A wisdom tooth needs to come out when it is causing pain, repeated gum infections, decay in itself or in the tooth in front of it, or when an X-ray shows it is impacted in a way that will cause trouble. A wisdom tooth that has come through fully, sits in line and can be cleaned can usually stay. In Mumbai, a simple extraction costs ₹3,000 to ₹6,000 and surgical removal of an impacted tooth ₹8,000 to ₹18,000.
Here are the seven signs worth acting on, when a wisdom tooth is fine to leave, and what removal actually involves.
Why wisdom teeth cause trouble
Wisdom teeth, the third molars, are the last to appear, usually between 17 and 25. By then the jaw has finished growing and often has no room for them. A tooth with no room can come through at an angle, only part of the way, or not at all. Dentists call this impaction. A partly erupted tooth leaves a flap of gum over it that traps food and bacteria, and an angled tooth pushes against the molar in front. Both are why wisdom teeth are removed more often than any other tooth.
7 signs your wisdom tooth may need to come out
1. Pain or pressure at the back of the jaw
A dull ache behind the last molar, sometimes spreading to the ear or the side of the head, that comes and goes over weeks. Pain on its own is not always a reason for removal, but it is a reason for an X-ray.
2. Swollen, red or bleeding gum over the tooth
The flap of gum over a partly erupted wisdom tooth gets infected easily. This is called pericoronitis. The gum becomes swollen and tender, biting on it hurts, and it can flare up every few months. One episode may settle with cleaning and antibiotics. Repeated episodes mean the tooth should go.
3. A bad taste or bad breath from the area
Food and bacteria trapped under the gum flap, or between the wisdom tooth and its neighbour, produce a persistent unpleasant taste that brushing does not fix. It is an early sign of the same problem.
4. Difficulty opening your mouth or swallowing
When a wisdom tooth infection spreads into the surrounding tissues, the jaw muscles stiffen and opening the mouth becomes hard. Swelling of the face or difficulty swallowing means the infection is spreading and needs same-day attention.
5. Decay in the wisdom tooth or the tooth in front
Wisdom teeth are hard to reach with a toothbrush, so they decay. Worse, an angled wisdom tooth creates a trap against the back of the second molar, and that healthy tooth decays too. On an X-ray this is a common finding, and it is a clear reason to remove the wisdom tooth before the second molar needs a root canal.
6. Food packing between the last two teeth
If food gets stuck in the same spot behind your last molar after every meal, there is a gap or an angle that should not be there. Over time this leads to decay and gum disease at that spot.
7. An X-ray shows impaction, a cyst or damage to the neighbour
Sometimes there are no symptoms at all and the problem shows up on a routine X-ray: a horizontal tooth pressing on the second molar, a tooth that will never come through, or a fluid-filled cyst around the crown. Cysts grow slowly and can weaken the jaw, so these teeth are removed even when they do not hurt.
When a wisdom tooth can stay
Not every wisdom tooth is a problem. If it has come through fully, sits level with the other molars, meets a tooth in the opposite jaw when you bite, and you can clean it, there is no need to remove it. The same goes for a fully buried tooth that is well away from the nerve and the neighbouring roots and shows no cyst on X-ray; it can simply be watched at check-ups. Removing wisdom teeth just in case is not a good use of anyone’s money or recovery time.
What removal involves
Assessment
A digital X-ray shows the position of the tooth, the shape of its roots, and how close it sits to the nerve that runs through the lower jaw. That picture determines whether removal is simple or surgical, and the dentist should show it to you and explain it. If the roots are wrapped around the nerve, a 3D scan may be advised before surgery.
Simple extraction
For a wisdom tooth that has come through, the dentist numbs the area with local anaesthesia, loosens the tooth and lifts it out. You feel pressure but no pain. The whole thing takes 15 to 30 minutes, and the socket heals over a week or so. In Mumbai this costs ₹3,000 to ₹6,000 per tooth.
Surgical removal
For an impacted tooth, the dentist opens the gum, may remove a small amount of bone around the tooth, and often sections the tooth into pieces so each can be lifted out with less force. The gum is stitched afterwards. It is still done under local anaesthesia, takes 30 to 60 minutes, and costs ₹8,000 to ₹18,000 per tooth including follow-up and suture removal. The higher end applies to deeply buried or horizontally impacted teeth.
Recovery
Bite on gauze for half an hour, then rest for the day. Expect soreness and some swelling for two to four days, more after surgical removal, controlled with the painkillers prescribed. Eat soft, cool food, avoid rinsing hard or spitting for the first day, avoid straws, and do not smoke; all of these can dislodge the clot and cause a painful dry socket. Stitches are removed or dissolve within 7 to 10 days. Most people are back at work the day after a simple extraction, and within two or three days of a surgical removal.
A little numbness of the lip or tongue after a lower wisdom tooth is uncommon and almost always temporary, which is exactly why the X-ray assessment matters.
At i-Smile
At i-Smile Dental Clinic in Ghatkopar East, a simple wisdom tooth extraction costs ₹3,000 to ₹6,000 and surgical removal of an impacted tooth ₹8,000 to ₹18,000, including a digital X-ray to assess the tooth and the nerve position, local anaesthesia, post-operative advice and follow-up. Dr. Upasana Gosalia has been practising since 2009. The clinic is open Monday to Saturday from 9 am to 9 pm, and Sunday from 10 am to 6 pm.
If a wisdom tooth is bothering you, book a consultation for ₹350. It is adjusted against treatment on the same visit, and you will leave knowing whether the tooth needs to come out, and if so, how.
