Fact Sheet: Wisdom teeth removal

Just why we call them wisdom teeth is not clear. It could be because these teeth usually start to break through when people are between 17 and 24 years old. It might have been seen as a sign that the person was becoming wiser. The wisdom teeth are the last and furthest tooth back at the end of each side of the upper and lower jaw. They are the third and last molars.



What happens if a wisdom tooth does not break through?

Wisdom teeth often donot break through at all, or they only partly come through. This could happen when there is not enough room oin the jaw or other teeth are in the way. This is called an impacted or retained wisdom tooth. It is very common. In Sweden, for example, over 70% of people between the ages of 20 and 30 have at least one wisdom tooth that has not broken through.

Impacted wisdom teeth do not cause problems for most people. Sometimes they can lead to pain, swelling or ulcers in the gums. This is called a symptomatic impacted wisdom tooth. Impacted wisdom teeth can sometimes push on other teeth or cause other problems.

What are the advantages and disadvantages of having symptom-free impacted wisdom teeth removed?

The removal of wisdom teeth is one of the most common dental operations. But it is not completely harmless, especially with the lower wisdom teeth. Nerves and blood vessels can get damaged during this procedure. This can cause bleeding and temporary or permanent nerve damage that can cause numbness or even paralysis around the tooth, including the tongue or even that part of the face. The risks are greater when the tooth is deeper in the gum.

The operation can also cause infections in the teeth or bone. For most people, the area where the teeth were removed will be swollen after the operation and it will be hard to open the mouth fully. Pain is common. The operation will be done under a local or sometimes general anaesthetic. General anaesthetic itself can cause a variety of complications.

The overall risk of the procedure probably increases with age, and this is often an argument made for removing them when people are young.

What about the costs?

Wisdom teeth are often removed by orthodontists or dental surgeons. The coverage of costs depends on the health care service. In Germany, health insurance funds cover the costs of removing wisdom teeth, whether or not they are causing symptoms.

© IQWiG (Institute for Quality and Efficiency in Health Care)