Wisdom teeth usually appear between the late teens and mid-twenties. Many people do not have enough space for them to come through properly, and they become impacted, trapped partly or fully beneath the gum or bone. Impacted wisdom teeth do not always cause symptoms, but they can lead to pain, infection and damage to neighbouring teeth. Knowing the warning signs helps you seek advice at the right time.
A wisdom tooth is impacted when it cannot fully erupt into its normal position. This is usually because the jaw is too small, the tooth is angled, or another tooth or bone blocks its path. Some impacted teeth remain completely under the bone, while others break through the gum only partly. Partly erupted teeth are often the most troublesome, because food and bacteria can collect under the gum flap that covers them.
Wisdom teeth can be angled in different directions. A mesial impaction leans forward toward the tooth in front, which is the most common type. A vertical impaction is upright but blocked. A horizontal impaction lies on its side and can press against the roots of the neighbouring molar. A distal impaction leans backward. The angle and depth of the tooth affect both the risk of problems and the complexity of removal.
Signs include pain or tenderness at the back of the jaw, swollen or red gums around the wisdom tooth, a bad taste or bad breath, difficulty opening the mouth, pain when chewing and swelling of the jaw or face. Some people experience earache or headaches on the same side. Symptoms may come and go, flaring up for a few days and then settling.
Pericoronitis is an infection of the gum flap over a partly erupted wisdom tooth. It is one of the most common reasons people seek help with wisdom teeth. It causes swelling, pain, difficulty swallowing and sometimes fever. Mild cases may settle with cleaning and rinses, but recurring episodes are a common reason to remove the tooth.
An impacted wisdom tooth pressing against the second molar can trap food, causing decay in the back of that molar, which is hard to clean and treat. In some cases, pressure can damage the roots of the neighbouring tooth. Gum disease can also develop between the two teeth. Regular X-rays help detect these problems early, even when there are no symptoms.
Rarely, a fluid-filled sac called a cyst can form around an impacted wisdom tooth, damaging bone and neighbouring teeth. These are usually detected on X-rays during routine check-ups. Early detection makes treatment simpler.
Removal is commonly advised for recurring infection, decay in the wisdom tooth or neighbouring tooth, damage to adjacent teeth, cysts or gum disease that cannot be managed. If a wisdom tooth is impacted but causing no problems, your dentist may recommend monitoring it with periodic X-rays rather than removing it straight away.
Your dentist will examine the area and take an X-ray, often a panoramic image, or in complex cases a 3D scan. This shows the position of the tooth, its roots and its relationship to the nerve in the lower jaw or the sinus in the upper jaw. This information guides whether removal is advisable and how it should be done.
If you have a flare-up, rinse gently with warm salt water, keep the area as clean as possible with a soft toothbrush, and use pain relief as directed. Contact your dentist promptly, especially if swelling spreads, you have a fever or you struggle to open your mouth or swallow.
No. Teeth that cause no problems may simply be monitored with periodic X-rays.
Pain and swelling at the back of the jaw, often with a bad taste, are common signs.
Sometimes partially, but if there is not enough space, it may remain impacted.
Book an assessment if you have pain at the back of your jaw.
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