Most wisdom teeth don't need to come out. Some absolutely do.
Wisdom teeth are the most frequently extracted teeth in Australian adults. Yet a significant proportion of those extractions are done preventively on teeth that are causing no problems and may never cause problems. This guide explains when removal is genuinely necessary and when watchful waiting is the right call.
Why wisdom teeth cause problems
Impaction occurs when the tooth cannot fully erupt because it is blocked by the adjacent second molar or by the angle of the jaw. Pericoronitis is the most common reason I extract wisdom teeth in young adults. When a wisdom tooth is partially erupted, the overlying gum flap traps bacteria and food debris, causing recurrent infections. Two or more episodes is a strong indication for extraction. Decay on the wisdom tooth itself, or on the adjacent second molar where it cannot be accessed for cleaning, is another legitimate reason for removal.
When watchful waiting is appropriate
A fully erupted, upright wisdom tooth with a healthy gum and no adjacent decay may not need extraction even if it is asymptomatic. The decision to extract should be based on clinical and radiographic assessment, not on the default assumption that all wisdom teeth will eventually cause problems.
When extraction is recommended
I recommend extraction when there have been two or more episodes of pericoronitis, when there is active decay on the wisdom tooth or the adjacent second molar that cannot be restored, when a cyst or tumour is associated with the tooth, or when removal is part of an orthodontic treatment plan.
The procedure
Difficulty ranges from straightforward (a fully erupted, upright tooth) to complex (a horizontal impaction with curved roots). Simple extractions are done under local anaesthetic in the chair. Surgical extractions are also typically done under local anaesthetic, though IV sedation is available for anxious patients or complex cases.
Cost in Sydney
- Simple extraction (fully erupted): $200 to $350
- Surgical extraction (impacted): $350 to $600 per tooth
- OPG panoramic X-ray: $120 to $180
- IV sedation (optional): $500 to $900 additional
At Lumi Dental, Melrose Park
We assess wisdom teeth at your dental check-up, review your OPG, and give you an honest recommendation about whether extraction is actually indicated. Same-day emergency appointments for infected wisdom teeth. Open 7 days at Melrose Central. Book online.
