Wisdom teeth are the last teeth to erupt in the jaw and almost every adult faces the question at some point: Should I have them extracted or not?!
Pain, swollen gums, pressure on adjacent teeth – symptoms can be extremely uncomfortable, and lack of information only increases fear.
This guide gives you concrete answers: why wisdom teeth cause problems, when extraction is necessary, what the procedure looks like, and what to expect during recovery.
What are wisdom teeth
Wisdom teeth are the third molars (third molars), located at the very end of the dental row – two in the upper jaw and two in the lower jaw. In dentistry, they are often called eights because they are the eighth teeth from the midline of the dental arch.
The name “wisdom teeth” comes from the fact that these teeth erupt during the period of maturation, when a person has already “acquired wisdom,” hence the English term wisdom tooth. From Greek philosophy comes the explanation that the pain during eruption stimulates wise thinking.
Unlike other permanent teeth that erupt in childhood, wisdom teeth appear much later – usually between 17 and 25 years of age, and sometimes in the third decade of life. This late eruption is the main reason why they often cause problems: the jaw is already formed and there is not enough space.
How many wisdom teeth does a person have
Most people have four wisdom teeth – one in each corner of the jaw. However, it is not uncommon for one or more wisdom teeth to never erupt, or to fail to form at all. Some people have only upper teeth, some only lower.
There are also people who develop a fifth, so-called supernumerary wisdom tooth, but that is an exception. The exact number and position of wisdom teeth is determined by X-ray or 3D imaging of the jaw.
Wisdom tooth growth – When they grow and how long it takes
Wisdom teeth usually start to erupt between 17 and 25 years of age, but there is no fixed rule. For some people, wisdom teeth begin to emerge after age 30.
The eruption process itself can be rapid – the tooth breaks through the gum in a few weeks, but it can take years. In many people, growth occurs periodically: the wisdom tooth begins to emerge, then stops, and resumes after several months. This means that the entire period from the first eruption to complete growth of all four teeth can take several years.
The speed of growth depends on several factors: the amount of space in the jaw, the position of the tooth in the bone, and the general condition of the gums. That is why it is important to monitor the situation from the first symptom, because even if the wisdom tooth does not cause problems immediately, that does not mean it will not in the future.
Upper and lower wisdom teeth – Is there a difference
There is a difference, and it is clinically significant.
Upper wisdom teeth are usually easier to extract because the bone of the upper jaw (maxilla) is softer and has a more porous structure. They often have a simpler root shape and better access.
Lower wisdom teeth are a more common source of problems. The bone of the lower jaw (mandible) is denser and harder, so lower wisdom teeth are more often impacted – trapped in the bone or at the wrong angle. Also, the inferior alveolar nerve runs near the lower wisdom teeth, which requires extra care during surgical extraction.
Wisdom tooth pain – why it hurts and what to do
Wisdom teeth hurt most often for three reasons: gum inflammation during eruption, infection in pockets around the tooth, and pressure on adjacent teeth due to lack of space in the jaw.
First, the eruption process itself means that the tooth must break through the gum to emerge on the surface. The surrounding tissue becomes inflamed, and chewing further irritates the area. This is a natural occurrence, but it can be very uncomfortable.
Second, pockets often form between the wisdom tooth and the gum – so-called pockets where food particles get trapped. If these pockets are not cleaned properly, they create ideal conditions for bacteria to multiply, leading to infection.
Third, if there is not enough space in the jaw, the wisdom tooth pushes against adjacent teeth. This pressure causes a deep, dull pain that can spread.
What you can do while waiting to see a dentist:
Pain relievers (ibuprofen or acetaminophen) can temporarily ease the pain. Cold compresses on the outside of the cheek reduce swelling. Avoid hot food and beverages because they increase inflammation.
However, pain in the wisdom tooth area is always a signal to visit a dentist, because the cause may be more serious than it appears at first glance.
Wisdom tooth inflammation – Symptoms and causes
Wisdom tooth inflammation (pericoronitis) is one of the most common conditions that accompanies the growth of these teeth. It occurs when the gum that partially covers the wisdom tooth becomes infected with bacteria.
Symptoms of wisdom tooth inflammation include:
- Redness and swelling of the gum around the wisdom tooth
- Pain when chewing and swallowing
- Unpleasant taste in the mouth and bad breath
- Difficulty opening the mouth
- Elevated temperature in severe cases
- Swollen lymph nodes on the neck
Inflammation occurs because the area around partially erupted wisdom teeth is difficult to maintain hygiene. Food and bacteria accumulate under the gum flap, leading to infection.
In mild cases, inflammation can be controlled with antibiotic therapy and proper hygiene maintenance. At DentalVortex, laser gum removal intervention is also available – a completely painless method that creates space for wisdom tooth growth and eliminates pus pockets, preventing further complications.
If inflammation recurs, this is usually a sign that the wisdom tooth should be extracted.
Impacted wisdom tooth
An impacted wisdom tooth is a tooth that is completely or partially trapped in the jaw – it has not erupted on the surface or has only partially erupted. This is one of the most common reasons for surgical extraction.
Impaction occurs when there is simply not enough space in the jaw for the tooth to be in the correct position. The wisdom tooth can then be:
- Vertically impacted – in a normal position but trapped below the gum
- Horizontally impacted – lying horizontally and pushing the adjacent tooth (second molar)
- Angularly (obliquely) impacted – tilted at an angle toward the adjacent tooth or toward the back of the jaw
Horizontally and obliquely impacted wisdom teeth are most problematic because they actively push the second molar, can cause decay on the adjacent tooth, and often lead to cyst formation around the unerupted tooth.
An impacted wisdom tooth does not necessarily cause problems immediately – it can go months or years without symptoms. But that does not mean it is harmless. An X-ray reveals the position and direction of growth, on the basis of which the surgeon assesses whether extraction is necessary.
Decayed wisdom tooth: Extract or treat
A decayed wisdom tooth is a wisdom tooth affected by cavity. Because of its position at the very end of the dental row, wisdom teeth are extremely difficult to clean with a toothbrush and floss, making them more prone to decay.
Whether a decayed wisdom tooth is treated or extracted depends on several factors:
Extraction is recommended when the cavity has deeply affected the tooth, when the wisdom tooth is in an unfavorable position that makes filling difficult, or when the decayed wisdom tooth endangers the adjacent tooth.
Treatment may be an option only if the wisdom tooth has fully erupted, is in the correct position, and the cavity is in the early stage.
In practice, decayed wisdom teeth are extracted far more often than they are treated. The reason is practical: even if a filling is placed, poor accessibility for hygiene means the cavity will likely recur.
Wisdom tooth extraction – When it is necessary
Wisdom tooth extraction is necessary when the tooth causes pain, inflammation, or damages adjacent teeth. However, not every wisdom tooth needs to be extracted – if it has erupted correctly, does not push adjacent teeth, and is easy to maintain, it can stay in the jaw.
The most common reasons for wisdom tooth extraction are:
- Recurrent gum inflammation around the wisdom tooth (pericoronitis)
- Wisdom tooth pushes the adjacent tooth and causes pain or decay on it
- Impaction: tooth cannot erupt or is in the wrong position
- Cavity on the wisdom tooth that cannot be adequately treated
- Cyst formation around the unerupted tooth
- Orthodontic indications – wisdom tooth interferes with planned treatment
Dentists’ opinions generally differ: some recommend preventive extraction before problems occur, while others believe you should wait and react only when the first symptoms appear.
The best approach is to consult with an oral surgeon specialist who will assess your individual case based on an X-ray.
Simple wisdom tooth extraction
Simple (routine) wisdom tooth extraction is possible when the tooth has fully erupted into the oral cavity, is in the correct position, and there are no complications. In this case, the dentist extracts the tooth with forceps under local anesthesia, without cutting the gum and without sutures.
The procedure is quick (usually takes about 15 minutes) and recovery is shorter than with surgical extraction. Pain after the procedure is minimal and is controlled with standard pain relievers.
Simple extraction is possible in only a small percentage of cases because most wisdom teeth are not in an ideal position for this approach.
Surgical wisdom tooth extraction
Surgical wisdom tooth extraction is the most common form of intervention on these teeth and is performed when the wisdom tooth cannot be extracted by standard means, either because it is impacted, partially erupted, or the crown portion is destroyed.
The procedure involves an incision on the gum, if necessary removal of bone around the tooth, and extraction of the tooth whole or in pieces. At the end, the wound is sutured and the sutures are removed after seven days.
The procedure is performed under local anesthesia and is completely painless. For patients who experience significant anxiety, DentalVortex offers inhalation sedation – a treatment using a mixture of oxygen and nitrous oxide that relaxes the patient while keeping them conscious throughout the procedure.
Learn more about the procedure itself, types of interventions, and pricing on the page about surgical tooth and wisdom tooth extraction.
What does wisdom tooth surgery look like – step by step
Before each procedure, a digital X-ray is taken which gives the surgeon insight into the tooth position, root shape, and condition of the surrounding bone. In more complicated cases, a 3D image is also necessary for precise planning of the approach.
Wisdom tooth surgery step by step:
- Application of local anesthesia – the procedure begins only when anesthesia is fully effective
- The surgeon makes an incision on the gums to access the tooth
- If necessary, a portion of bone that impedes access is removed
- The tooth is extracted whole or in pieces, depending on position
- The wound is cleaned and PRF preparation is applied if necessary for faster healing
- Sutures are placed and removed after 7 days
Surgery duration depends on case complexity: a vertically impacted wisdom tooth is extracted faster (15–30 minutes), while horizontally impacted teeth require more time (up to 45 minutes, rarely up to an hour).
Recovery after wisdom tooth extraction
Recovery after wisdom tooth extraction takes about seven days, until suture removal. The first 48-72 hours are the most important period. By following the surgeon’s instructions, healing proceeds without complications
What to do in the first few days:
- Remove the gauze placed on the wound after 20 minutes
- Ice the surgical area from the outside – cold compresses for 10 minutes, several times during the first day
- Eat soft, cold food for the first 24 hours – yogurt, ice cream, puree foods
- Take pain relievers and antibiotics only as recommended by the surgeon
- Maintain oral hygiene with a soft toothbrush, being careful around the wound
What to avoid:
- Rinsing the wound with water or solutions in the first few days – the coagulum in the wound protects it and should not be removed
- Smoking for at least 48 hours – nicotine slows healing
- Intense physical activity for the first 2–3 days
- Hot food and beverages for the first 24 hours
How long does pain last after extraction?
There is no exact period for pain duration – it can last half a day or seven days because it is all individual. Severe pain 3 or more days after the procedure is not normal; if it occurs, contact the clinic.
PRF treatment for faster recovery – At DentalVortex, PRF (platelet-rich fibrin) is applied after surgical extraction – a completely natural preparation made from the patient’s own blood. The PRF membrane is placed directly in the wound and significantly accelerates healing, reduces swelling and pain in the days following the procedure. It has been used in the clinic for more than ten years as a standard part of the protocol.
Wisdom tooth extraction price
The price of wisdom tooth extraction depends on the complexity of the case, whether simple or surgical extraction is needed, what the tooth position is, and whether additional treatments are necessary.
| Service | Price |
| Surgical tooth extraction | 12,000 RSD |
| Surgical wisdom tooth extraction | 15,000 RSD |
| PRF preparation | 6,000 RSD |
| PRF preparation for 2 teeth | 10,000 RSD |
| Package: surgical extraction + inhalation sedation + PRF | 30,000 RSD |
The surgeon can give you an exact price only after examination and imaging because each case is individual. At your first visit to DentalVortex, you will receive a clear estimate and explanation of all procedure steps before anything is done.