Before deciding whether to remove your wisdom (extraction), your dentist will make a thorough examination of your teeth, gums, and jaw This will usually involve taking an X-ray of your mouth in order to identify the nature of the problem.

Wisdom teeth that have become impacted, or that have not fully broken through the surface of the gum, can cause dental health problems. This is usually because they are difficult to clean.

If your wisdom teeth have only partially grown through, food and bacteria can get trapped under the edge of the gum, around the wisdom tooth. Even when they are fully emerged, wisdom teeth are difficult to clean.

As they are positioned at the back of your mouth, and often at an angle where they are wedged against your other teeth, they are difficult to reach with a toothbrush.

As a consequence, food particles and bacteria can get trapped around them and cause a build up of plaque.

Plaque

Your mouth is full of millions of tiny bacteria. When you consume food and drink that are high in carbohydrates (typically sugary, or starchy, foods or drinks) the bacteria breaks the carbohydrates down into acid. The acid then combines with the bacteria, the saliva in your mouth, and the small particles of food left after brushing to produce a sticky film called plaque.

A build up of plaque on your wisdom teeth is not reason enough to remove them. However plaque can often go on to cause other dental health problems, such as those outlined below.

Dental health problems

Problems that may develop as a result of a build up of plaque include:

• dental caries (tooth decay) - where the plaque begins to break down the surface of your tooth. When tooth decay becomes more advanced it leaves cavities (holes) in the tooth. Cavaties may also affect the second molars, which sit next to the wisdom teeth,
• gum disease (also called gingivitis or periodontal disease) - where the plaque releases toxins which irritate your gums, making them red, swollen, and painful. Gum disease can also affect the first and second molars and the bone surrounding the tooth.
• pericoronitis - where the plaque causes an infection of the soft tissue that surrounds the tooth.
• cysts and tumours - if the tissue surrounding an impacted wisdom tooth becomes infected, there is an increased risk of a cyst or tumour developing (however, this is very rare).
• cellulitis - a bacterial infection in the soft tissue that connects your gum to your teeth.
• osteomyelitis - an infection inside the bone of your tooth, and
• abscess - where pus collects in your tooth or gums as a result of a bacterial infection.

If dental health problems such as these cannot be treated another way, your dentist may recommend that you have your wisdom teeth extracted. Extraction may not be your dentist's first option because some of the above problems can be treated with antibiotics. However, if the problem returns, or if you are in considerable pain due to a problem with your teeth, extraction may be the best option. 

Glossary

Bacteria

Bacteria are tiny, single-celled organisms that live in the body. Some can cause illness and disease and some others are good for you.

Cyst

A cyst is a fluid-filled sac or cavity in the body.

Pain

Pain is an unpleasant physical or emotional feeling that your body produces as a warning sign that it has been damaged.

Tissue

Body tissue is made up of groups of cells that perform a specific job, such as protecting the body against infection, producing movement or storing fat.

X-ray

An X-ray is a painless way of producing pictures of inside the body using radiation.