Wisdom Teeth

Wisdom Teeth Coming In? What You Need to Know

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While not everyone has wisdom teeth, when they do erupt, they can become impacted or infected, causing pain and, sometimes, a need for extraction. Here, I explain how to tell if your wisdom teeth are the source of any soreness, effective ways to beat the pain, and how to decide whether they should be removed.

by Dr. Burhenne

Wisdom Teeth Coming In? What You Need to Know

Around the age of six, our adult teeth begin to come in, replacing the baby teeth we were born with. In most people, the central incisors are the first to emerge, followed by lateral incisors and first molars. By age 13, most permanent teeth are in place—except for the wisdom teeth, that is.

Wisdom teeth are completely unpredictable, in terms of both when they will arrive and whether they will erupt at all. Some people don’t have any wisdom teeth, some have just two of four, and others have a full set.

Unfortunately, if and when they do arrive (typically between the ages of 17 and 25), wisdom teeth can bring a host of problems, including inflammation, swelling, and pain.

When our faces haven’t grown to their full potential (for reasons I’ll discuss below), wisdom teeth simply don’t have enough room to emerge. As a result, they can become impacted or infected. And, yes, they may need to be extracted.

If your wisdom teeth are coming in, you may have a lot of questions, like:

  • Why are my wisdom teeth so painful?
  • How can I cope with the pain?
  • Do I need to have my wisdom teeth removed?
  • Why do I even have wisdom teeth in the first place?

In this article, I’ll answer those questions and more to help you navigate your wisdom teeth eruption with as little pain and complications as possible.

Why do we have wisdom teeth?

In general, wisdom teeth serve no recognized purpose, other than providing an additional molar pair on each side of the mouth for the process of grinding food to make it easier to swallow. However, due to their late arrival—usually between the ages of 17 and 24—these four extra teeth can become problematic if they don’t have enough room to emerge.

Our modern diets often contain too little vitamin K2, which research has found to be responsible for the underdevelopment of our jaw. (1) Many dentists, particularly those aware of the work of Weston A. Price, believe this underdevelopment is one of the reasons why wisdom teeth commonly have no place to properly emerge.

And there are other causes of an underdeveloped jaw, including decreased breastfeeding rates, and an infant diet that consists primarily of soft foods.

Wisdom teeth (a.k.a., third molars) are the final teeth to push through the gums. If their placement and alignment are good and the gum tissue around them is healthy, they are unlikely to cause problems. In this case, they don’t need to be removed.

However, wisdom teeth may begin to emerge sideways or at odd angles to the rest of your teeth. They can remain trapped under the gum or disrupt the natural alignment of your teeth. Additionally, these “third molars” can become impacted and/or develop tumors or cysts which can eventually destroy the jawbone and otherwise healthy teeth if left unattended. And if the wisdom teeth only partially erupt, they can allow bacteria to enter the gums, causing an infection that causes stiffness, swelling, pain, and extreme discomfort. Studies have also shown that gum disease most often begins around wisdom teeth, before spreading to other parts of the mouth. (2)

Not surprisingly, when considering the potential for these and other problems, many dentists encourage the early removal of wisdom teeth.

How to tell if you have wisdom teeth coming in (or something else)

The emergence of wisdom teeth can be painful for some people, but pain in the back of the mouth isn’t always a result of wisdom teeth. In fact, TMJ can cause similar symptoms to wisdom teeth.

Signs it might be wisdom teeth:

  • Pressure or throbbing in your gums in the back of your mouth.
  • Swollen gums or visible cuts in your gums.
  • Persistent earaches or headaches, which may occur when wisdom teeth are trying to make their way down and there’s not enough room in the mouth. Pressure can build up around the surrounding teeth and tissues, causing significant pain in the mouth that is referred to other areas.
  • Vigorous brushing or rinsing in the area provides relief

A common misconception is that a change in the alignment of your teeth could be wisdom teeth causing crowding. However, there is no clinical evidence to support this popular theory. Here are some other symptoms that are likely unrelated to wisdom teeth coming in:

Signs it’s probably not wisdom teeth:

  • Non-lingering sensitivity to sweets, hot drinks, cold drinks, ice cream, and even to cold air may indicate an exposed root, which is the most common type of tooth pain.
  • Mild to sharp pain when you bite down, a visible hole in your tooth, or staining, which is likely a cavity.
  • A persistent toothache or sensitivity that lasts for at least a few minutes after exposure to hot, cold, or sweets, which may be a sign of nerve damage.

Pain is our body’s way of telling us something’s wrong. It comes in many different forms, rearing its ugly head at the most inopportune times. And because it often radiates from its source, it can be difficult to determine the root cause.

Wisdom tooth pain is no exception. While not everyone will experience discomfort—or even have wisdom teeth at all—if you’re between the ages of 16 and 25, you should be aware of the symptoms associated with erupting wisdom teeth.

Why Wisdom Teeth Cause Pain

Generally, the pain associated with erupting wisdom teeth is due to a few causes.

Sometimes the wisdom tooth is trying to emerge without sufficient room to fully erupt. This can allow the tooth to attempt eruption at odd angles, pressing against other teeth. This condition is called impaction.

Wisdom teeth can also partially erupt. This allows bacteria to enter the area and cause an infection, as well as swelling, stiffness, and pain. This condition is called periocoronitis. It is essentially the adult version of teething and is the most common cause of wisdom teeth pain.

A more serious cause of pain can be the result of tumors or cysts forming around the impacted wisdom tooth. This condition can lead to the destruction of the jawbone and other healthy teeth if not treated properly. (3)

All-Natural Ways to Cope with Wisdom Teeth Pain

If you’re experienced prolonged pain with erupting wisdom teeth, I strongly encourage you to see your dentist as soon as possible. You’ll obviously want to do what you can to reduce the pain, and while over-the-counter and prescription painkillers can do the job, there are also some natural pain relievers worth trying.

Clove Oil

Clove oil is a natural anesthetic, and it can be mixed in a 1:1 ratio with a carrier oil, such as coconut oil, to provide pain relief—simply rub into onto the affected gum area. This is a short-term option for pain relief that is best utilized while awaiting surgery to remove an impacted or problematic wisdom tooth. Please also note that the use of essential oils in the mouth is not recommended on a prolonged basis because these compounds can kill useful bacteria and disrupt the balance of the oral microbiome. (4, 5)

Peppermint Oil

Another essential oil that can provide natural pain relief is peppermint oil. It, too, can be mixed with a carrier oil, such as coconut oil, in a 1:1 ratio and then applied directly to the gums. This is another short-term tooth/gum pain relief option while awaiting a more permanent solution.

Saltwater

Real sea salt contains compounds that are both antibacterial as well as pain relieving. In fact, the use of a warm salt water solution to relieve pain and reduce the chance of infection has been a common practice among cultures for centuries. To decrease wisdom teeth pain, swish warm salt water in the mouth for 1-2 minutes.

Anti-inflammatory diet

When aiming to reduce pain—which is simply a symptom of inflammation—one important solution is to seek ways to reduce sources of inflammation throughout the body. Eating an anti-inflammatory diet full of fruits, vegetables, healthy proteins, nuts/seeds, and healthy fats is a great way to do this, but there are also a number of supplements and spices that are scientifically proven to reduce inflammation and potentially help with tooth pain. My favorites include the spices ginger, turmeric, garlic, and basil. (6, 7, 8, 9)

How to Tell if Your Wisdom Teeth Need to Be Removed

If your wisdom teeth have become impacted and are unable to fully break through the gums—due to their position in the mouth or lack of sufficient space for them to emerge—extraction may be necessary. And as I mentioned, impacted wisdom teeth are most often, but not always, accompanied by infection and significant pain. (10)

Another reason the wisdom tooth may need to be extracted (or partially extracted) is if the tooth has become involved with the inferior alveolar nerve. As mentioned above, this has the potential for serious consequences. If the wisdom tooth has been found to be diseased in some way, it may also need to be extracted to prevent a worsening of the condition or spreading to other nearby teeth.

A final reason you and your dentist may choose extraction of the wisdom teeth is if their eruption causes other teeth in the mouth to be crowded into a position that makes chewing more problematic. The proper alignment of the teeth is necessary for correct functioning of the teeth for biting and chewing of foods.

Many people opt to have their wisdom teeth removed simply because they are causing pain. But pain, alone, doesn’t necessitate an extraction.

Although we don’t often remember it, there is always some level of discomfort involved in the eruption of teeth through the gums. As a young adult, the discomfort may be very noticeable. This discomfort does not, however, mandate that the wisdom teeth be removed.

And if the discomfort goes away once the wisdom teeth have fully emerged, it is likely that they will not need to be extracted.

A recent study found that more than 10 million third molar extractions are performed each year on 5 million people. These result in more than 11 million days of “standard discomfort or disability,” which can include pain, swelling, bruising, and malaise.

Additionally, more than 11,000 people each year suffer permanent numbness of the lip, tongue, and cheek, known as paresthesia, due to nerve injury during the procedure.

Perhaps more importantly, one review found that at least two-thirds of these extractions were unnecessary. (11)

Given the potential for injury, wisdom tooth extraction isn’t always needed. Therefore, you need to know when your wisdom teeth need to be extracted and if it’s worth the additional risks.

8 important things to know about erupting wisdom teeth

We’ve covered quite a bit about wisdom teeth and the symptoms they can cause when they start to come in. Here’s a recap, along with even more insight on these finicky teeth:

1) Not all wisdom teeth need extraction.

Wisdom teeth are the third molars in the back of your mouth. Some push through with no problem, some become impacted, some are positioned perfectly, and some simply wreak havoc. In other words, not all wisdom teeth are created equal!

In any given family, one sibling may need all four extracted while another may experience absolutely no wisdom tooth pain or problems at all. So don’t make assumptions about your own need for extractions based on what your friends or siblings have experienced.

Instead, consult your dentist for an expert opinion on whether you should have your wisdom teeth removed. If your dentist considers the possibility of extraction, he or she can refer you to an oral surgeon who will give you definitive answers.

2) Not everyone experiences wisdom tooth pain.

Just because you have wisdom teeth doesn’t mean you’re going to have pain or problems. Many lucky teenagers and young adults have plenty of room in their mouths and experience only minor irritation (or no pain at all) when their wisdom teeth come in.

3) Impacted wisdom teeth are more likely to become infected.

While impacted wisdom teeth are quite common and don’t always cause pain, they are more likely to become infected.

An impacted tooth is one that gets stuck in the bone or gum tissue when it’s trying to make its way out. Even when the tooth is only partially erupted, it can be suddenly exposed to a new set of bacteria inside the oral cavity. The emerging tooth can then create hard-to-clean pockets where these bacteria can build up, eventually triggering infection.

Signs of infection include redness, swelling, pain, and bad breath (halitosis). If you experience any of these symptoms, it’s time for a trip to your dentist!

4) Not all wisdom teeth come in at the same time.

Your wisdom teeth may not come in at the same time as your sister’s or your best friend’s did. And all four of yours may not come in at once, either. One tooth could be impacted while three others may emerge with no problem. Two may come in at once and the other two might take another year or two. Dental x-rays and regular exams are the best way to stay aware of their progress or lack thereof.

5) Extraction doesn’t have to be a bad experience.

We’ve all heard the horror stories of impacted, infected wisdom teeth being extracted, resulting in patients writhing in pain and slurping horrible-tasting smoothies for days. (Check out this recipe for a tasty alternative.)

Keep in mind, someone else’s bad experience (which, more times than not, is grossly exaggerated) has absolutely no bearing on how you will recover. Honestly, most people don’t have post-surgical complications.

The best thing you can do to ease your mind is to do your research. Make yourself aware of the process, the procedures, and the probable timeline for recovery. Talk to your oral surgeon and don’t be afraid to ask questions. Like so many other things in life, when you know what to expect, it’s a lot less stressful! My article on wisdom teeth surgery can help you feel more prepared.

6) Early detection of impacted or infected wisdom teeth prevents problems.

Think, for a minute, about the roof on your home.

You’re on a ladder cleaning the leaves out of your gutters when you notice a couple of shingles have gone askew. Your instinct is to push them back in place and hope for the best, but you know that ignoring the little things can cause a domino effect. Before you know it, you’d have a real problem, like buckets of water in your living room!

Alternatively, you can nip it in the bud and call in a professional roofer to fix those shingles and patch up your roof while the problem is still small.

Well, the same thing goes for your mouth. Impacted wisdom teeth are not always problematic, but they are more likely to become infected, which is not a problem to ignore. I suggest you see a dentist as soon as possible to identify and address any potential issues before they become a problem.

Plus, the earlier you have your wisdom teeth extracted (if that is the best option for you), the better. The surgical procedure will likely be easier, as the teeth are rounder and less developed.

A wisdom teeth extraction could be performed as early as age 14, if the wisdom teeth have already erupted.

A paragraphic x-ray is the best way to determine whether there is, in fact, enough room for the wisdom teeth to fully emerge. If there’s not, I recommend not waiting beyond age 17 to make the decision to have them removed.

7) Home remedies can help with infections and wisdom tooth pain.

While many of us are quick to grab the bottle of painkillers, there are many natural ways to help reduce pain and treat infection. Ginger, turmeric, and basil are known for their anti-inflammatory properties while peppermint, clove, and garlic may help to alleviate tooth pain.

8) Not everyone has wisdom teeth!

If you’ve been wondering when your wisdom teeth are going to emerge, just know that you could be waiting a lifetime. Some people do not have any wisdom teeth, some only have two, and still others have three.

Wisdom teeth are actually some of the most common of all teeth to be missing. Likewise, there’s a small population of people who are born with an extra set of wisdom teeth.

While everyone will have a different experience with wisdom teeth, it doesn’t have to be a traumatic encounter. Stay on top of the state of your wisdom teeth with regular x-rays and dental exams, and be sure to talk with your dentist if you have any questions or concerns.

And, if you’re wondering… the amount of wisdom teeth you have or don’t have is no indication of how wise you will grow up to be!

read next: Wisdom Teeth Removal: Know Before You Go

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Dr. Mark Burhenne DDS

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