Parents usually bring up wisdom teeth somewhere between a teenager’s 14th and 17th check-up. It’s a fair question — you’ve heard stories, you want to get ahead of it, and you’re not sure whether you’re meant to be doing something now or just waiting. Here’s how we handle it in our practice, what the X-ray actually tells us, and the symptoms worth watching for between appointments.
When the wisdom teeth are even there
Wisdom teeth — the third adult molars, four of them, one in each back corner — usually push through the gums between the ages of 18 and 25. Healthdirect puts the typical eruption window at “around 18 to 25 years.” Some people’s show up earlier, some never at all — roughly one adult in four is missing at least one wisdom tooth, and we see that regularly.
What matters for parents is that the teeth start forming well before they erupt. By the mid-teens we can usually see them developing under the gum on an X-ray, with the roots still partly formed. That’s useful, because it gives us a picture of what’s likely to happen before it actually happens.
The right age to start checking
There’s no single magic age, but the honest answer is: we start looking at wisdom teeth as part of the normal check-up from about 14 onwards. Not by taking an X-ray every time — just by feeling the gums at the back, asking about any soreness, and watching the bite.
For most teenagers, somewhere between 16 and 18 is the useful window for a baseline look with a panoramic X-ray (an OPG), if there’s a clinical reason to take one. That’s the age range where:
- The wisdom teeth are usually visible enough on X-ray to judge their angle and space
- The roots are still partly formed, which matters if we do end up removing them
- Orthodontic treatment is often wrapping up or being planned — and wisdom teeth sometimes factor into that conversation
That doesn’t mean every 17-year-old needs an X-ray. It means if we do need one, that’s the age where it earns its keep.
What an OPG actually shows us
An OPG is a single panoramic X-ray that captures the whole upper and lower jaw in one go. On a teenager’s OPG, we’re looking at four things with the wisdom teeth:
- Are they there at all? Some people are genuinely missing one or more.
- What angle are they sitting at? Upright is good. Tilted forward, backward, or sideways is the classic setup for impaction.
- Is there space for them? We can measure the distance between the back of the second molar and the jawbone, and get a reasonable sense of whether the tooth has somewhere to go.
- How close are they to important structures? In the lower jaw especially, the root tips of the wisdom teeth can sit near the inferior dental nerve. Seeing that on a single X-ray changes how — and sometimes whether — we’d plan removal.
One image, a handful of answers. If you’d like more detail on when we’d reach for an OPG versus a more detailed 3D scan, we’ve written about OPG vs CBCT X-rays in its own post.
We don’t push unnecessary X-rays
This bit matters, because it’s where practices sometimes differ. Radiation doses from a modern dental OPG are low, but “low” isn’t “none,” and for a teenager it’s fair to only take one when it actually changes what we’d do.
In our practice, we take an OPG when:
- There’s a symptom — soreness, swelling, a flare-up, a bad taste
- Something we can feel on examination looks off
- An orthodontist needs it for planning
- The second molars are hard to clean because of how a wisdom tooth is pushing in
If none of those apply and everything looks healthy at the check-up, we simply note it and keep an eye on things. No X-ray just for the sake of having one.
If you’d like to book your teenager in for a routine check with Dr Daniel Johnston at Biltoft — no pressure, no up-sell — you can book online or call the practice on (02) 6672 1980.
Warning signs worth watching between appointments
Teenagers are famously good at not mentioning things until they’re quite sore, so it’s worth knowing the signals yourself. Any of these, book a check:
- Soreness at the very back of the mouth, especially one-sided, that lasts more than a week or keeps coming back
- Swelling or a puffy gum flap over an erupting wisdom tooth — often with a bad taste when they press on it
- Bad breath that brushing doesn’t shift, when their hygiene is otherwise fine
- One-sided jaw pain or stiffness, especially in the morning or when opening wide
- Food constantly packing between the back two teeth — sometimes the first hint of a wisdom tooth pushing in at an angle
- A tender cheek or ulcer from biting where a partially erupted tooth is rubbing
And the ones that are same-day, not next-week:
- Spreading facial swelling
- Fever with mouth pain
- Difficulty swallowing or opening the mouth beyond a couple of fingers’ width
Those can point to a spreading infection. Call us or, if it’s out of hours, head to an emergency department.
For a fuller walk-through of the symptoms side, our post on signs wisdom teeth need removal goes deeper on each of these.
Not every teenager needs theirs out
This is the part that often surprises parents. The older default was to remove wisdom teeth more or less routinely. The current thinking — and it’s reflected in how Healthdirect frames it — is that removal is for teeth that are causing problems, or clearly about to.
Reasons we’d plan removal:
- Repeated infection around a partially erupted tooth (pericoronitis)
- Impaction causing decay or gum problems on the second molar next door
- A cyst forming around an unerupted tooth
- Orthodontic plans that specifically require it
Reasons we wouldn’t:
- “They’re there” — not enough on its own
- A single episode of mild soreness during eruption
- Mild crowding that can’t be clearly linked to the wisdom teeth (the evidence for blaming wisdom teeth for front-tooth crowding is weaker than most people think)
If a tooth does need to come out, doing it while the roots are only partly formed — generally in the late teens — tends to be a gentler procedure with a more predictable recovery. That’s a reason not to delay a warranted removal. It’s not a reason to pull healthy teeth for the sake of it.
What parents ask us most
A few questions come up in the chair almost every week when this topic lands, and they’re worth answering plainly.
”Do wisdom teeth cause crowding at the front?”
The popular story is that wisdom teeth push the front teeth out of line as they erupt. The research honestly doesn’t support that as cleanly as people assume — front-tooth crowding in the late teens and twenties happens in plenty of people who don’t have wisdom teeth at all. We don’t recommend removing wisdom teeth just to prevent crowding. If your teenager has finished orthodontic treatment, the retainer is the proven tool for holding the result; the wisdom teeth are usually a separate conversation.
”They had braces — does that change the plan?”
Sometimes. An orthodontist may specifically request assessment or removal of wisdom teeth as part of a treatment plan, particularly if they’ve created space at the back or if a lower wisdom tooth is clearly going to push in at an angle. If your teenager’s orthodontist has given a recommendation, bring that with you — we read the treatment letter and work with it rather than around it.
”Can they just have them all out under sleep dentistry?”
It’s a fair question. At Biltoft we work under local anaesthetic only — we don’t offer IV sedation or general anaesthetic in-house. For straightforward cases that suits most teenagers just fine, and we can take our time and keep things gentle. For complex cases — all four impacted, close to the nerve, or significant anxiety — we refer to a specialist oral surgeon and explain exactly why. That honesty is deliberate; we’d rather send someone to the right person than stretch beyond what we should.
What a teenager’s wisdom teeth visit looks like with us
If you book your teenager in specifically for a wisdom teeth assessment, the appointment is fairly simple:
- A chat about any symptoms they’ve noticed — teenagers often downplay, parents often over-worry; we try to find the honest middle
- A look and a feel at the back of the mouth, including the gum tissue and any partially erupted teeth
- An OPG only if it’s going to change what we do
- A plain-language plan: either “all looks fine, check again in 12 months,” or “here’s what we’re seeing, here’s what’s likely, here’s what we’d do and when”
For the wider picture on costs, timing, and what to expect if removal does end up on the cards, read our full wisdom teeth guide.
The short version
Start the conversation at the regular check-ups from around age 14. Consider a baseline look with an OPG somewhere between 16 and 18, but only if there’s a reason. Watch for soreness, swelling, bad breath or one-sided jaw pain between visits. And remember that “checking” doesn’t mean “removing” — plenty of wisdom teeth are perfectly welcome to stay. If you’d like Dr Daniel Johnston to take a look at your teenager’s wisdom teeth, you can book online or call the practice on (02) 6672 1980.
Frequently asked questions
At what age do wisdom teeth usually come through? +
Healthdirect notes wisdom teeth — the third adult molars — usually grow through the gums between 18 and 25 years old. They start forming under the gum years before that, though, which is why we can already see them on an X-ray in the mid-teens and make a sensible plan.
Does every teenager need a wisdom teeth X-ray? +
No. We only take an OPG when there's a clinical reason — a symptom, something we can feel in the gum, or a clear need to plan ahead (for example, before orthodontic treatment). If your teenager's mouth looks healthy at their check-up and we have no concerns, we leave the X-ray alone.
Do all wisdom teeth have to come out? +
Not at all. If they come through upright, there's room for them, and your teenager can clean them properly, leaving them alone is a perfectly good plan. We see plenty of wisdom teeth that never cause a problem. It's the impacted or partially erupted ones that tend to earn their way out.
What warning signs should I watch for in my teenager? +
Soreness or swelling right at the back of the mouth, a bad taste or bad breath that won't shift, one-sided jaw pain, trouble opening wide, or a flare-up that settles and comes back a few weeks later. Any of those, book a check. Spreading facial swelling or fever is same-day.
How much does removal cost if it's needed? +
Our fee at Biltoft is $500 to $650 per tooth under local anaesthetic. We don't offer IV sedation or general anaesthetic in-house — if that's needed for a complex case, we refer on to a specialist oral surgeon and explain why. The exact cost for your teenager comes out of the consult.
Is it better to remove wisdom teeth earlier rather than later? +
If a tooth clearly needs to come out, younger patients generally recover a little more easily — the roots are often still partly formed and the bone is more forgiving. That's not a reason to take out healthy teeth, though. It's a reason not to put off removal once we've decided it's warranted.