Wisdom Teeth: Key Questions, Interesting Facts and Why Surgery Matters for Your Oral Health
·7 min read·Dr. Daniel Rodríguez Leal
What wisdom teeth are, at what age they come in, when removal makes sense and why surgery protects your oral health. Answers by age, from children to adults.
Short answer: wisdom teeth (third molars) start forming in childhood and usually come in between ages 17 and 25. Not everyone has four, and not everyone needs them removed. But when they don't have room to come in properly (they are impacted), they are hard to clean and can cause pain, infections, cavities and damage to the neighboring molar. That is why they should be evaluated starting in the teenage years with an X-ray, so a decision can be made in time.
What wisdom teeth are
They are the third molars, the last teeth to appear, at the back of each side of the mouth. They are called "wisdom teeth" because they come in during young adulthood. A full mouth can have up to four: two on top and two on the bottom.
Wisdom teeth by life stage
| Stage | What happens with wisdom teeth | What to do |
|---|---|---|
| Childhood (approx. ages 7 to 12) | What happens with wisdom teethWisdom teeth are not visible yet: they begin forming inside the bone | What to doThey are generally not removed. Follow-up X-rays show how they are forming. In select cases a germectomy may be considered (see the questions below) |
| Adolescence (ages 13 to 17) | What happens with wisdom teethThe roots are not yet fully formed and the bone is softer | What to doA panoramic X-ray evaluation makes it possible to anticipate whether there will be room |
| Young adults (ages 17 to 25) | What happens with wisdom teethThis is when they usually come in. If there is no room, they become impacted or come in crooked | What to doDecide with the surgeon whether to remove or monitor them |
| Adults (age 26 and older) | What happens with wisdom teethThe roots are already formed. Problematic wisdom teeth can be removed at any age, and surgery tends to be more complex than in youth | What to doConsultation and an individual plan |
Interesting facts about wisdom teeth
- They form in childhood. Although they come in as adults, they begin developing inside the bone around ages 7 to 9.
- Not everyone has them. An analysis of 92 studies (63,314 people) estimated that about 22.6% of the world population is born without at least one wisdom tooth.
- They come in late. That is why they are called "wisdom" teeth: they appear when a person is already a young adult, typically between ages 17 and 25.
- Often there isn't room. At the end of the jaw there may not be enough space, and the tooth gets trapped in the bone or gum.
- They are hard to clean. They sit at the back of the mouth, where the toothbrush barely reaches; food debris and bacteria build up there.
- Younger, simpler surgery. According to the American Association of Oral and Maxillofacial Surgeons (AAOMS), removal tends to be easier in young people, because the roots are not fully formed and the bone is softer.
Why wisdom teeth surgery matters for your oral health
When a wisdom tooth can't come in properly, these are the most common problems:
| Problem | What happens |
|---|---|
| Pain and swelling | What happensThe gum over a partially erupted wisdom tooth easily becomes inflamed and infected (pericoronitis) |
| Cavities | What happensThe wisdom tooth and the molar next to it collect food debris in a space that can't be cleaned |
| Damage to the neighboring molar | What happensA crooked wisdom tooth can press on or damage the adjacent molar |
| Gum disease | What happensThe area is hard to clean and promotes inflammation and infection |
| Cysts | What happensA cyst can form around an impacted wisdom tooth that, untreated, damages the bone and nearby structures |
Why it matters: surgery is not done "just because"; it is done to prevent or resolve these problems. Doing it in time, before there is infection or damage to another tooth, is usually simpler for the patient.
When to get checked
- You have pain, swelling or a bad taste at the back of your mouth.
- A wisdom tooth is coming in crooked or only partially came in.
- Your dentist or orthodontist saw impacted wisdom teeth on an X-ray.
- Your teenager has never had a panoramic X-ray.
- Your wisdom teeth have never been checked and you are between 17 and 25.
More detail about the procedure on the wisdom teeth surgery page. If pain worries you, read Does wisdom teeth removal hurt? and, for after surgery, recovery after wisdom teeth removal.
Frequently asked questions
- At what age should wisdom teeth be evaluated?
- AAOMS recommends an evaluation in the early teenage years. The evaluation is done with a clinical exam and a panoramic X-ray, and shows how many wisdom teeth there are, how they are positioned and whether they will probably have room.
- Do wisdom teeth have to be removed in everyone?
- No. It is decided case by case. A wisdom tooth that came in well, can be cleaned and causes no problems can be kept with check-ups. Removal is recommended when it is impacted, causes pain or infections, damages the neighboring molar or has a lesion around it.
- What does it mean for a wisdom tooth to be impacted?
- It means it got trapped in the bone or gum and could not come in completely. It can be tilted, lying sideways or fully covered. It shows up on an X-ray.
- How do I know if I need an X-ray?
- Without an X-ray there is no way to know how the wisdom teeth are: many are below the gum and can't be seen. A panoramic X-ray or CT scan is what makes a decision possible.
- Can wisdom teeth be removed in children?
- Generally not: they are still forming inside the bone, and the usual approach is a follow-up X-ray to see how they develop. But there is an exception, germectomy, which consists of removing the tooth germ (the wisdom tooth in formation). In some cases it can be considered, for example, when there is a marked tendency toward skeletal Class III (forward growth of the lower jaw): removing the growth center of the wisdom teeth can help control growth a little. It may also be indicated, selectively, for orthodontic reasons. It is decided case by case.
- What is the best age to remove them?
- There is no single age. When removal is indicated, it is usually simpler in teenagers and young adults, because the roots are not fully formed. If there are problems at any age, they can be removed; surgery in older adults tends to be more complex.
- Is it better to remove all four wisdom teeth at once?
- As long as cost is not an issue, it is usually the best option: it is a single recovery, with a single course of prescribed medication, and the care and possible discomforts are the same as for removing just one. A trained, experienced surgeon can remove all four in a single procedure. It is confirmed at the consultation.
- What happens if I don't remove an impacted wisdom tooth?
- Some cause no symptoms for years and are monitored. Others cause repeated infections, cavities, damage to the neighboring molar or cysts. That is why follow-up with X-rays is important.
- Does wisdom teeth surgery hurt?
- During surgery it shouldn't hurt, because anesthesia is used. Afterward there is discomfort that is managed with medication.
- Who should remove wisdom teeth?
- A general dentist can remove simple wisdom teeth. Impacted ones, or those in contact with the nerve, are usually handled by an oral and maxillofacial surgeon.
Sources
- American Association of Oral and Maxillofacial Surgeons (AAOMS). Can Impacted Wisdom Teeth Lead to Significant Problems? myoms.org
- Carter K., Worthington S. Morphologic and demographic predictors of third molar agenesis: a systematic review and meta-analysis. Journal of Dental Research. 2015;94(7):886-894. doi:10.1177/0022034515581644
- Elsevier. Third molar anatomy (calcification in the 7th to 9th year; eruption between ages 17 and 21). elsevier.com
This article is informational and does not replace a consultation. Every case is evaluated individually.