Wisdom Teeth

Everything You Need to Know

Introduction

For many people, the arrival of wisdom teeth is a dental milestone that brings more discomfort than wisdom. These third molars usually make their appearance in the late teens or early twenties — a time when you’re already dealing with plenty of change. For some, they emerge smoothly and cause little trouble. For others, they can lead to pain, swelling, or infection that requires attention.

At Hugo Orthodontics, we often see patients worried about whether their wisdom teeth need to come out, what recovery will feel like, and whether keeping them could cause long-term problems. This blog brings together trusted clinical guidance to give you a clear understanding of what wisdom teeth are, when they become problematic, and what treatment options exist — so you can make informed decisions about your oral health.

What Are Wisdom Teeth?

Wisdom teeth, also known as third molars, are the last set of molars that usually erupt between the ages of 17 and 25. Most people develop four — two on the top jaw and two on the bottom — but some people have fewer, and a lucky few have none at all.

They’re called “wisdom teeth” because they tend to appear at a more mature age, long after childhood molars have come in. Unfortunately, by the time they arrive, there often isn’t enough room left in the jaw to accommodate them. This can lead to a variety of dental issues, which is why wisdom teeth have earned such a troublesome reputation.

When Do Wisdom Teeth Come Out — and Why Problems Happen

Wisdom teeth generally erupt between the ages of 17 and 25, though the exact timing varies. Some people notice early warning signs, such as:

• Tenderness on the gums behind their second molars

• Swelling or redness where the tooth is pushing through.

• Jaw stiffness or mild headaches.

• Food getting trapped at the back of the mouth.

The main problem? Space. Over thousands of years, human jaws have become smaller due to changes in diet and evolution. This means wisdom teeth often don’t have enough room to come through properly. As a result, they may grow at an angle, get stuck in the bone, or push against neighbouring teeth — a condition known as impaction.

Common Wisdom Teeth Problems

Not all wisdom teeth cause issues, but when they do, they usually fall into these categories:

1. Impacted Wisdom Teeth

• Teeth trapped in the jawbone or growing at an angle.

• Can press on second molars, leading to decay or resorption.

2. Pericoronitis

• Infection of the gum around a partially erupted tooth.

• Symptoms: pain, swelling, bad or sour taste, difficulty opening the mouth.

• Often recurrent and a leading reason for extraction.

3. Decay and Gum Disease

• Wisdom teeth are hard to clean.

• Food and bacteria collect, leading to cavities or gum infection.

4. Cysts and Other Pathology

• In rare cases, a fluid-filled sac forms around an impacted tooth.

• Can damage bone or neighbouring teeth if left untreated.

Do All Wisdom Teeth Need to Be Removed?

This is one of the most common questions patients ask — and the answer is no, not always.

For decades, dentists debated whether all wisdom teeth should be removed pre-emptively. Some argued that even if they weren’t causing problems now, they would likely cause trouble later. More recent evidence, however, suggests a more balanced approach: remove when there’s clear risk, monitor when there isn’t.

When removal is usually recommended:

• Ongoing or repeated infection (pericoronitis).

• Non-restorable decay.

• Cyst or tumour formation.

• Damage to adjacent teeth.

• Pain or swelling that doesn’t resolve.

When observation may be enough:

• Teeth are fully erupted, healthy, and easy to clean.

• No signs of infection or decay.

• Adequate space in the jaw.
  

Age also matters. Studies show that removing wisdom teeth in your teens or early twenties is associated with faster healing and fewer complications than removing them later.

Wisdom Teeth and Orthodontics

A common concern for orthodontic patients is whether wisdom teeth will undo the results of braces or aligners. Studies support that wisdom teeth eruption cannot solely be the reason for anterior crowding in early adulthood.

More importantly, impacted or partially erupted wisdom teeth can create areas that are difficult to clean, leading to gum problems or decay near newly straightened teeth. And in some cases, we can make use of the wisdom teeth space to move teeth backwards in the arches to help resolve crowded or proclined teeth, and removing these teeth will help us to align the teeth better.

For patients who have undergone orthodontic treatment, careful monitoring of wisdom teeth is essential. Your orthodontist may recommend removal if there is a high risk of damage to second molars, or if the wisdom teeth could compromise the long-term stability of your smile.

Treatment Options

1. Monitoring

• Regular X-rays and dental check-ups.

• Safe if teeth are currently symptom-free.

2. Extraction (Removal)

• Standard approach when wisdom teeth are problematic.

• Can be simple or surgical, depending on how impacted the tooth is.

3. Coronectomy

• In some cases, the roots of lower wisdom teeth lie close to nerves that control sensation in the lips and chin.

• To avoid permanent numbness, a coronectomy may be advised. This involves removing only the crown of the tooth while leaving the roots in place.

• Lower risk of nerve damage, but requires careful follow-up in case the roots migrate or become infected.

The treatment option best for your case will be decided on by the Maxillofacial Surgeon or Dental Surgeon who will be performing the procedure. We will refer you accordingly if and when it is an appropriate time to make the decision.

The Wisdom Teeth Removal Process

If removal is necessary, here’s what you can expect:

• Anaesthetic Options:

• Local anaesthetic numbs the area.

• Sedation keeps you calm but awake.

• General anaesthetic may be recommended for complex extractions.
  

• The Procedure:

• A small incision in the gum is likely to be made.

• Bone around the tooth may be gently drilled.

• The tooth is either removed whole or in sections.

• The gum is stitched closed.
  

• Recovery Time Off:

• Most people take 2–5 days off from normal activities.

• More complex cases may require a week.

Recovery and Aftercare

The healing process is just as important as the procedure itself. Here’s what helps:

• What to Eat After Wisdom Teeth Removal

• Soft foods like yoghurt, mashed potatoes, scrambled eggs, and smoothies.

• Avoid hot, spicy, crunchy, or sticky foods.
  

• How to Speed Up Wisdom Teeth Recovery

• Use ice packs for the first 24 hours.

• Keep your head elevated when resting.

• Rinse really gently with warm salt water after 24 hours.

• Avoid smoking and drinking through straws.
  

• Healing Timeline

• Swelling: up to 14 days.

• Gum closure: 2–3 weeks.

• Full bone healing: several months.
  

• Possible Complications

• Dry socket (pain due to loss of clot).

• Infection (rare if good oral hygiene is maintained).

• Temporary numbness if nerves are bruised.

FAQ:

Quick Answers to Common Wisdom Teeth Questions

Conclusion

Wisdom teeth are a natural part of development, but they don’t always play nicely. For some, they erupt without issue. For many, they can cause infection, pain, or long-term damage to nearby teeth. The key is individualised assessment: your orthodontist or maxillofacial surgeon will weigh up the benefits of removal against the risks of keeping them.

At Hugo Orthodontics, our goal is to help you make the right decision for your oral health. Whether your wisdom teeth need close monitoring, extraction, or specialist techniques like coronectomy, we’ll guide you, in collaboration with your dental or maxillo-facial surgeon, every step of the way.