How to Know When Your Wisdom Teeth Require Extraction

Wisdom teeth are the last set of molars most people get — typically between ages 17 and 25. They sit in the very back of your mouth, and for some, they come in straight and healthy. 

But for many, they can cause problems because there often isn’t enough room in the jaw, or they grow in at odd angles.

At American Dental Clinic in San Diego, Dr. Emmanuel Aguilar takes a thoughtful, conservative approach to evaluating wisdom teeth. He doesn't recommend extraction unless it makes sense for your dental health, and our team walks you through your options with comfort, safety, and clarity.

Signs your wisdom teeth may need removal

Not all wisdom teeth need to be extracted. But certain signs suggest they may be causing harm — even before you feel pain. Watch for these common indicators:

Pain or persistent discomfort in the back of your mouth

Wisdom teeth can bite into your gum tissue or press against neighboring teeth, causing soreness that doesn’t go away with routine care.

Swelling, redness, or gum tenderness

Inflammation behind your molars often signals irritation or infection around a wisdom tooth, even if you don’t feel sharp pain yet.

Trouble chewing or opening your mouth fully

If your jaw feels tight, stiff, or off when you try to eat or yawn, an impacted wisdom tooth may be interfering with normal bite and movement.

Bad breath or unpleasant taste you can’t explain

Food debris and bacteria can collect around partially erupted wisdom teeth, leading to persistent odor and frequent bad taste — a sign of infection or gum trapping.

Repeated infections in the soft tissue around your back teeth

Pericoronitis (infection around a partially erupted wisdom tooth) shows up as swelling, pain, or pus around the gum tissue near the back molar.

Crowding or shifting of other teeth

Even if your wisdom tooth isn’t painful itself, pressure from its misaligned growth can push neighboring teeth out of position, compromising your bite and alignment.

Cysts or damage seen on X-ray

Dr. Aguilar uses X-rays to see below your gum line. If your wisdom tooth is trapped against bone or roots, or if a cyst is forming, he typically recommends removal.

When wisdom teeth do not need to be removed

Not all wisdom teeth require extraction. If they’re fully erupted (not trapped under your gums), coming in straight, and aren’t interfering with your bite, they can safely remain in place. Some adults keep their wisdom teeth comfortably for decades.

The downsides of unnecessary removal include:

• Pain and swelling during recovery
• Risk of dry socket or infection
• Temporary nerve irritation or numbness (rare)
• Time away from daily routines

Dr. Aguilar and our team take a conservative approach, which means we don’t rush to remove healthy wisdom teeth that aren't causing harm. Your situation — including your age, dental history, and overall oral health — guides our recommendations.

Why expert assessment matters

You may feel fine, but still have developing issues beneath the surface. Wisdom teeth can lurk under the gums, misaligned or partially impacted, for years before symptoms show. Regular dental exams and imaging help Dr. Aguilar spot problems early, when they’re easier to treat and less likely to cause complications.

Because every mouth is different, there’s no single rule that fits everyone. Some people in their 20s never need wisdom teeth removed; others experience trouble earlier, as teeth shift and jaw space fills in.

Dr. Aguilar combines his clinical expertise with a gentle, conservative philosophy. At American Dental Clinic,  we aim to preserve natural teeth when possible, intervene when necessary, and support your comfort throughout the process.

If you’ve been feeling pressure or discomfort in the back of your mouth, or if it’s simply been a while since your last exam, we encourage you to schedule a consultation. 

With a careful evaluation and clear recommendations, you’ll know exactly where you stand — and what makes the most sense for your long-term oral health.

Call American Dental Clinic in San Diego, California, or book an appointment online to get your wisdom teeth checked. Your comfort and confidence in your smile are worth it.