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Do I Really Need My Wisdom Teeth Removed?
By the Celestial Dental Centre clinical team · Published
Wisdom teeth are the last four molars, right at the back, and they usually try to come through between the ages of about 17 and 25. They are the teeth most likely to cause trouble, because by the time they arrive there is often no room left for them. But that does not mean they all have to come out. The honest answer is that a wisdom tooth which is healthy, has come through fully, sits in a normal bite and can be kept clean does not need to be removed. Removing healthy, problem-free wisdom teeth just in case is no longer routine practice. The teeth that need to go are the ones causing problems, or the ones clearly heading for them.
Why do wisdom teeth cause so many problems?
The jaw often does not have space for that last tooth, so the wisdom tooth gets stuck part-way, which is called being impacted. It may come through at an angle, push against the tooth in front, or stay half-covered by a flap of gum. Each of those creates a specific problem:
- A half-covered tooth has a flap of gum over it that traps food and bacteria, which cannot be cleaned out. This leads to repeated painful infections of the gum, called pericoronitis.
- A tooth angled into its neighbour creates a trap where food packs in and decay starts, often on the otherwise healthy tooth in front, which is harder to save.
- A tooth you cannot reach with a brush gets decay and gum disease simply because it cannot be cleaned.
So the problem is usually less the tooth itself and more the spot it is stuck in and whether you can keep it clean.
When should a wisdom tooth be removed?
Removal is generally recommended when there is an actual problem, or a clear and repeating risk of one. The common reasons are:
- Repeated infections or gum swelling around a partly erupted tooth
- Decay in the wisdom tooth or the tooth in front of it that cannot be properly restored
- Gum disease around the tooth that cannot be controlled because you cannot clean there
- A cyst or damage to the neighbouring tooth or bone shown on an X-ray
- Persistent pain or pressure traced to the tooth
- Sometimes before certain orthodontic or jaw treatments, on the dentist's advice
When can I keep them?
You can usually keep wisdom teeth that:
- Have come through fully and sit in a normal position
- Bite properly against the tooth above or below
- You can reach and clean like any other tooth
- Are not decayed and have healthy gum around them
- Are not causing pain or trapping food
A wisdom tooth like that is just another molar and deserves to be kept. The decision is made tooth by tooth, usually with an X-ray to see the roots and the angle, so the right thing for a friend or family member may be the opposite of the right thing for you.
What does removal involve?
It depends entirely on how the tooth sits. A wisdom tooth that has come through fully often comes out much like any other tooth, under local anaesthetic, in a straightforward appointment. An impacted tooth still under the gum or bone needs a minor surgical procedure: the gum is opened, sometimes the tooth is divided into pieces to remove it through a smaller space, and the area is stitched. That is still done under local anaesthetic in most cases, and you are awake but feel no pain, only pressure.
Afterwards, some swelling, soreness and stiffness for a few days is normal, and it settles steadily. The aftercare that helps it heal fast, protecting the clot, keeping the area clean, managing swelling, is the same as for any extraction and we cover it in detail at celestialdental.org/tooth-extraction-aftercare-how-to-heal-fast. Following it closely is what prevents the main complication, a painful dry socket.
Is it better to remove them earlier or later?
When a wisdom tooth clearly needs to come out, there is a reasonable case for not delaying. In younger adults the roots are often less fully formed and the bone is more forgiving, so healing tends to be quicker and the procedure simpler. In older adults the roots are longer and the bone denser, which can make removal more involved. This is a reason not to ignore a problem tooth for years, but it is not a reason to remove a healthy one early. The starting point is always whether the tooth is actually a problem.
What if I just leave a problem tooth alone?
A wisdom tooth causing repeated infections or decay will not settle by itself, because the cause, a spot that cannot be cleaned, does not go away. Left alone it tends to mean more frequent infections, decay spreading to the healthy tooth in front, and occasionally a cyst forming around a buried tooth. Painkillers and antibiotics can quiet an infection for a while, but they treat the flare, not the cause. If a dentist has told you a wisdom tooth is the source of repeated trouble, dealing with it is usually less disruptive than a series of infections that keep coming back.
When should I see a dentist?
Book an appointment if you have pain, swelling or a bad taste at the back of the jaw, if the gum over a wisdom tooth is sore or keeps flaring up, if food constantly packs behind the last tooth, or if you simply want to know whether yours are fine to keep. An X-ray and an examination answer the question clearly, and if the tooth is healthy the advice may well be to leave it alone.
Book an assessment
A wisdom tooth assessment, with an X-ray where needed, tells you whether yours can stay or should go, no guessing. Celestial Dental Centre has clinics in Kasarani (Nairobi), Kamakis (Ruiru) and Eldoret, open every day from 07:00 to 20:00. Assessments and extractions are commonly included in insurance dental benefits. Send us your insurer or SHA scheme name, member category and preferred branch and we will confirm eligibility before your visit.
Call or WhatsApp +254 707 535 000 or book online at celestialdental.org. If a wisdom tooth is flaring up right now, tell us when you book so we can see you promptly.