Third Molars – AKA Wisdom Teeth

The last teeth to erupt in your mouth are your third molars, or “wisdom teeth.” These molars come in one on each side, located at the very back of your upper and lower jaws. The terms wisdom tooth or wisdom teeth come from the fact that they appear during early adulthood, at a time when young people are coming into an age of maturity. Most often, wisdom tooth begin to erupt between the ages of 18 and 21. These are the last of the 32 permanent teeth. These molars are also a source of discomfort for many young adults.

Wisdom Teeth

When Do Wisdom Teeth Need to be Extracted?

A thorough oral examination will help determine whether or not your wisdom teeth need extraction. Some wisdom teeth erupt with no problems; however, many of these third molars have anywhere from minor to significant problems that make extraction advisable or necessary. Some factors taken under consideration when determining if a wisdom tooth needs extraction are:


In some instances a person’s jawbone is not large enough to accommodate the third molars. In most of these cases, the wisdom teeth are impacted and grow underneath or slightly underneath the second molars. In such a situation, as the wisdom teeth erupt, they push on adjacent teeth and may cause crowding as the teeth shift out of position to make room for the molars.

Infection and Pain

Sometimes a third molar may partially erupt, “breaking through the gum” so that part of the tooth can be seen. Partial eruptions cause a problem because the gum often forms a flap creating a food trap. This area is very difficult to clean so bacteria build up, causing inflammation. If the situation is not treated in a timely manner, gum disease can result and/or dental cavities may form in the partially erupted tooth. Infected, swollen gums can be quite painful and cause bad breath.


Occasionally, a tooth which has not fully erupted, or one that is impacted, may be associated with benign but aggressive pathology. Clinical signs or symptoms of a problem are not always present. An x-ray can reveal sources of pathologic lesions or cysts. Removing the impacted tooth and associated cyst is usually sufficient to permanently resolve the pathology.

Adjacent Tooth Resorption

In some cases, when a third molar is impacted, it will cause the adjacent tooth to begin to resorb. This affects the health of the second molar and will lead to its eventual loss. Losing an otherwise healthy and functional tooth can be avoided by extracting the impacted wisdom tooth.

Problems with Erupted Third Molars

Because of the location of third molars, they can be difficult to keep clean. If not thoroughly cleaned, cavities can form; and if one forms in an area that is not conducive to being restored with a filling, the tooth will need to be removed.


It is best to remove wisdom teeth at an earlier age before the roots are fully developed. This leads to a faster recovery from surgery and less likelihood of developing complications.

Wisdom Teeth

There is no blanket approach to addressing wisdom teeth since each person’s case is unique.

A thorough examination along with x-rays will allow Dr. Millwala to make the best determination for recommendations on how to manage your wisdom teeth.

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