Introduction

Wisdom teeth come in at the very back of our mouth, with one at the end of each row of teeth. They usually don’t develop fully until the ages of 18 to 24, and it is only then that they appear, if they do at all. These teeth are commonly thought of as “troublemakers” because there often isn’t enough space for them and they can cause problems.

At a glance

• Wisdom teeth are right at the back of the mouth.
• They break through the gums later in life – sometimes only in part, if at all.
• They often don't cause any problems.
• But they sometimes lead to pain and inflammations.
• Wisdom teeth are only removed if they cause too many problems.

Upper and lower jaw, with wisdom teeth

Wisdom teeth are thought to date back to our distant ancestors who had larger jaws and more teeth. Nowadays, most people’s jaws are too small for these “extra” teeth. For a while in the past they were almost always pulled. But because they don’t always cause problems, and removing them can lead to other problems, dentists are now a bit more hesitant.

Prevalence

Everyone has four wisdom teeth – two in the upper jaw and two in the lower jaw. They don't always break through the gums and grow out, though: In about 80 out of 100 young adults, at least one wisdom tooth stays inside the jaw. Sometimes a wisdom tooth doesn't grow out fully: Part of the crown might then still be covered by gum tissue, or the tooth might not grow out into the mouth as far as other teeth do.

Effects

When wisdom teeth don't break through the gums, or don't grow out completely, it often isn't a problem. But in some people it can lead to pain, swelling or inflamed gums. The wisdom teeth may also damage nearby teeth and increase the likelihood of tooth decay.

The same is true if wisdom teeth break through: Sometimes they have enough space. But they may push against other teeth, come in crooked, and cause inflammations or other complications.

Diagnosis

If you're worried about your wisdom teeth, it's best to talk to your dentist. He or she will first ask you about your symptoms and examine your mouth and jaw. An x-ray is taken to see the position of the wisdom teeth. This thorough examination can help to predict whether the wisdom teeth will cause problems or will come in normally.

Treatment

If one or more wisdom teeth start causing problems, they will usually need to be pulled. This can usually be done in an outpatient setting using a local anesthetic (in other words, without a hospital stay).

In the past, even wisdom teeth that weren't causing any problems used to be pulled in most cases. Now experts usually only recommend this if the teeth are causing problems or it's thought that they will do in the future.

Further information

As well as going to the dentist because of a toothache, many people also go for regular check-ups. You can read about how to find the right dentist in our topic "Health care in Germany" – and our list of questions can help you to prepare for your appointment.

Sources

• Deutsche Gesellschaft für Mund-, Kiefer- und Gesichtschirurgie (DGMKG), Deutsche Gesellschaft für Zahn-, Mund- und Kieferheilkunde (DGZMK). Operative Entfernung von Weisheitszähnen (S2k-Leitlinie). AWMF-Registernr.: 007-003. 2019.
• Dodson TB, Susarla SM. Impacted wisdom teeth. BMJ Clin Evid 2014: pii: 1302. [PMC free article: PMC4148832] [PubMed: 25170946]

• IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

  Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. informedhealth.org can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

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