If you do not remove wisdom teeth, nothing may happen at all, as long as they are fully erupted, healthy, and easy to clean. Problems arise when wisdom teeth are impacted or only partly through the gum, where they can cause repeated infections, decay, gum disease, damage to the neighbouring molar, and, less commonly, cysts. Keeping healthy wisdom teeth is common and safe, but ignoring symptomatic or impacted ones can lead to serious complications, so regular X-ray monitoring with a dentist in Ottawa is the safest approach.
Many people delay a decision about their wisdom teeth because they feel fine, dread surgery, or have heard mixed advice. Some are told removal is always necessary, while others hear it is never needed. The truth sits in between and depends entirely on your teeth, your jaw, and your symptoms. Our page on wisdom teeth removal in Ottawa explains when surgery is typically recommended and how it is performed.
For patients who feel anxious about oral surgery, comfort options range from nitrous oxide to IV sedation and general anesthesia, all described on our sedation dentistry page.
Eligible patients may also be able to use benefits through the Canadian Dental Care Plan, and you can review details on our CDCP information page. If you have questions about your specific situation, you can reach our team to arrange an assessment. Below, we explain what can happen when wisdom teeth are left in place, how to tell whether yours are a risk, and how dentists decide.
What Are Wisdom Teeth?
Wisdom teeth are the third molars, usually erupting between the late teens and mid-twenties. Because they are the last teeth to arrive, there is often not enough space in the jaw for them to come in straight and fully. Some people never develop them, while others have one, two, three, or all four.
Impacted vs Erupted Wisdom Teeth
- Fully erupted: The tooth has come through completely and meets the opposing tooth. Often safe to keep if it can be cleaned well.
- Partially erupted: Part of the tooth is visible, with gum covering the rest. This creates a pocket that traps bacteria and food.
- Soft tissue impaction: The tooth is under the gum but above the bone.
- Bony impaction: The tooth is partly or fully trapped in the jawbone, often at an angle.
What Can Happen If Problem Wisdom Teeth Are Not Removed?
1. Pericoronitis (Recurring Gum Infection)
Partially erupted wisdom teeth commonly cause pericoronitis, a painful infection of the gum flap. Symptoms include swelling, a bad taste, difficulty opening the mouth, and pain when swallowing. It often returns repeatedly until the tooth is removed.
2. Tooth Decay
Wisdom teeth are hard to reach with a toothbrush. Decay in the wisdom tooth, or on the back of the second molar next to it, is very common.
3. Damage to the Second Molar
An impacted wisdom tooth leaning forward can press against the second molar, causing decay in a hard-to-treat spot or even resorbing its root. In some cases, both teeth are eventually lost.
4. Gum Disease and Bone Loss
Deep pockets around wisdom teeth allow bacteria to damage the supporting bone, which can also affect the second molar.
5. Cysts and Tumours
Occasionally, a fluid-filled cyst forms around an impacted tooth. Cysts can slowly expand, damaging bone and nearby teeth. Rarely, other growths develop.
6. Spreading Infection
Untreated infections around lower wisdom teeth can spread into the spaces of the jaw and neck, which can become a medical emergency.
What Happens If Healthy Wisdom Teeth Are Kept?
Many people keep healthy wisdom teeth for life without problems. Fully erupted, upright wisdom teeth that meet their opposing teeth and can be cleaned properly may even be useful for chewing or as future bridge supports. The key is monitoring. Wisdom teeth that are healthy at 20 may develop issues later, so periodic X-rays and exams are recommended.
Comparison Summary: Keep or Remove?
- Keep and monitor: Fully erupted, upright, cleanable, no decay, no gum pockets, no symptoms.
- Consider removal: Repeated infections, decay that cannot be restored, damage to the second molar, gum disease around the tooth, cysts, or pain.
- Discuss preventive removal: Impacted teeth likely to cause problems, especially in younger patients when surgery tends to be easier.
Does Age Affect the Decision?
Younger patients often recover faster because their roots are not fully formed and their bone is less dense. As people age, roots lengthen and may sit closer to nerves, and healing can be slower. This does not mean everyone should have wisdom teeth removed young, but it does make early evaluation, usually in the late teens, very worthwhile.
How Dentists Evaluate Wisdom Teeth: Step by Step
- History: Symptoms such as pain, swelling, or bad taste.
- Clinical exam: Checks for gum flaps, decay, and pocket depth.
- Imaging: Panoramic X-rays show tooth position and root development. 3D imaging may be used when roots are close to nerves or sinuses.
- Risk assessment: The dentist weighs the likelihood of future problems against surgical risks.
- Recommendation: Remove, monitor, or refer, with a clear explanation.
- Follow-up plan: Monitoring schedule or surgical and sedation planning.
Common Myths About Wisdom Teeth
Myth: Everyone must remove their wisdom teeth.
Fact: Healthy, functional wisdom teeth can often stay with monitoring.
Myth: No pain means no problem.
Fact: Decay, bone loss, and cysts around wisdom teeth can develop without symptoms.
Myth: Wisdom teeth are the main cause of crooked front teeth.
Fact: Research suggests late crowding has several causes, and wisdom teeth are not considered the main one.
Myth: Removal always means a terrible recovery.
Fact: With good planning and aftercare, most people feel much better within a few days.
Real Patient Scenarios
Scenario 1: A 19-year-old has four impacted wisdom teeth seen on X-ray but no symptoms. Given the angle of the lower teeth toward the second molars, removal is recommended while healing is typically faster.
Scenario 2: A 35-year-old has fully erupted upper and lower wisdom teeth that he cleans well. They are kept and checked at routine visits.
Scenario 3: A 28-year-old has had three episodes of pericoronitis in a year. After the swelling settles, the tooth is removed and the infections stop.
Common Mistakes People Make
- Ignoring repeated swelling at the back of the mouth.
- Relying on antibiotics for each flare-up without addressing the cause.
- Skipping X-rays because nothing hurts.
- Delaying removal until a painful emergency occurs.
- Smoking after extraction, which increases the risk of dry socket.
Safety Disclaimer
Seek urgent care for swelling spreading to the neck or eye, difficulty breathing or swallowing, or high fever. This article is general information and does not replace an individual assessment. Wisdom tooth evaluation and surgery should be performed by licensed dental professionals registered with the Royal College of Dental Surgeons of Ontario (RCDSO).
Wisdom Tooth Care in Ottawa
DentoCare Dental is a trusted Ottawa dental clinic providing complete family dental care under one roof, with modern technology and a gentle, compassionate approach. The fully digital office uses modern imaging to assess wisdom teeth accurately for families across Ottawa and surrounding communities.
New patients and CDCP (Canadian Dental Care Plan) patients are welcome. Services include wisdom teeth surgery, preventive care and oral hygiene, Invisalign, dental implants and full mouth reconstruction, cosmetic dentistry including whitening, veneers, and bonding, crowns, bridges, fillings, dentures, root canal therapy, gum disease treatment, and laser therapy. Sedation dentistry, including general anesthesia, is available for anxious patients or complex surgery.
If your wisdom teeth are bothering you, or you need an emergency dentist in Ottawa for swelling, visit 90 Richmond Rd, Ottawa, Ontario K1Z 0C3, call (613)-900-5751, or email info@dentocare.ca. Many families rely on this best dental clinic in Ottawa for clear, honest advice.
What Does Wisdom Tooth Removal Involve?
- Planning visit: Imaging, medical history, and a discussion of comfort options.
- Anesthesia: Local anesthetic numbs the area, with sedation or general anesthesia if chosen.
- Removal: The tooth is lifted out, sometimes in sections if it is impacted.
- Closure: Stitches may be placed to support healing.
- Aftercare: Gauze, cold compresses, soft foods, and pain management for a few days.
- Follow-up: A check to confirm healing is on track.
Most patients return to normal routines within several days, with the gum fully closing over the following weeks.
How to Care for Wisdom Teeth You Keep
- Use a compact-head or angled toothbrush to reach the back of your mouth.
- Floss behind the last molar, or use an interdental brush.
- Rinse with water after meals to clear trapped food.
- Keep regular cleanings and X-rays as recommended.
- Report any swelling, bad taste, or pain early.
Upper vs Lower Wisdom Teeth: Different Risks
Lower wisdom teeth are more likely to become impacted and infected because the lower jaw has less room and denser bone. They also sit close to the inferior alveolar nerve, which provides feeling to the lower lip and chin, so careful 3D imaging is often used before removal to reduce the risk of nerve irritation.
Upper wisdom teeth are generally easier to remove, but their roots can sit close to the maxillary sinus. When an upper wisdom tooth has no lower tooth to bite against, it may drift downward, rub against the cheek, or trap food against the second molar. Because the risks differ, your dentist considers each wisdom tooth individually. It is common for some to be removed while others are simply monitored.
Signs Your Wisdom Teeth Need Attention
- Pain or pressure at the back of the jaw
- Red, swollen, or bleeding gums behind your last molar
- A bad taste or persistent bad breath
- Difficulty opening your mouth fully
- Food repeatedly trapped at the back of the mouth
- Swelling along the jawline or swollen glands in the neck
- Sensitivity or decay in the second molar
Any of these signs deserve an exam. Early treatment is usually simpler, more comfortable, and more predictable than waiting until an infection becomes severe.
Does Removing Wisdom Teeth Affect Your Face Shape?
This is a common concern, but wisdom tooth removal does not typically change the shape of your face. The teeth sit far back in the jaw and do not support the cheeks the way front teeth do. Temporary swelling after surgery can make the face look fuller for a few days, but this resolves as healing progresses.
How Often Should Wisdom Teeth Be Checked?
For patients who keep their wisdom teeth, a clinical exam at every routine checkup is standard, with X-rays taken periodically based on risk. Teeth that are partially erupted or positioned at an angle may need closer monitoring than fully erupted, upright ones. If you notice any change in how the back of your mouth feels, such as new tenderness, swelling, or food trapping, mention it at your next visit or call sooner if symptoms are significant. Consistent monitoring allows problems to be caught early, when treatment is most straightforward.
Frequently Asked Questions
Is it okay to keep my wisdom teeth?
Yes, if they are fully erupted, healthy, and easy to clean. Regular monitoring is still recommended.
Can impacted wisdom teeth cause problems later in life?
Yes. Some impacted teeth stay quiet for years and then cause infection, decay, or damage to nearby teeth.
What age is best to remove wisdom teeth?
When removal is needed, the late teens to mid-twenties is often ideal because healing tends to be faster.
Can wisdom tooth infections go away on their own?
Symptoms may settle, but infections around partially erupted teeth usually return without treatment of the cause.
Do wisdom teeth cause headaches or ear pain?
They can cause referred pain to the jaw, ear, or head, especially during infection or eruption.
Conclusion
Healthy, fully erupted wisdom teeth can often stay, but impacted or partially erupted ones can cause infections, decay, and damage.
Many problems develop quietly, so regular X-rays and exams are essential.
A personalized assessment helps you decide whether to monitor or remove your wisdom teeth.