6 Common Reasons to Remove Your Wisdom Tooth

Just like any other tooth, wisdom teeth don’t always need to be removed. If they’re healthy, not causing problems, and unlikely to cause issues in the future, wisdom teeth can help you chew your food just like your other molars.
The reason these teeth often get blamed is because they’re the last to come in—usually in your late teens or early twenties. By then, there’s often not enough space left in your mouth, which can lead to problems like pain, infection, gum disease, and cavities.
In this article, we’ll break down 6 common reasons why your wisdom tooth might need to be removed.
In this article...
1. Prevent Bone Loss and Gum Disease
2. Pericoronitis (Infection of the Gum Over a Wisdom Tooth)
3. Prevent Tooth Decay
4. Prevent Damage to the Roots of Nearby Teeth
5. Ulceration and Cheek Damage
6. Prevent or Treat a Cyst or Tumor Around the Wisdom Tooth
How to Know If a Wisdom Tooth Needs to Be Removed
Is There a Better Time to Extract a Wisdom Tooth?
1. To Prevent Bone Loss and Gum Disease
Wisdom teeth grow in a very delicate area—right behind your second molars, the last teeth at the back of your mouth. As they try to push their way in, they can press against the bone that supports your second molars, making it thinner and weaker. This increases the risk of gum disease, receding gums, and bone loss in that area.What makes things worse is that these back teeth are the hardest to reach with a toothbrush. Plaque, food particles, and bacteria can easily build up around them, creating the perfect environment for gum inflammation.
Even mild inflammation behind your molars can open the door for bacteria to travel deep down into the gums and bone. This leads to the formation of "pockets"—spaces between the gum and the tooth where bone begins to break down. If this continues, you could end up losing not just the wisdom tooth, but also the healthy tooth right in front of it.
Removing wisdom teeth early can help prevent all of this. It gives your gums and bone a chance to heal before the damage becomes more severe and harder to treat.
2. Pericoronitis (Infection of the Gum Over a Wisdom Tooth)
When a wisdom tooth doesn’t fully erupt, it often ends up partially covered by gum tissue. Part of the tooth is visible, while the rest remains trapped beneath the gums.This awkward and unhealthy position makes it easy for food and plaque to get stuck, creating the perfect environment for bacteria to grow. When the gum covering the tooth becomes inflamed and infected, it leads to a condition called pericoronitis.
The telltale signs are red, swollen, and painful gums around the tooth, along with bad breath and sometimes difficulty opening the mouth. In more severe cases, you might also experience fever, facial swelling, and a general feeling of being unwell.
If the symptoms keep coming back or don’t go away with treatment, removing the wisdom tooth is often the best solution.
In some cases, the swollen gum becomes irritated by the opposing wisdom tooth from the other jaw constantly biting down on it. When this happens, the opposing tooth may also need to be removed.
3. To Prevent Tooth Decay
When a wisdom tooth is tilted or not properly aligned with the rest of your teeth, it’s much more likely to develop cavities. That’s because misaligned teeth tend to trap more plaque and are harder to brush and clean effectively.Since wisdom teeth sit right next to your second molars, they often end up affecting them too. If the wisdom tooth hasn’t come in straight, removing it can help prevent cavities that might otherwise damage both your wisdom tooth and the healthy molar next to it.
4. To Prevent Damage to the Roots of Nearby Teeth
Sometimes, wisdom teeth grow at an angle beneath the gums and push directly against the roots of the second molars. Instead of pushing on the bone, they can press so hard that they damage and resorb the roots of the adjacent tooth to make room to emerge.This can shorten your second molar's roots, causing the tooth to loosen over time, and may eventually fall out. This means you could lose not only your wisdom tooth but also a healthy molar right next to it.
Removing the wisdom tooth early—before it ever touches the neighboring tooth—is often the best way to protect your back teeth and avoid further pain or complications.
5. Ulceration and Cheek Damage
Sometimes, a wisdom tooth grows at an angle where its sharp chewing surface constantly rubs or presses against the inside of your cheek. This repeated friction can lead to irritation, injuries, and even painful ulcers on the cheek lining.It can become so uncomfortable that it affects your ability to eat, speak, or enjoy daily activities.
If the tooth can’t be reshaped or its sharp edges smoothed out, removing it is often the best way to stop the irritation.
6. To Prevent or Treat a Cyst or Tumor Around the Wisdom Tooth
Although it’s rare, abnormal growths like cysts or tumors can sometimes form around a wisdom tooth—especially if the tooth is impacted (stuck within the jawbone). In fact, many jaw-related cysts and tumors are linked to impacted wisdom teeth. Studies show that about 1% to 2% of impacted wisdom teeth are associated with these kinds of lesions.These growths often develop silently, with no noticeable symptoms at first. But as they grow, they can cause swelling, distort the jawbone, and even press on nearby nerves—leading to pain and discomfort.
Most of these lesions are benign (non-cancerous) and can be successfully treated by surgically removing both the wisdom tooth and the growth around it.
How to Know If a Wisdom Tooth Needs to Be Removed
The key rule to remember is simple: if the wisdom tooth is properly aligned, symptom-free, and unlikely to cause problems in the future, there’s no benefit to removing it. Extraction would only leave you with one less tooth.The decision to remove a wisdom tooth first depends on whether it's fully emerged or impacted.
Fully Emerged Wisdom Tooth
For teeth that have fully broken through the gums, there are two main things we look at: position and angulation.
A common scenario is when the wisdom tooth is partially covered by gum and tilted toward the adjacent molar. This position often traps bacteria and food, making the gum inflamed and prone to recurring infections. If the infection keeps coming back despite treatment, removal is usually the best option.
Another common reason to remove a fully erupted wisdom tooth is if it's misaligned with your bite and constantly injures your cheek or tongue. If reshaping the tooth doesn’t help, extraction might be the most comfortable solution.
Impacted Wisdom Tooth
If the wisdom tooth is trapped inside the jawbone, there's no way you can tell whether it needs to be removed just by looking in the mirror. In this case, your dentist will typically take a panoramic X-ray to evaluate:
- The position and angle of the tooth
- Its proximity to nearby nerves
- Whether it's affecting or threatening nearby teeth
If the impacted tooth isn’t causing any symptoms and is positioned away from other structures, there may be no need to remove it.
However, if the X-ray reveals a bad position that could lead to serious problems later—like root damage, cyst formation, or gum disease—then early removal might be the wiser choice.
Before recommending surgery, your dentist will always weigh the benefits and risks of the procedure, as sometimes it can be complex and carry certain risks.
Is There a Better Time to Extract a Wisdom Tooth?
Once it’s been decided that a wisdom tooth needs to be removed, the ideal time to do it is typically between 18 and 25 years old. At this time, the procedure is usually easier and the risk of complications is much lower.At a younger age, the roots of the wisdom teeth aren’t fully formed yet, and the surrounding bone is softer and more flexible. This makes it easier for the dentist to remove the tooth, and the healing process is usually quicker and smoother.
After the age of 30, things get a bit more complicated. The bone becomes denser, and the roots are fully developed. This can make the extraction more difficult and increase the chance of complications, like longer healing time, bone injury, or nerve damage.
That’s why, if your dentist believes the tooth will eventually need to be removed, it’s often best to do it sooner rather than later—while the conditions are still ideal for a safe and smooth recovery.