Understanding Impacted Wisdom Teeth
Wisdom teeth often do not have enough room to come through properly. Find out when this causes problems and what your options are.
Urgent help: who to contact
Call 999 or go to A&E now if you have a lot of swelling in your face, find it hard to breathe or swallow, or have an infection that is spreading.
What are wisdom teeth?
Wisdom teeth are your third and last set of molars (the large back teeth). Most people have four, one in each corner of the mouth.
They usually come through between the ages of 17 and 25. They can come later, or not at all.
They are the last teeth to come through, so there is often not enough room in the jaw. A wisdom tooth may not be able to come fully into the right place. This is called impacted.
Impacted wisdom teeth are very common. An estimated 7 in 10 people will have at least one.
Not all impacted wisdom teeth cause problems. Many can be left alone and checked carefully.
Why do wisdom teeth cause problems?
A wisdom tooth may be only partly through the gum, or stuck at an angle. This can cause problems:
- Gum infection (pericoronitis). The flap of gum over a wisdom tooth that is partly through gets infected. This is the most common wisdom tooth problem. Food and germs get trapped under the flap. This leads to pain and swelling, and sometimes the infection spreads.
- Tooth decay. Impacted wisdom teeth are hard to clean, so they decay more easily. If they press against the next molar, they can cause decay in that tooth too.
- Gum disease. The area around a wisdom tooth that is partly through is very hard to keep clean. This makes gum disease more likely.
- Cysts. Rarely, a cyst (a sac of fluid) can form around an impacted tooth and damage the jawbone.
- Pain and discomfort from the tooth trying to push through.
Signs and symptoms
Common signs that a wisdom tooth may be causing a problem:
- Pain at the back of the mouth, often spreading to the jaw, ear or throat
- Swollen, red or sore gum around the wisdom tooth
- Finding it hard to open your mouth fully
- A bad taste or bad breath near the back teeth
- A swollen jaw or cheek
- Pain when you swallow
Call 999 or go to A&E now if you find it hard to breathe or swallow.
Get urgent advice if you get a lot of swelling in your face, find it hard to open your mouth, or have a high temperature. These may be signs of a spreading infection that needs quick treatment.
Do wisdom teeth always need to come out?
No. NICE guidance says wisdom teeth that are not causing problems should not routinely be removed.
Taking a tooth out carries risks. It is only advised when there is a clear clinical reason, such as:
- repeated infection (two or more bouts of pericoronitis)
- decay that cannot be treated
- damage to the tooth next to it
- a cyst forming
Many people with impacted wisdom teeth just have regular X-rays and check-ups. If your dental team advises leaving them in, this is a careful decision based on evidence.
What is involved in removing a wisdom tooth?
If removal is advised, what happens depends on where the tooth sits and how deep it is:
- Simple extraction. The tooth is easy enough to reach to be taken out in the dental chair with a numbing injection (local anaesthetic). This is like any other extraction.
- Surgical extraction. This is needed if the tooth is deep or at a hard angle. A small cut is made in the gum. Sometimes a little bone around the tooth is removed to reach it. This can be done with a numbing injection (local anaesthetic), with sedation to help you relax (conscious sedation), or while you are asleep (general anaesthetic). This depends on how complex it is and what you prefer.
Simple cases are usually treated at a general dental practice. More complex cases may be referred to an oral surgery unit in a hospital or specialist practice.
Important risks to know about:
Taking out lower wisdom teeth carries a risk of numbness of the lower lip, chin or tongue. The numbness may be temporary. Rarely, it can be permanent.
This is because two nerves run close to these teeth. The inferior alveolar nerve gives feeling to the lower lip and chin. The lingual nerve gives feeling to the tongue and nearby gum.
Permanent changes in feeling affect about 1–2% of patients. Your dental team or oral surgeon will talk you through these risks before any treatment.
Managing discomfort at home
If a wisdom tooth is causing discomfort and is not yet being treated:
- Take painkillers you can buy (over the counter), such as paracetamol or ibuprofen. Follow the instructions on the packet. Do not take ibuprofen if you have asthma, heart or blood vessel disease (cardiovascular disease), stomach problems or kidney problems. Do not take it if you take blood thinners or are pregnant.
- Rinse gently with warm salty water to keep the area clean and calm the gum (reduce inflammation).
- Use a soft toothbrush to gently clean around the wisdom tooth as well as you can.
- Avoid very hard or chewy foods that may irritate the area.
- See your dental team if it does not settle within a few days.
This leaflet is for general information only and does not replace professional dental advice. Your dental team will discuss your individual circumstances and any risks and treatment specific to you. Treatment outcomes vary between patients depending on individual circumstances.
Sources
- Guidance on the extraction of wisdom teeth (TA1). National Institute for Health and Care Excellence (NICE), 2000.
- Parameters of care for patients undergoing mandibular third molar surgery. Faculty of Dental Surgery, Royal College of Surgeons of England, 2020.
- Wisdom tooth removal. NHS website (nhs.uk), reviewed June 2024.
Links checked 18 October 2026.
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