Despite their important-sounding name, wisdom teeth have no real purpose.

These additional pairs of molars usually emerge in a person’s late teens or 20s, but they’re usually unnecessary for healthy chewing.

Wisdom teeth aren’t problematic in and of themselves, but they can create problems if the mouth has no room for them or if they don’t come in straight.

There are definite symptoms you may experience that will indicate whether your four new molars will be problem-free — or whether some or all of them will need to be removed.

A dental X-ray may be the first indication that your wisdom teeth are on their way. In particular, a panoramic X-ray that captures all of the teeth and jaws in one image can reveal the position of your wisdom teeth and if they’re close to coming in.

Without an X-ray, you may know your wisdom teeth are coming in because you’re starting to notice some unpleasant symptoms. Some common indications your wisdom teeth are about to break through include:

  • swelling of the gums, usually behind your second molars
  • jaw pain
  • bleeding or tender gums
  • difficulty opening your mouth wide
  • a bad taste in your mouth
  • bad breath

The pain is usually mild, but you may experience an occasional stab of sharp pain. It may also be painful or uncomfortable to chew using the molars near where your wisdom teeth are about to come through.

These symptoms are usually due to wisdom teeth being impacted, which means they’re stuck under the gum or don’t have enough space to fully break through.

Research suggests that impacted wisdom teeth have the potential to cause inflammatory dental disease, which may harm nearby teeth and jawbone.

If your wisdom teeth are actually breaking through the gums, you may experience a low-grade fever. You may also notice a small flap of gum, known as a pericoronal flap, over the area of the emerging tooth.

While mild pain, tenderness, and other common symptoms can occur whether or not there are problems with your wisdom teeth, you should be aware of signs of trouble that require a dentist’s evaluation.

Bleeding gums should always be evaluated by a dentist, especially when accompanied by jaw pain and noticeable gum swelling. Even if there are no wisdom teeth issues, persistent bleeding gums are a concern, as it could indicate gum disease.

Signs that may indicate potentially serious dental problems include:

  • loose or shifting teeth
  • receding gums
  • sores inside your mouth
  • persistent dry mouth
  • toothache
  • tooth sensitivity
  • cracked or broken tooth
  • damage to a filling, crown, or bridge
  • gum or cheek swelling

New teeth breaking through the surface of the gums can hurt, whether you’re a teething baby or an 18-year-old whose wisdom teeth are pushing through. Just the temporary injury to gum tissue is enough to cause swelling and pain.

The primary reason wisdom teeth pose any risk at all is simply that the adult mouth doesn’t usually have room for four new molars.

As a result, impacted wisdom teeth can come in at abnormal angles and push against existing teeth. This can happen well before a wisdom tooth reaches the gum line.

An impacted wisdom tooth pushing against the root of the adjacent molar will cause jaw pain and potentially cause a harmful change to the alignment of your teeth. An impacted tooth usually requires extraction.

Disease, decay, and more

The process can become more complicated when wisdom teeth have only partially come in, allowing bacteria to collect under the gum line so that an infection develops. This type of infection is what usually causes more serious symptoms.

The flap covering the tooth can cause pain and become swollen, leading to a condition called pericoronitis.

Gum disease is also a risk with impacted wisdom teeth, and if the condition is properly treated, the loss of bone and other teeth can occur. Like your other teeth, an impacted wisdom tooth can also become decayed or form decay on the back of the second molar, possibly exposing the nerves.

An impacted wisdom tooth may also develop a cyst or tumor, causing further symptoms and potentially serious complications, such as the loss of tooth or bone.

Preventing complications

If you have regular dental checkups and periodic X-rays taken, you may be able to avoid any wisdom teeth complications. You can also reduce your risk for problems if you see a dentist promptly when symptoms develop.

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There’s little clinical trial evidence to support the extraction of disease-free, asymptomatic impacted wisdom teeth.

A 2020 report in the Cochrane Database of Systematic Reviews stated that there may be a small association with symptom-free impacted wisdom teeth and gum disease and bone loss on second molars, but the evidence isn’t high quality.

Overall, this study concluded that the decision to remove wisdom teeth in these situations rests with the desires of the patient and the expertise of the dentist.

In addition, researchers advise that if wisdom teeth are left in place, they should be assessed by a dentist regularly to prevent problems down the road.

Wisdom teeth can cause problems if they go unaddressed — even if you’re not in any pain. It’s important to watch out for signs that your wisdom teeth are coming in or that there may be a problem.

If you suspect an issue with your wisdom teeth, talk to a dentist to make sure these teeth aren’t going to cause issues if you opt not to remove them.

Complications from wisdom teeth can cause gum disease and tooth decay, among other possible problems. The chances of an easier extraction and smoother recovery are improved if you respond quickly to signs that your wisdom teeth are coming in.