Third molars arrive last, usually between seventeen and twenty-five, into a jaw that has often run out of room. Some come through fully and cause no trouble for life. Others stop part way, tilt into the tooth in front or stay buried in bone, and it is these partially erupted and impacted teeth that generate most of the pain patients describe. The commonest problem is pericoronitis: a flap of gum lies over a tooth that has only partly emerged, food and bacteria collect beneath it, and the tissue becomes inflamed and sore, sometimes with a bad taste, swelling and difficulty opening. It flares, settles and flares again. Contrary to what many people were told a generation ago, wisdom teeth are no longer removed simply because they exist. UK guidance is to leave a symptom-free wisdom tooth alone and to remove one only when it is causing repeated infection, decay in itself or the tooth in front, gum disease, a cyst or other clear disease. Our Wimpole Street dentists assess which category yours is in and treat the acute episode first.
Dull ache or throbbing behind the last molar
Inflammation of the gum flap or pressure from an erupting tooth.
Red, swollen gum over the tooth that hurts when the upper tooth bites onto it
The operculum is being traumatised by the opposing tooth with every closure.
Bad taste or smell from the back of the mouth
Debris and pus trapped beneath the gum flap.
Difficulty or pain opening wide, or swallowing
Inflammation spreading into the muscles behind the jaw; a sign the episode is more severe.
Swelling of the cheek or below the jaw angle, tender glands, fever
Spreading infection that needs prompt treatment, sometimes antibiotics as well as local care.
Pain or decay in the molar in front
An impacted wisdom tooth leaning on its neighbour traps plaque against the second molar’s root.
When a wisdom tooth breaks the gum but does not come through fully, the remaining flap creates a pocket that cannot be cleaned. Bacteria multiply, the tissue swells, and the upper tooth then bites on the swollen flap, making it worse. This cycle is pericoronitis, and it accounts for most wisdom tooth emergencies.
A tooth angled forwards presses on the root and crown of the molar in front. Plaque sits in the angle between them, decaying the second molar’s back surface or causing bone loss there. The neighbour, not the wisdom tooth, may be the one you feel.
Because they are hard to reach, wisdom teeth decay readily. A large cavity produces the same toothache and abscess as any other tooth, but restoring a poorly accessible third molar is often less predictable than removing it.
A tooth pushing through bone and gum causes a dull, intermittent ache in the late teens and early twenties that comes and goes over months. This settles once the tooth has erupted or stopped moving and does not in itself require removal.
The sac around a buried wisdom tooth can occasionally enlarge into a cyst that expands the jaw and displaces neighbouring teeth, usually painlessly at first. Routine X-rays pick these up and they are a clear reason for removal.
These are holding measures, not a substitute for an examination. Use any pain relief exactly as directed on the pack and check with a pharmacist if you take other medicines.
We examine the tooth, the gum over it and the molar in front, and take an X-ray to see the angle of the tooth, its roots, the nerve beneath and any decay or bone loss. This shows whether the tooth is likely to come through, stay stuck or cause harm.
About this treatmentThe pocket under the flap is irrigated and cleaned, the opposing tooth is smoothed if it is biting on the gum, and antibiotics are prescribed only where there is swelling, fever or spread beyond the local area.
About this treatmentA tooth that is upright, has room and is still erupting is left alone with cleaning advice and reviewed; many settle without any procedure once fully through.
About this treatmentOccasionally, for an upright tooth with a persistent flap, trimming the gum (operculectomy) resolves recurrent pericoronitis without extracting the tooth.
About this treatmentAdvised for repeated pericoronitis, decay in the wisdom tooth or its neighbour, gum disease around it, or a cyst. Simple removal is from £250; surgical removal involving bone and sectioning of the tooth is quoted up to £650. Sedation is available.
About this treatmentWhere the tooth in front has decayed against the wisdom tooth, it is filled or crowned after the wisdom tooth is removed and access is possible.
About this treatmentAn assessment at Wimpole Street with X-rays is expected to be £95, and an emergency appointment for an acute flare, including cleaning under the flap, is around the same fee. Removal of a wisdom tooth that is upright and fully through is from £250. Surgical removal of an impacted or partly buried tooth, which involves lifting the gum and sometimes removing a little bone, is quoted up to £650 depending on difficulty, and sedation is an additional fee.
Where the second molar has been damaged, a filling is from £185 and a crown £995. Removing a wisdom tooth on the NHS is possible where it meets guidance criteria; we will tell you if that applies and let you choose. We do not recommend removing wisdom teeth that are not causing problems.
Figures are indicative prices for Wimpole Street and are confirmed in a written plan once a dentist has examined you. Fees match our South Kensington and St Paul's clinics.
Leave your details and we will be in touch when the Marylebone diary opens. If the problem cannot wait, the same clinicians are already seeing patients in South Kensington and at St Paul's.
Opening 1 October 2026
Wimpole Street is not yet seeing patients. Until then, please book or call our South Kensington clinic on 020 7183 2362 or our St Paul's clinic on 020 7183 3709. Questions about the new clinic: wimpolestreet@md.co.uk.
The same clinical team already works from two other Medical & Dental clinics. Book at either one now and, if you prefer, move your ongoing care to Wimpole Street once the doors open.
