Wisdom teeth removal
Treatment to prevent pain, infection and give your other teeth plenty of room to grow
Everything you need to know
about wisdom teeth removal
It’s natural to feel nervous about getting wisdom teeth removed. However, there may be no other way around it – if your final set of adult teeth are causing problems. This could be the best way to banish oral pain, prevent infection and give your other teeth plenty of room to grow so they don’t become damaged in the future. We tell you everything you need to know about wisdom tooth extraction, so you can feel relaxed about it, and empowered to support your healing.
Table of Contents
What are wisdom teeth?
Wisdom teeth are back molars (or “third molars”) that grow in each corner of the mouth during adulthood.
Contrary to the name, these late bloomers don’t make us any wiser.
They usually emerge from the gums between the ages of 17 and 25 – when we’re meant to be a little more enlightened (hence the label).
Most people have four wisdom teeth – but some have fewer or more (‘supernumerary teeth’)!
There are even people who have none at all – which comes down to evolution and genetics.
You see, third molars are no longer required for human survival (we don’t need them).
Although our ancestors needed more teeth to grind raw foods, our eating habits have changed and our jaws are often no longer big enough to comfortably accommodate all 32 adult teeth.
Research suggests that around 35 per cent of people will stop developing wisdom teeth, for this reason!
And perhaps this is for the best, considering that wisdom tooth removal is one of the most common procedures in Australia (it’s almost a rite of passage for young people).
Why are wisdom teeth removed?
In many cases, there’s not enough room in the mouth to comfortably accommodate third molars. By the time this last set of adult teeth emerge, the first and second molars have already hogged all the space at the back of the jaw bone.
This prevents the third molar from sprouting properly, causing it to be trapped under the gums (“impacted”) or positioned at a bad angle.
Problems caused by impacted or poorly positioned teeth:
- food and bacteria is easily trapped (plaque builds up)
- It’s difficult to clean around the tooth (limited space)
- tooth decay or infection
- losing bone around the roots
- pericoronitis (tissue inflammation)
- cysts and benign growths
- damage to surrounding teeth
Sometimes third molars are removed before they’ve erupted from the gums, if x-rays show overcrowding in the mouth.
Signs that you may require wisdom tooth extraction:
- Your mouth feels sore and tender, but you’re not sure where pain is coming from.
- Swelling, inflammation and pain in the gums at the back of your mouth.
- Consistent headaches or earaches, but you don’t know why.
- Bad breath caused by infection and inflammation.
- Other teeth start to shift due to overcrowding.
- Surrounding teeth show signs of fractures, pain and discomfort.
- Dislodgement or cracks in fillings and crowns on nearby teeth.
What age should you get your wisdom teeth removed?
Typically, third molars are removed around the time they emerge – between the ages of 18 and 25.
During your consultation, x-rays determine whether or not extraction is required, and what the best approach is.
Please note, extraction isn’t always necessary – especially if you’re not experiencing any problems. When symptoms are mild, dentists may decide on alternative solutions (such as antibiotics, or putting a small incision into the gums to encourage proper growth).
However, if your dentist believes that third molar removal can help you – try not to delay as this may cause complications in the future. If you have any doubts, make sure you get a second opinion from another dentist.
Should you get your wisdom teeth removed before braces or Invisalign?
Yes, this is preferred in many cases.
We usually recommend that people with impacted wisdom teeth delay their orthodontic treatment until after extraction – in case the positioning of these teeth causes more misalignment problems.
The same advice applies when these late bloomers haven’t yet erupted, but are likely to grow in a problematic way (x-rays help us to determine if this could happen).
Thankfully, patients don’t need to put off this treatment until all of their teeth have come through. Wisdom tooth extraction can be performed before or after the molars have emerged from the gums.
Wisdom teeth and pregnancy
Women who have problems with their third molars should consider getting them removed before planning to fall pregnant, if this can be arranged. We already know that pregnancy makes women more susceptible to tooth decay and inflammation, so this may lower the risk of further dental complications.
However, any procedure carries some risk – so it’s best to avoid wisdom tooth extraction while pregnant (unless this can’t be delayed due to severe pain and inflammation).
Pregnant women should also avoid x-rays unless it’s an emergency – in which case your dentist will take precautionary measures to protect your baby (lead shielding, for example).
How are wisdom teeth removed? (local vs general anaesthetic)
There are two approaches, depending on the severity of the case and the number of wisdom teeth being extracted.
Extraction generally takes anywhere between ten minutes to an hour.
- Extraction under local anaesthetic (your dentist does this at the clinic)
- Surgery with general anaesthetic (performed by a specialist oral surgeon at hospital)
Extraction under local anaesthetic:
This procedure is for simple extractions at the dental clinic. It’s suitable when the tooth has emerged from the gums with no major issues.
A local anaesthetic is used to numb the area while the patient remains awake, though they may choose to be mildly sedated if this is an option. Forceps are used to loosen and remove the tooth, in much the same way as a regular tooth extraction.
For patients who need to remove all four wisdom teeth – it’s common to remove the upper and lower molar on the same side during a single session, and come back at a later date for the other side.
Wisdom teeth surgery using general anaesthetic:
Dental surgery occurs at hospital under general anaesthetic, which means the patient isn’t conscious during the procedure. This is a day procedure, so it’s important to organise for someone to drive you home.
This is the only option for complex cases where the tooth is trapped beneath the gums (impacted) or there are other obstacles (such as the roots getting in the way).
The procedure involves cutting the gum to extract all tooth fragments and traces of infection, before disinfecting the area and sealing the wound with stitches.
Your dentist will discuss the best option and refer you to a specialist oral surgeon if surgery is recommended.
Surgery may also be considered by patients who want to extract all four teeth at the same time to get it over and done with, even if their case isn’t complicated.
Wisdom teeth removal cost (Australia)
Pricing is influenced by:
- The number of extractions
- Complexity of the case
- Type of anaesthesia
Your dentist will give an accurate estimate during the consultation, but here’s a general idea:
$250 - $500
Single tooth removal under local anaesthetic
$1,000 - $2,000
Extraction of 4 wisdom teeth under local anaesthesia
Is wisdom teeth removal covered by dental insurance or by medicare?
Private health insurance: A portion of the costs may be covered by your insurer – depending on the level of cover and location of your procedure (hospital or dental clinic).
Ask your dentist or oral surgeon for the treatment item number, so you can check with your provider if it’s covered by your policy, and how much you will get for it. In the meantime, read more about it here.
Medicare: Wisdom tooth extraction isn’t covered by Medicare, unless you’re eligible for public dental services (there are waiting periods).
What if you can't afford wisdom teeth removal in Australia?
Australian residents who can’t afford third molar extraction may be eligible for public dental services, which means the government covers the costs.
This website provides resources for all states and territories, so you can check your eligibility (this depends on where you live).
In NSW, for example, all residents under the age of 18 can access public dental services.
However, adults in NSW must also have a Health Care Card, Pensioner Concession Card or Commonwealth Seniors Health Card. NSW residents can find out more here.
Public dental services are a safety net for people who can’t afford the treatment, however waiting lists can be long (sometimes around a year – which isn’t ideal when you’re in pain).
What to expect after wisdom tooth removal?
We recommend taking a week off school, work and other activities – to focus on recovery.
There will be some discomfort, bleeding and swelling for a few days after the procedure, as your body works hard to heal damaged tissue.
Thankfully the puffy “chipmunk cheeks” and other symptoms will soon subside, and you can confidently go out into the world again.
Most people are back to normal within a week, however it can take longer for complex cases to heal (especially if stitches have been used to seal the gums).
Even if you’re well enough to resume normal activities straight away, remember it can take months for your wounds to heal completely. In the meantime, avoid doing anything that could loosen your stitches.
Although it’s normal to experience some pain, swelling and bleeding, please call your dentist if this is excessive, or lasts longer than a week.
For most patients, there are no problems. However, some people may require urgent treatment if the wound gets infected.
Wisdom Teeth removal complications
After the extraction, a blood clot usually forms over the empty socket to protect the bone and nerve endings. This is a good thing.
Problems arise if the clot becomes dislodged, or fails to develop. Food particles can get trapped in the exposed area (called a “dry socket) and cause infection. And this can lead to painful nerve damage, if left untreated.
What to do for wisdom tooth infection after removal:
Book an emergency consultation with your dentist or oral surgeon. Antibiotics may be enough to treat it, but the area usually needs to be numbed with local anaesthetic and thoroughly cleaned (this occurs at the dental clinic, hospitalisation isn’t required).
Signs that you may have an infection or dry socket
How to avoid these complications…
- Gently rinse your mouth with saline water. Your dentist will give you detailed instructions for keeping the wound clean.
- Take painkillers that your dentist has prescribed, and apply an ice pack to reduce the swelling.
- Avoid smoking, alcohol consumption, drinking out of a straw, slurping, spitting and exercising while recovering – as these activities make you more susceptible to infection. For women, some oral contraceptives also heighten the risk of developing a dry socket due to the estrogen levels. Your dentist will tell you if you should avoid taking any medications during this time.
- Best foods to eat after getting wisdom teeth removed (for the first few days to a week): Eat only soft foods, such as soup, mashed potato, yoghurt, scrambled eggs, porridge, pudding, avocado and smoothies. Don’t consume scalding hot foods and beverages that could burn your mouth, and please avoid anything that requires a lot of chewing, as this could dislodge stitches or even create a dry socket. Spicy foods are a no-go, as they can irritate the wound.
- How to brush teeth after wisdom tooth extraction: You must be very gentle when brushing your teeth and rinsing your mouth. For the first 24 hours, focus on carefully rinsing with tepid salt water, and letting the water fall out by angling your head over the sink (don’t swish and spit). Avoid brushing, flossing, swishing or spitting during the first 24 hours after the procedure.