Do All Wisdom Teeth Need to Be Removed? A Local Guide

If you've been told you have wisdom teeth coming through, you might be wondering if they all have to go. It's a fair question, and the honest answer is no. Not every wisdom tooth needs to be removed. At Two Rocks Dental Care, we look at each tooth on its own, using a clear picture from an X-ray and a proper look in your mouth, before we talk about what's actually best for you.

This article walks you through when a wisdom tooth can usually be left alone, when removal tends to be the better option, and how we use X-rays to help make that call. We'll also cover impacted wisdom teeth, since that's often where the confusion starts.

So, do all wisdom teeth need to be removed?

No. Plenty of people keep their wisdom teeth for life without any trouble at all. Whether yours need to come out depends on things like how much room you have at the back of your jaw, which way the tooth is growing, and whether it's causing any problems right now or is likely to later.

A wisdom tooth that has come through straight, sits level with the teeth next to it, and is easy to reach with a toothbrush can often just be left where it is. The main thing we watch for is whether it's doing its job without putting the rest of your mouth at risk.

When it's usually fine to leave wisdom teeth alone

There are a few signs that suggest a wisdom tooth is not causing trouble and doesn't need to come out straight away.

• It has fully come through the gum and sits in line with the tooth next to it.
• You can brush and floss around it properly.
• There's no decay, no gum soreness and no cysts showing on the X-ray.
• It isn't pushing against or damaging the tooth beside it.

Even if your wisdom teeth look fine today, we'll usually keep an eye on them at your regular check-ups. Things can change over time, so it's worth having them reviewed rather than forgetting about them completely.

When removal is usually the better option

On the other hand, there are situations where leaving a wisdom tooth in place is more likely to cause problems down the track. According to healthdirect, wisdom teeth can cause issues when they don't come through fully and get stuck against other teeth or bone, which is what dentists call being impacted. Lower wisdom teeth take longer to come through and are more likely to become impacted than upper ones, which can make repeated gum infections more likely.

Common reasons removal is advised include:

• Repeated or ongoing infection around the gum covering the tooth.
• Tooth decay that's hard to clean or fix because of where the tooth sits.
• A wisdom tooth growing out at an angle and pressing into the tooth next to it.
• Cysts or other changes showing up around the tooth on an X-ray.
• Pain, swelling or difficulty opening your mouth properly.

If any of these sound familiar, it's worth getting it checked rather than waiting to see if it settles on its own.

What does impacted actually mean?

An impacted wisdom tooth is simply one that hasn't been able to push all the way through the gum, usually because there isn't enough space. It might be stuck under the gum, angled sideways, or pressing against the tooth in front of it. This often leaves a flap of gum sitting over part of the tooth, which can trap food and bacteria underneath.

Not every impacted wisdom tooth causes pain straight away. Some sit quietly for years. But because they're harder to clean and harder to see without an X-ray, they're more likely to cause problems eventually, which is why we tend to keep a closer eye on them.

How the X-ray helps us decide

You genuinely can't tell what's happening under the gum just by looking in the mirror. A wisdom tooth might look fine on the surface but be angled awkwardly underneath, or pressing into a nerve or the tooth beside it.

That's where an OPG comes in. It's a single X-ray that shows your whole jaw in one wide image, including teeth that haven't come through yet. We take this on-site X-ray ourselves at the practice, so there's no separate trip or referral needed before we can talk through your options.

Once we have the image, we can see exactly which direction each wisdom tooth is growing, how close it is to nearby nerves or teeth, and whether there's any decay, infection or cyst starting to form. This is what turns a guess into an actual plan, and it's a big part of how we explain our wisdom teeth advice to you in plain terms.

What happens if removal is the right call

If we do think a wisdom tooth should come out, we'll walk you through why, along with the other options and what's involved. We never push you into a decision. You get to ask questions and take the time you need.

Where it's suitable, our team can take care of wisdom teeth removal in the chair here at the practice, without you needing a trip down to Joondalup or further into Perth. Not every case is suitable for this, and some impacted teeth need a referral to an oral surgeon, particularly if they're sitting close to a nerve or are more deeply buried in the jaw. If that's the case for you, we'll explain exactly why and what the referral involves.

Frequently asked questions

Do impacted wisdom teeth always need to be removed?

Not always. If an impacted wisdom tooth isn't causing pain, infection or damage to nearby teeth, it may simply be monitored over time. Removal tends to be recommended when it starts causing symptoms or shows signs of future problems on an X-ray.

How do I know if my wisdom tooth needs to come out?

The only reliable way is a dental check-up combined with an X-ray. Pain isn't always a good guide, since some problem teeth don't hurt until things have gotten worse, and some teeth that feel fine are actually impacted underneath.

Can a wisdom tooth be left in if it's not hurting?

Often yes, if it's fully through, aligned well and easy to clean. We'd still want to check it at your regular visits, since things can shift or change without much warning.

Does removing one wisdom tooth mean I need all four taken out?

No. Each tooth is assessed on its own. Some people only need one or two removed while the others are left alone, depending on how each one is sitting.

Will my health fund cover wisdom teeth treatment?

That depends on your policy and the item numbers involved. We're a preferred provider for HBF, HCF and nib, which usually means a smaller gap for eligible treatment, and we can process your claim through HICAPS on the spot. We'll always give you a written quote first so you can check the details with your fund.

If you've been putting off getting your wisdom teeth looked at, it doesn't need to be a big ordeal. At Two Rocks Dental Care, we'll take a proper look, use our on-site X-ray if needed, and talk you through exactly what we see and why, so you can make a decision that makes sense for you. We're based locally for Two Rocks, Yanchep and Perth's northern coast, so you don't need to drive into the city for this. Give us a call on (08) 9502 9040, read more on our new patients page, or choose a time that suits you to book an appointment online.