Yes, wisdom teeth grow on both the top and bottom of your mouth. You can have up to four wisdom teeth total: two on top (one on each side) and two on the bottom. The upper ones sit at the very back of your upper jaw, behind your second molars, and are clinically called maxillary third molars.
Not everyone gets all four, though. Some people develop only one or two, and others never develop any at all. If you’re wondering whether you personally have top wisdom teeth, a dental X-ray is the only way to know for sure, since they can remain hidden beneath the gumline for years or never form in the first place.
Where Top Wisdom Teeth Sit
Upper wisdom teeth are the most distant teeth in your upper arch. They’re anchored in the bone of your upper jaw and sit remarkably close to your maxillary sinuses, the air-filled spaces behind your cheekbones. In some cases, the roots of these teeth actually extend into the floor of the sinus cavity. This proximity to the sinuses is what makes upper wisdom teeth unique compared to lower ones, and it’s the reason they can cause symptoms you might not expect from a tooth.
Structurally, upper wisdom teeth look a lot like your other molars. They typically have three roots and a crown made of the same enamel and dentin layers as the rest of your teeth. The main difference is size: they tend to be slightly smaller and more variable in shape, which is part of why they’re often considered “extra” teeth that your jaw may not have room for.
When They Come In
Wisdom teeth generally erupt between the ages of 17 and 25. Upper wisdom teeth often come through a bit more quietly than lower ones, partly because the bone in the upper jaw is less dense and softer, giving the tooth an easier path. That said, many upper wisdom teeth never fully erupt. They may poke partially through the gum, stay completely embedded in bone, or emerge at an odd angle. The most common impaction pattern for upper wisdom teeth is vertical (straight up and down but stuck), followed by mesioangular, meaning the tooth is tilted forward toward the next molar.
Many People Are Missing Them Entirely
A significant portion of the population never develops one or more wisdom teeth. This is called third molar agenesis, and it varies widely by ethnicity and geography. Studies show the highest rates of missing wisdom teeth in Korean populations (about 41%), while native African and American Indian populations have the lowest rates (around 10 to 11%). In England the rate is roughly 13%, while in Spain it’s about 25%.
The trend appears to be evolutionary. Over thousands of years, human jaws have gotten smaller as diets shifted from tough, raw foods to softer, cooked, and processed ones. Smaller jaws mean less space at the back of the mouth, and in many people, the body simply stopped producing wisdom teeth altogether. If you’re missing your top wisdom teeth, you’re part of a growing percentage of the population moving in that direction.
How Dentists Check for Them
Because upper wisdom teeth can sit high in the jaw and stay completely buried under gum and bone, you can’t always feel them or see them in a mirror. A panoramic X-ray is the standard tool dentists use to find them. This single wide-angle image captures your entire jaw, both upper and lower, along with your sinuses and the surrounding bone. It clearly shows whether wisdom teeth are present, how they’re positioned, and whether they’re impacted or on track to erupt normally. Most dentists recommend this type of X-ray in your late teens to get ahead of any potential problems.
Symptoms Specific to Upper Wisdom Teeth
Lower wisdom teeth tend to cause pain in the jaw and gums, but upper wisdom teeth can produce a different set of symptoms because of their closeness to the sinuses. When an upper wisdom tooth is inflamed, infected, or pushing against surrounding tissue, you may feel pressure or fullness in your cheekbone area that mimics a sinus infection. Some people experience headaches, a stuffy nose on one side, or a dull ache across the upper face.
The connection works both ways. A genuine sinus infection can send pain radiating down into your upper back teeth, making it feel like you have a toothache when the real problem is above. This overlap makes upper wisdom tooth issues tricky to self-diagnose. If you have pain in both your upper teeth and your sinus area, it’s worth getting both checked.
What Makes Removing Top Ones Different
Upper wisdom tooth extraction is often considered easier than lower extraction in terms of the procedure itself. The upper jawbone is spongier and less dense, so the tooth tends to come out with less force. Recovery from upper extractions is also frequently shorter, with less swelling and discomfort compared to lower wisdom tooth removal.
The trade-off is a complication unique to top teeth: sinus perforation. Because the roots of upper wisdom teeth can sit right against or inside the sinus floor, removing them sometimes creates a small opening between the mouth and the sinus cavity. This happens in roughly 10 to 13% of upper wisdom tooth removals. The risk is highest for fully impacted teeth (about 24%) and lowest for teeth that have already fully erupted (about 5%). Older patients and those whose roots fracture during the procedure also face higher odds.
The good news is that the vast majority of these openings are tiny, less than 3 millimeters across in about 83% of cases. Most heal on their own without any additional surgery. In roughly 1 in 5 cases where a perforation occurs, the dentist will close the opening with a small tissue flap during the same appointment. Symptoms of an undetected sinus perforation include air or liquid passing between your mouth and nose, so if you notice bubbling in your nose when you drink after an upper extraction, let your dentist know.