If your wisdom teeth need to come out, when is the right time?

Getting your wisdom teeth out seems to be a common milestone for many young adults. But why is it so common among people in their late teens and 20s? ¹ And do you really need to have your wisdom teeth removed if they’re not bothering you?

The short answer: Maybe. Dentists often recommend removing wisdom teeth to prevent problems down the road, notes Louis Rafetto, D.M.D., an oral surgeon in Wilmington, Delaware, and a past president of the American Association of Oral and Maxillofacial Surgeons. But when to remove them depends on a few factors.

Here’s what you need to know about wisdom teeth, including how they got their name and when it may be time to get them out.

Wisdom teeth are a person’s third molars located in the very back of the mouth. They’re no different than the other molars, except that they grow in last out of all the teeth, usually between ages 17 and 21.¹ That’s why they got the name “wisdom” – a play off the classic “older and wiser” adage.

Some wisdom teeth grow in and don’t cause any problems. Other times, they can become impacted, which generally means they don’t have enough room to grow in correctly.

It’s like a game of musical chairs, says Dr. Rafetto. “When the jaw stops growing during your teenage years, that’s when the music stops,” he explains. This leaves no place — or, in this analogy, “chairs” — for more teeth, including the wisdom teeth.

Too little space can cause big problems. Food can get trapped in between the molars when the wisdom teeth aren’t in the right position. Plus, it’s tougher to brush and floss if your wisdom teeth haven’t come in properly or only partially come through. That can lead to cavities or infection.¹

Another issue: Those third molars can crowd the other teeth. Or they can even cause a cyst to form that can harm the roots of the molars next to the wisdom teeth. The cyst can also destroy the bone that supports the teeth.¹

“Not all wisdom teeth need to be removed. But they should be evaluated during the teen years, so you can set up a strategy going forward,” says Dr. Rafetto. Your dentist may monitor them with X-rays every year or so. Then they will discuss the right time to take them out. 

Generally, your dentist will suggest removing your wisdom teeth as soon as they cause problems, such as a cyst or pain. Or if you have gum disease or tooth decay.¹

Wisdom teeth can be removed at any age, but the easiest time is when they first come in, explains Dr. Rafetto. When you’re a teenager, the roots of these molars are still growing. “As we age, the roots get more fully developed. So, removing the teeth becomes more difficult,” adds Dr. Rafetto. That’s especially true if the roots grow into nearby nerves in your lower jaw, he says.

If the dentist has trouble taking out the teeth, the recovery is tougher when you’re older too. “We just don’t heal as efficiently as we do when we’re younger,” Dr. Rafetto says.

Some wisdom teeth are fully erupted. Others are impacted, which means the teeth get encased in your gums or jawbone. Your dentist may recommend an oral surgeon to remove impacted wisdom teeth. ²

First, you and your dentist will decide what type of anesthesia to get. There are a few types – local anesthesia, intravenous (IV) sedation or general anesthesia.³ “Not everyone who has their wisdom teeth out needs to be asleep or sedated,” says Dr. Rafetto. 

Next, the dentist will give you a shot to numb the area around the wisdom teeth. Then they will cut into the gum to remove the tooth. To get the tooth out, sometimes the dentist will need to break the tooth into pieces or use a drill to remove some bone surrounding the tooth, according to Dr. Rafetto. 

After the wisdom teeth are removed, your gums will be sewn up with dissolvable stitches. If you receive IV sedation or general anesthesia, a responsible adult must drive home. And it’s best if that person can stay until the anesthesia wears off.

That’s the most important thing to do after surgery, notes Dr. Rafetto. Your dentist will send you home with gauze to bite down on. The gauze helps absorb the blood, and the pressure slows the bleeding. The bleeding should stop after an hour or so, says Dr. Rafetto. 

Take it easy after surgery. The next day you can do a little more activity, explains Dr. Rafetto.

Ice your jaw as often as possible for the first 48 hours after surgery, recommends Dr. Rafetto. That will help reduce the swelling. Swelling usually lasts 2 or 3 days, depending on how well you’ve been applying ice, he adds.

“The first day is the worst day in terms of discomfort,” says Dr. Rafetto. “That should begin to get better after the first 24 hours.” 

Stick to soft foods, or what Dr. Rafetto calls “minimal chew foods” for a few days. Liquids and smoothies are good. But soft foods such as pasta, rice, omelets and pancakes are fine too, he says.  

Drink adequate water to help keep teeth clean. But avoid using a straw, which can disturb the blood clots that help your mouth heal. ⁴

If the pain starts to get worse instead of better after a few days, let the dentist know. You could have dry socket. That’s when the blood clot that forms over your socket is displaced and exposes nerves and bone. Your dentist will clean out the area and apply a dressing with some topical medication.⁵

If you decide to keep your wisdom teeth, be sure to schedule regular dental checkups. Your dentist can keep tabs on any potential issues and keep the rest of your teeth healthy too.