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.

Category: Conditions

What are wisdom teeth?

Wisdom teeth are your third and final set of molars — the large back teeth. Most people have four of them, one in each corner of the mouth. They usually appear (erupt) between the ages of 17 and 25, though they can appear later or not at all.

Because they are the last teeth to come through, there is often not enough space in the jaw for them. When a wisdom tooth cannot fully emerge into its correct position, it is described as 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, and many can be left alone with careful monitoring.

Why do wisdom teeth cause problems?

When a wisdom tooth is partially through the gum or stuck at an angle, it can cause a range of issues:

Pericoronitis — infection of the gum flap (operculum) overlying a partially erupted wisdom tooth. This is the most common wisdom tooth problem. Food and bacteria become trapped under the flap, leading to pain, swelling, and sometimes spread of infection.
Decay — impacted wisdom teeth are difficult to clean and are therefore more prone to tooth decay. They can also cause decay in the neighbouring molar if they are pressing against it.
Gum disease — the area around partially erupted wisdom teeth is particularly difficult to keep clean, making gum disease more likely.
Cysts — in rare cases, a cyst (fluid-filled sac) 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 include:

Pain at the back of the mouth, often extending to the jaw, ear, or throat
Swollen, red, or tender gum around the wisdom tooth area
Difficulty opening your mouth fully
A bad taste or bad breath near the back teeth
Swollen jaw or cheek
Pain when swallowing

Seek urgent advice if you develop significant facial swelling, difficulty opening your mouth, difficulty swallowing or breathing, or a high temperature — these may indicate a spreading infection that needs prompt treatment.

Do wisdom teeth always need to come out?

No. NICE guidance advises that wisdom teeth that are not causing problems should not routinely be removed. Extraction carries risks and is only recommended when there is a clear clinical reason — such as repeated infection (two or more episodes of pericoronitis), decay that cannot be treated, damage to the adjacent tooth, or cyst formation.

Many people with impacted wisdom teeth are simply monitored with regular X-rays and examinations. If your dentist recommends leaving them, this is a considered, evidence-based decision.

What is involved in removing a wisdom tooth?

If removal is recommended, the procedure and recovery depend on the position and depth of the tooth:

Simple extraction — the tooth is accessible enough to be removed straightforwardly under local anaesthetic in the dental chair, similar to any other extraction.
Surgical extraction — if the tooth is deeply impacted or at a difficult angle, a small incision in the gum is needed. Sometimes a small amount of bone around the tooth is removed to access it. This can be done under local anaesthetic, conscious sedation, or general anaesthetic depending on the complexity and your preference.

Straightforward cases are usually managed in general dental practice. More complex cases may be referred to an oral surgery unit in a hospital or specialist practice.

Important risks to be aware of: Removal of lower wisdom teeth carries a risk of temporary or, rarely, permanent numbness of the lower lip, chin, or tongue. This is caused by proximity to two nerves — the inferior alveolar nerve (supplying the lower lip and chin) and the lingual nerve (supplying the tongue and adjacent gum). Permanent altered sensation affects approximately 1–2% of patients. Your dentist or oral surgeon will discuss these risks with you before any procedure.

Managing discomfort at home

If you are experiencing discomfort from a wisdom tooth that is not yet being treated:

Take over-the-counter pain relief (paracetamol or ibuprofen) as directed on the packet. Avoid ibuprofen if you have asthma, cardiovascular disease, stomach problems, kidney issues, take blood-thinning medications, or are pregnant.
Rinse gently with warm salty water to keep the area clean and reduce inflammation.
Use a soft-bristled brush to gently clean around the wisdom tooth as best you can.
Avoid very hard or chewy foods that may irritate the area.
See your dentist if symptoms do not settle within a few days.

This leaflet is for general information only and does not replace professional dental advice. Your dentist will discuss your individual circumstances and any risks and treatment specific to you. Treatment outcomes vary between patients depending on individual circumstances.

When to Seek Urgent Help

If you develop significant facial swelling, difficulty breathing, difficulty swallowing, or a spreading infection, go to your nearest A&E immediately or call 999.

References

Aligned with guidance from: NICE, SDCEP, FGDP(UK).

Last reviewed: 2026-03-01.

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