Oral Surgery (Impaction)


Adults can have a maximum of 32 teeth. The wisdom teeth are the last to come through, right at the back. They usually appear between the ages of 17 and 25. Although sometimes they appear many years later.

Nowadays people often have jaws that are too small for all 32 teeth , 28 is often the most we have room for. So if all the other teeth are present and healthy there may not be enough space for the wisdom teeth to come through properly. If there is enough room they will usually come through into useful position and cause no more problems than any other tooth.

Often there will be some slight discomfort as they come through, but this is only temporary and will disappear once the tooth is fully in position.

As shown in the picture above if there is not enough room, the wisdom tooth may try to come through, but will get stuck against the tooth in front of it. The wisdom tooth will be at an angle, and will be described by the dentist as 'IMPACTED'.


If part of the wisdom tooth has appeared through the gum and part of it is still covered, the gum may become sore and perhaps swollen. Food particles and bacteria can collect under the gum edge, and it will be difficult to clean effectively. Your dentist will advise you whether this is a temporary problem that can be dealt with by using mouthwashes and special cleaning methods (and possibly antibiotics), or whether it is better to have the tooth removed.

A mouthwash of medium hot water with a teaspoonful of salt will help to reduce gum soreness and inflammation. Swish the solution around the tooth, trying to get it into the areas your toothbrush cannot reach. An antibacterial mouthwash can also be very useful to reduce the inflammation. Pain-relieving tablets can also be useful for short-term use, but consult your dentist if the pain continues.

The dentist will usually take x-rays to see the position of the root, and to assess whether there is room for the tooth to come through into a useful position


Indications for removal of the wisdom tooth

  • When it is clear that the wisdom teeth will not be able to come through into a useful position because there is no enough room, and when they are also causing some pain or discomfort.
  • If they have only partially come through and are decayed - such teeth will often be susceptible to decay as it will be difficult to clean them as thoroughly as your other teeth.
  • If the wisdom tooth is causing a cleaning problem and has no real use.
  • If a wisdom tooth starts to 'over-grow'. This often happens if the lower one has already been removed or is impacted and cannot come through, The upper one will come down too far, looking for a tooth to make contact with.
  • If they are painful.

Are wisdom teeth difficult to take out?


It all depends on the position and the shape of the roots. Your dentist will advise you as to how easy or difficult each tooth will be to remove after looking at the x-rays. Upper wisdom teeth are often more straightforward to remove than the lower ones, which are more likely to be impacted. Our oral surgeon usually takes 10-15 min. to remove an impacted tooth

Removing wisdom teeth may produce some swelling for a few days but as soon as the area is healed, there will be no difference to your face or appearance. Your mouth will feel more comfortable and less crowded, especially if the teeth are impacted.


What should I expect after a wisdom tooth is taken out?


The amount of discomfort will depend on how easy the removal of the tooth was. There is usually some swelling and discomfort for a few days afterwards, and it is important to follow any advice you will be given about mouthwashes etc, to help with the healing. Usual pain-killers will deal with any pain. It is best to stay fairly quiet and relaxed for 24 hours afterwards to make sure there are no bleeding problems. There may be some stitches to help the gum heal over - your dentist will probably want to see you again about a week later to check on the healing, and to remove any stitches.