing, go to a hospital emergency department straight away.
If you study at Macquarie University or work in the business park, our Macquarie Park dentist team is about three minutes’ walk from the Metro station.
Frequently asked questions
What age do wisdom teeth come through?
Usually between the late teens and mid-twenties, although some come through later and some never fully erupt. Some people do not develop wisdom teeth at all.
How do I know if my wisdom tooth is infected?
Signs include red, swollen gum behind your last molar, pain, a bad taste or pus, difficulty opening your mouth, and sometimes facial swelling or fever. See a dentist promptly if you notice these.
Should I have my wisdom teeth removed if they do not hurt?
Not necessarily. Healthy wisdom teeth causing no problems can often be monitored. Your dentist may still recommend removal if X-rays show decay, damage to the tooth in front or other changes.
How long does wisdom tooth pain last?
Discomfort from an erupting tooth can come and go over weeks or months. If pain is persistent, severe or comes with swelling, have it checked rather than waiting.
Can a general dentist remove wisdom teeth?
Many wisdom teeth can be removed by a general dentist under local anaesthetic. More complex cases may be referred to a specialist oral surgeon.
If a wisdom tooth is bothering you, an examination and X-ray will show what is going on. Call North Ryde Dentistry on (02) 8090 1102 or book an appointment.
This article is general information only and is not a substitute for advice from your own dentist. Any treatment carries risks; your dentist will discuss whether it is suitable for you.