Wisdom Teeth:   Everything You Need to Know

Wisdom teeth are third molars that typically emerge in early adulthood at the back of the mouth, often causing pain, crowding, or impaction when there is insufficient space for proper growth.

Wisdom teeth are so called, because, unlike our other teeth, they want to push through when we are a bit older, and perhaps a bit wiser.

At Hamilton Dental Centre, one of New Zealand’s leading dental practices, we have vast experience in dealing with the unique challenges that wisdom teeth present.

Clinically, wisdom teeth assessments are one of the most common consultations for patients aged 16–25, and many cases are first identified through routine dental X-rays before symptoms develop.

Our team understands that the appearance of these molars can be a significant milestone in dental development, usually emerging in the late teens to mid-twenties. These teeth can often lead to discomfort and require professional attention, not just because of overcrowding but also due to their potential impact on overall dental health. With state-of-the-art technology and a patient-centred approach, we are dedicated to providing comprehensive care, from initial consultation to possible extraction, ensuring your dental wellness is always our top priority.

WIth all that in mind, let us answer the most common questions we get asked about wisdom teeth:

What are Wisdom Teeth?

Wisdom teeth are our third molars, which are the last to erupt at the very back of our mouths.

Most people have 4 wisdom teeth, one at the back of each quadrant of the mouth.  

Not everyone will experience the presence of wisdom teeth. Some people don’t get any wisdom teeth coming through, and others might only get one, two, or three of their wisdom teeth erupting.

These large teeth usually make themselves known when a person enters adulthood, during the late teens to early 20’s.  They can cause a lot of discomfort as they move up and erupt through the tender gums.

It is believed that these teeth hark back to caveman times, when humans may have needed the extra teeth for gnawing on raw meat.  Needless to say, this is less of a need now, in modern times. 

How Will I Know if I am Getting Wisdom Teeth?

It is usual that a young person will feel the following symptoms when a wisdom tooth is coming in. In practice, symptoms vary significantly – some patients experience pain and swelling, while others may have impacted wisdom teeth with no symptoms at all. This is why imaging is essential.

Gum Irritation 

Before the eruption of the wisdom tooth, it would be normal for the gum behind the existing second molar to become slightly swollen and irritated. This happens because the tooth is slowly pushing through the gum tissue, which can cause local inflammation. In some cases, the area may also feel tender when brushing or chewing.

Aches and Pains 

As the wisdom tooth moves toward the surface of the gum, it is normal to feel a dull aching jaw pain. This discomfort may come and go depending on how the tooth is shifting.

Wisdom teeth can also put pressure on the surrounding nerves and nearby teeth, which may cause referred pain in the jaw, and occasionally in areas such as the ears or temples. This is a common pattern seen during eruption in late teens and young adults.

Redness

Just before the tooth erupts through the gum, the gum may look bruised, turning red or dark pink. This is due to increased blood flow and irritation in the gum tissue as it stretches to allow the tooth to come through. The area may also feel slightly warm or sensitive to touch.

Small White Specks

You will see the points of the white tooth as it finally starts to surface. At this stage, only a small portion of the tooth crown may be visible above the gumline. This often indicates that the eruption process is actively progressing, although full emergence may still take several weeks or months depending on available space in the jaw.

How Can I Relieve the Pain of Wisdom Teeth Coming in?

Whether for your teenager or for yourself, here are our tips to provide some relief from the discomfort of wisdom teeth coming in. Pain relief methods such as over-the-counter medication can help temporarily, but they do not address the underlying cause of impaction or infection.

Cold Compress

If you moisten some flannels and pop them in the freezer to cool, they make the perfect cold compress! Hold the cool flannel over an aching jaw for instant relief!

Anti-Inflammatory Topical Gel

Head to your local pharmacy, and ask the pharmacist about oral anti-inflammatory gels available to buy over the counter.

These gels contain medications that relieve the pain of inflamed tissues in your mouth.  You simply smear a little gel over the affected area, as advised by the pharmacist, or as per the instructions on the packaging.

Simple Painkillers

There are two main types of simple painkillers available to buy in most convenience stores, supermarkets and pharmacies throughout New Zealand: Paracetamol (Panadol) and Ibuprofen (Nurofen).

It is important to read the packaging instructions and to only take these medications as directed.

Both of these medications are excellent for the control of pain caused by a wisdom tooth pushing through.

What is the Problem with Wisdom Teeth?

For some people, the wisdom teeth align properly and the surrounding gum tissue heals healthily, and the wisdom teeth cause no problems at all! Lack of jaw space is the most common reason wisdom teeth become impacted, particularly in modern populations where jaw size is often smaller compared to historical anatomy.

Unfortunately for others, there isn’t enough room for the extra third molars.

When there isn’t enough room for the wisdom teeth to develop or push through normally, they can become trapped.  We call this ‘impacted’.

What are the Complications of an Impacted Wisdom Tooth?

Sometimes, the impacted wisdom tooth won’t cause any problems at all!  If that is the case, the tooth can be left alone. Impacted wisdom teeth are often classified as “asymptomatic” or “symptomatic,” but even asymptomatic cases may still require monitoring through periodic X-rays.

However, impacted wisdom teeth can often lead to the following dental problems:

• Damage to other teeth

When impacted wisdom teeth rub against other teeth, they can cause damage, increasing the risk of infection. Pressure from impacted molars can contribute to root resorption or decay in the adjacent second molar if left untreated.

Wisdom teeth can also cause crowding in the mouth as they push other teeth around and this can lead to further issues and a need for straightening treatment.

• Gum disease 

Sometimes the impacted wisdom teeth grow at a funny angle, and only partially erupt through the gum.  This increases the chance of gum disease developing around the tooth. Partially erupted wisdom teeth create deep gum pockets that are difficult to clean, increasing bacterial accumulation and infection risk.

• Decay

The wisdom teeth themselves can be at higher risk of decay when they grow awkwardly and don’t sit correctly above the gumline. They become harder to keep clean, causing a higher level of tooth decay and more likelihood of cavities. Due to their position at the back of the mouth, wisdom teeth are among the most difficult teeth to clean effectively, increasing decay risk even with good oral hygiene.

• Cysts

The wisdom tooth develops in a sac within the jawbone. The sac can fill with fluid, forming a cyst that can damage the jawbone, teeth and nerves. Although less common, cyst formation around impacted wisdom teeth can lead to bone damage if not detected early via imaging.

Symptoms associated with these complications of impaction include:

• Swelling, particularly around the gums or around the jaw
• Jaw pain
• Bad breath
• Difficulty opening your mouth
• An unpleasant taste in your mouth

Conclusion

In conclusion, wisdom teeth, or third molars, which typically appear in late adolescence or early adulthood, often present a range of complications due to their impactation, including, but not limited to, damage to adjacent teeth, gum disease, decay, and cyst formation. Early evaluation of wisdom teeth through dental examination and radiographic imaging significantly reduces the risk of complications and allows for less invasive treatment options.

At Hamilton Dental Centre, we frequently encounter queries regarding the necessity of extraction, symptoms to watch for, and how to manage potential complications associated with impacted wisdom teeth. Our dedicated team is always on hand to provide tailored advice and treatments, ensuring the best possible outcomes for our patients’ dental health. Treatment decisions are based on clinical assessment, including X-rays, symptom severity, and risk of future complications rather than symptoms alone.

If you or your teenager are experiencing any of the above symptoms, you should schedule a consultation with the dentist at Hamilton Dental Centre.

Frequently Asked Questions

How can I tell if my wisdom teeth are impacted?

Impacted wisdom teeth often cause symptoms such as jaw pain, swelling of the gums, bad breath, difficulty opening your mouth, or an unpleasant taste. However, some impacted teeth cause no noticeable discomfort. A dental examination and X-ray are the most reliable ways to determine if your wisdom teeth are impacted.

At what age do wisdom teeth usually come through?

Wisdom teeth typically emerge between the late teens and mid-twenties, although they can appear earlier or later. Not everyone develops wisdom teeth, and some people may have fewer than four.

When should I see a dentist about wisdom tooth pain?

You should book a dental appointment if you experience persistent jaw pain, swelling, redness around the gums, difficulty opening your mouth, or pain radiating to the ear or eye area. Early assessment can prevent complications such as infection, gum disease, or damage to neighbouring teeth.

Reviewed by Dr. Dave Blom, Orthodontic Dentist (25+ years experience)

This article has been reviewed for general accuracy by a dental professional at Hamilton Dental Centre. Individual treatment requirements may vary following clinical assessment.