Oral Health›Dental visits and treatments

Wisdom Teeth: Problems, Removal and Recovery

Many wisdom teeth come through without trouble, but some get stuck and cause pain or infection. Here is when removal is and is not recommended, what it involves, and how to recover well.

Updated September 2026·By the OHA editorial team·7 min read·How we write
Key takeaways
  • Wisdom teeth are the last teeth to come through, usually in the late teens or early twenties. Some people have fewer than four, or none.
  • A wisdom tooth that is stuck (impacted) can trap food and plaque, leading to gum infection, decay and pain. Not all wisdom teeth cause problems.
  • In the UK, NICE guidance says wisdom teeth that show no signs of disease should not be removed just in case. Australian dental bodies are more open to removing problem-prone teeth early. The research evidence is limited.
  • After removal, some pain and swelling for up to 2 weeks is normal. Severe pain a few days later may be dry socket.
  • Get urgent help for bleeding that will not stop, pain and swelling that are getting worse, a high temperature, or trouble breathing, swallowing or opening your mouth.

Not all wisdom teeth need to come out. Whether yours should depends on their position, whether they are causing problems, and partly on which country's guidance your dentist follows.

What are wisdom teeth?

Wisdom teeth are the third molars, the last back teeth to come through. NICE (the National Institute for Health and Care Excellence, which advises the NHS) says this is usually between 18 and 24, the Australian Dental Association says around 18 to 25, and the American Dental Association (MouthHealthy) says usually between 17 and 21. Most people have four, but healthdirect Australia notes that some have fewer or none.

What is an impacted wisdom tooth?

A wisdom tooth is impacted when something stops it coming through fully. The NHS explains that it may be blocked by another tooth or partly covered by gum because there is not enough space. The Australian Dental Association says most people do not have enough room in their jaws for wisdom teeth to push through easily, and the Oral Health Foundation (UK) says lower wisdom teeth are more likely to be impacted.

The NHS says this can cause pain and swelling, gum infection, food getting stuck, tooth decay, gum disease, a cyst (a fluid-filled sac) around the tooth, or a dental abscess (a build-up of pus).

Pericoronitis: infection around a wisdom tooth

Pericoronitis is inflammation or infection of the gum around a wisdom tooth that is only partly through. The Oral Health Foundation explains that these teeth can trap food and plaque. The Better Health Channel (Victoria) lists signs including red, swollen gum, pain, pus, bad breath, fever, and difficulty opening your mouth or swallowing.

While a wisdom tooth is coming through, healthdirect, the Australian Dental Association and the Oral Health Foundation suggest brushing the area gently but thoroughly with a small-headed toothbrush and rinsing with warm salt water. An antibacterial mouthwash can help if the gum is too sore to brush, though the Australian Dental Association says it does not replace brushing.

The Better Health Channel says pericoronitis can be treated with better cleaning, a professional clean and sometimes antibiotics, but may keep coming back if the tooth stays.

Do wisdom teeth make other teeth crooked?

The Australian Dental Association says there is no evidence for this, while the American Dental Association says wisdom teeth are "thought by some" to crowd neighbouring teeth. A Cochrane review (an independent summary of the research) found no evidence from one trial, at high risk of bias, that removing them meaningfully changes the shape of the dental arch.

When should wisdom teeth be removed?

This is where guidance differs most between countries.

UK: NICE guidance

NICE advises that preventive removal of impacted wisdom teeth that show no signs of disease should stop in the NHS. It limits removal to teeth with evidence of disease, such as decay that cannot be repaired, infection, cysts or tumours, damage to the tooth or nearby teeth, or a tooth in the way of jaw surgery.

On pericoronitis, NICE says a first episode, unless particularly severe, should not usually be a reason for surgery, but second or later episodes should be. The NHS says a wisdom tooth that is not causing problems will usually be left and checked at routine appointments. NICE's guidance dates from 2000; NICE says it is being updated, with no publication date yet.

Australia

The Better Health Channel says a dentist may recommend removal if there is not enough room for the tooth to come through, as early removal may help prevent future problems, though some teeth can simply be watched. The Australian Dental Association lists reasons including being impacted or at risk of decay or gum disease, and says teeth that are causing problems or at high risk are best removed young, as removal by around 25 is easier than later.

US

The American Dental Association says wisdom teeth may need removing when there is evidence of changes such as pain, infection, cysts, tumours, damage to neighbouring teeth, gum disease or decay, and sometimes as part of treatment with braces. Teeth that are kept should still be monitored.

What the research says

A 2020 Cochrane review found not enough evidence to say whether impacted wisdom teeth with no symptoms or disease should be removed or kept. One study, with very uncertain results, suggested keeping them may raise the long-term risk of gum disease around the neighbouring molar. The reviewers advise shared decisions with your dentist, and regular checks for teeth that are kept.

What does removal involve?

An x-ray shows the tooth's position and how close it is to nerves, the Australian Dental Association explains. According to the NHS:

  • A dentist may remove the tooth, or refer you to a specialist.
  • You will usually have a local anaesthetic injection to numb the area. Sedation or a general anaesthetic (where you are asleep) may be offered if the tooth is difficult to remove or you are anxious.
  • The gum may be cut and the tooth removed whole or in 2 or 3 pieces, with dissolvable stitches if needed.
  • It often takes a few minutes, no more than 40, and you usually go home the same day.

If you feel nervous, see our guide to dental anxiety.

Recovery after removal

The NHS says you can usually return to normal activities the next day, or take 1 to 3 days off after a difficult removal or a general anaesthetic. For up to 2 weeks you may have pain and swelling (which should start to improve after 1 or 2 days), bruising, a stiff jaw and discomfort chewing. It advises:

  • paracetamol or ibuprofen for pain
  • soft food, avoiding hard or crunchy foods such as nuts and seeds
  • rinsing gently with mouthwash or warm salt water, and not disturbing the blood clot when brushing
  • pressing on any bleeding for at least 10 minutes
  • not smoking, and avoiding alcohol and very hot drinks
  • not driving for 48 hours after a general anaesthetic or 24 hours after a sedative injection

The Better Health Channel and the Oral Health Foundation both suggest waiting 24 hours before salt-water rinses. The Better Health Channel also advises against vigorous rinsing, spitting and drinking through a straw, which can loosen the clot.

Possible complications

The NHS lists dry socket, infection, and nerve damage causing numbness or tingling in the tongue, lip or chin, which usually improves but can last weeks or months. The Australian Dental Association adds damage to nearby teeth and, for upper wisdom teeth, an opening into the sinus.

Dry socket

Dry socket happens when the blood clot in the socket does not form properly or comes away, exposing the bone. healthdirect says it affects about 1 in 20 extractions and is more common after lower wisdom teeth are removed. Signs include severe, throbbing pain 1 to 3 days afterwards that may spread to the ear, bad breath and an unpleasant taste. Smoking, a previous dry socket, a difficult extraction and the contraceptive pill make it more likely. A dentist can clean the socket and place a medicated dressing. Other sources give later start times, up to 10 days; see our full guide to dry socket.

When to see a dentist
  • A wisdom tooth area is painful or swollen, or tastes or smells bad.
  • The gum over a wisdom tooth keeps becoming sore or infected.
  • Pain is getting worse a few days after an extraction rather than better, or you think you have dry socket.
Get help urgently
  • Ask for an urgent dental appointment (in the UK, call your dentist or NHS 111) if bleeding will not stop, pain and swelling are severe or getting worse despite painkillers, or you have pain with a bad taste, a high temperature or feel unwell. healthdirect Australia advises an emergency dental appointment if you think a wisdom tooth is infected or you have severe swelling or pain.
  • Call emergency services or go to an emergency department if you are finding it hard to breathe, speak or swallow, have a lot of swelling in your mouth, or are finding it hard to open your mouth.

See also dental emergencies.

Frequently asked questions

My wisdom teeth do not hurt. Should they come out?

Not necessarily. In the UK, NICE advises against removing wisdom teeth that show no signs of disease. Australian bodies may suggest early removal if a tooth is likely to cause problems. A Cochrane review found too little evidence to settle the question, so discuss the pros and cons with your dentist.

How long does recovery take?

The NHS says most people are back to normal activities the next day, though pain and swelling can last up to 2 weeks.

Is it easier to have wisdom teeth out when you are younger?

The Better Health Channel and the Australian Dental Association say so; the Better Health Channel explains that the roots are still forming in the teenage years. Whether a tooth that is not causing problems should come out early is where UK and Australian guidance differ.

Sources

  1. Wisdom tooth removal, NHS, accessed September 2026
  2. Dental abscess, NHS, accessed September 2026
  3. Guidance on the extraction of wisdom teeth (TA1): recommendations, NICE, accessed September 2026
  4. Guidance on the extraction of wisdom teeth (TA1): clinical need and practice, NICE, accessed September 2026
  5. Third molars (impacted): prophylactic removal, guidance in development, NICE, accessed September 2026
  6. Surgical removal versus retention for the management of asymptomatic disease-free impacted wisdom teeth, Cochrane, 2020, accessed September 2026
  7. Mouth and teeth: wisdom teeth, healthdirect Australia, accessed September 2026
  8. Dry socket, healthdirect Australia, accessed September 2026
  9. Wisdom teeth, Better Health Channel (Victoria), accessed September 2026
  10. Wisdom teeth, Australian Dental Association, accessed September 2026
  11. Wisdom teeth, American Dental Association (MouthHealthy), accessed September 2026
  12. All about wisdom teeth, Oral Health Foundation, accessed September 2026

This article is general information about oral health. It is not a diagnosis or a substitute for advice from a dentist or doctor who knows your situation. If you have pain, swelling, bleeding that does not settle, or a problem that is getting worse, see a dental professional. In an emergency, contact your local emergency service.

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