Wisdom teeth (or third molars) are the last (and 8th tooth) to erupt into each quadrant of the mouth... Usually in your late teens or early twenties.

They are located at the back of your upper and lower jaws, on the right and left sides.  Most people have four wisdom teeth, however it is not uncommon for people to have less than this (anywhere from none to four).  They are also called 18 (upper right), 28 (upper left), 38 (lower left) and 48 (lower right) 3rd molar teeth.

Sets of 4 perfectly healthy wisdom teeth, without caries or gum disease, and in normal occlusion, are occasionally seen. However, for the remaining 99% of us, having all four erupting into a perfect position and remaining healthy over a lifetime... Just doesn't happen.

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OPG of a general dentist, showing normally erupted wisdom teeth. Previous orthodontic removal of 4 premolar teeth have provided "dental room", and have allowed for normal eruption of wisdom teeth. Four perfectly normal wisdom teeth, in a normal occlusion is rare, and is seen in less than 1% of a normal adult patient population. Usually such people are highly motivated in their dental care, and have a higher degree of knowledge on dental health care techniques.

For most people there is inadequate space in their jaws to allow eruption of the wisdom teeth fully into their mouths.  When this occurs the wisdom teeth are considered to be impacted.  The degree and type of impaction is dependant on the position of the wisdom teeth, and the relationship to adjacent teeth and surrounding structures (such as the inferior dental nerve).

OPG showing impacted wisdom teeth. Whilst the patient is asymptomatic, and the wisdom teeth remained buried, the decision to prophylactically remove the impacted teeth is made by considering a balance between the risks of surgery, and the problems that may arise if you leave the wisdom teeth alone.

In general, the decision to remove wisdom teeth is based on a decision that the risks of keeping wisdom teeth, far outweigh the risks of removing them.

Risks of wisdom teeth removal are greatly reduced by having the procedure performed by specialists who have a broad experience of surgery generally, and who have a specific and almost exclusive interest in dentoalveolar surgery.

Always have your wisdom teeth removed by an oral and maxillofacial surgeon in order to maximise the benefits of removal, as well as maximally reduce the chance of adverse consequences from surgery.

Vertical Impaction                               Mesio angular impaction

Horizontal Impaction                                  Disto angular impaction

Different types of lower right wisdom teeth impactions seen, with variations in orientation requiring differing styles of surgery, as well as representing different levels of surgical difficulty.

Read more on the following questions to more fully understand the philosophies, processes and pitfalls of wisdom tooth surgery.

What are the risks of leaving asymptomatic impacted wisdom teeth? People can often obtain an OPG so their dentist can see all their teeth in one x-ray. Often this is the first time they become aware of impacted wisdom teeth, which thus far may have been hidden and asymptomatic. When you are advised to "Leave them alone until you get a problem", you should ask "What does a problem mean" and "By removing my impacted wisdom teeth, could I potentially prevent problems from arising?"... Read more

What are the surgical risks of removing wisdom teeth? Having surgery by a specialist as opposed to a generalist doesn't necessarily mean you are going to be more financially out of pocket. It should mean that you are seeking specialised treatment to reduce the chance of surgical complications arising... And if they do arise, that your specialist practitioner has a way of quickly, and easily treating you; before the complication takes on a life of it's own. Wisdom teeth removal does have complications, and some occur randomly, whilst others occur due to a reduced level of surgical skill or lack of surgical experience. Whilst having an absolute guarantee that "complications will never occur" is impossible, treatment by a surgical specialist does help in confirming that you're under the best possible care, and in the best possible circumstances of treatment... Read more

Can you have wisdom teeth removed in the presence of infection? Many people think that having a tooth abscess, or local infection means you have to have the infection treated before you can have any teeth removed. The truth is, this is a myth. Whilst possibly having some veracity in exceptional and unique circumstances, for the vast majority of people, removing the cause of sepsis remains a tenet and basis for good surgical practice... Meaning getting your wisdom teeth removed in the presence of infection, is the treatment for the infection they have caused... Read more

Who should remove wisdom teeth? Should I get a dental surgeon or an oral surgeon? What is the difference? Steeped in myth and controversy, the answer to who should remove wisdom teeth is simply... A dentist. But it should not be just any dentist. It should be someone who is a dentist, and a specialist in dentoalveolar surgery, and also someone who can deal with wider surgical issues; such as surgical complications, local infection, or in dissecting away tissues deeper than superficial gum tissue. What is an oral & maxillofacial surgeon, and why are such widely qualified people almost exclusively focused on the practice of wisdom teeth removal?... Read more

Is there any such thing as prophylactic removal of wisdom teeth? This is another controversy of dentistry generally. Most oral & maxillofacial surgeons agree that prophylactic wisdom teeth removal by Oral & Maxillofacial surgical specialists reduces both the risks of retaining (currently non-problematic) wisdom teeth, and the surgical risks of removing wisdom teeth. An analysis of an individual's risk vs benefit ratio should be made for any person considering wisdom teeth removal, with general advice being that the analysis is conducted by a surgical specialist who will conduct the surgery... Read more

Do I need to have my wisdom teeth removed before I start playing contact sports? Not all wisdom teeth lead to a predisposition to jaw fracture, and not all jaw fractures involve wisdom teeth. The overwhelming majority of jaw fractures that occur on the sporting field (in contact sports), involves the region containing the hidden and impacted wisdom tooth. Many sports physicians, sports dentists, and club trainers recommend for prophylactic screening of wisdom teeth (and for general dental disease) during the off season, and to actively prevent dental and jaw problems arising during the playing season... Read more

Do wisdom teeth affect the teeth in front of them? Are erupting or impacted wisdom teeth a mythical cause of late dental crowding? The objective evidence suggests otherwise, but anecdotal and specialist clinical experience suggests there is a direct link. Certainly wisdom teeth can adversely affect the periodontal health and enamel integrity of the forward second molar, and disease processes beginning in the impacted wisdom tooth can profoundly affect both global dental and jaw health... Read more

Where do you get wisdom teeth removed? Does it require a general or a local anaesthetic? There are three situations where wisdom teeth can be safely removed. Under local anaesthesia (LA), or under LA with intravenous (IV) sedation in the Honeysuckle rooms, or with LA and general anaesthesia in a private hospital. All three options have equal efficacy in terms of recovery from wisdom teeth surgery, but have different costs and insurance benefits depending on your level of private health insurance... Read more

If they aren't causing me any problems, should I get my upper wisdom teeth removed? Impacted upper wisdom teethcause just as many problems as lower impacted wisdom teeth, and even if they have erupted normally, can over erupt if the opposing wisdom tooth (in the lower jaw) is not present. There are a few complicatiosn or retetion, and some of removal you should know about when you make a conscious decision on removing them... Read more

Should I get all four wisdom teeth removed at once, or should I divide my operations into one per side? The practicality of any operation means time away from school or work for recovery, organising an admission to hospital, drug management and pharmaceutical purchases,and of course costs. Having one operation is cheaper is so many different ways to having two operations... Read more