Wisdom Teeth Removal

Purpose, Recovery, What to Expect, and More

Illustration of impacted wisdom tooth

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Wisdom teeth removal surgery, also called a wisdom tooth extraction, is a dental procedure used to remove a tooth from the third set of molars, commonly called your "wisdom teeth." The surgery is typically used when the tooth becomes impacted.

Wisdom teeth removal is typically performed as an outpatient procedure under mild anesthesia. Recovery from wisdom teeth extraction can take up to six weeks, but most people can go back to normal activities in a day or two.

This article walks you through what to expect if you are scheduled to undergo wisdom tooth removal surgery, including the possible risks and complications.

wisdom teeth removal process

Verywell / Hilary Allison

What Is Wisdom Teeth Removal Surgery?

Not everyone has wisdom teeth, but most people have one to four that usually come in between the ages of 17 and 25. The teeth can often become impacted, meaning there is not enough room for them to break through the skin and emerge. By getting the tooth removed, you can prevent damage to the surrounding teeth.

Wisdom teeth removal surgery is typically performed by a dentist or oral surgeon. The surgery involves cutting into the gum and removing the tooth either as a whole tooth or in pieces.

To prevent pain, you’ll be given anesthesia either as a gas or intravenously (into a vein). Your surgeon will decide which to use based on the complexity of the procedure, your comfort level, and the number of teeth that need to be extracted.

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Click Play to Learn All About Wisdom Teeth Removal Surgery

This video has been medically reviewed by Anju Goel, MD, MPH.

Risk and Contraindications

Wisdom tooth surgery in younger people is usually easier to perform than in older people who are at higher risk of complications.

In younger people, the bone is more flexible and elastic, making the tooth easier to extract while reducing the risk of bone fracture and nerve injury.

Wisdom tooth extractions are best done between the ages of 18 and 21, but the oral surgeon will decide when it should be done based on a thorough diagnosis, including dental X-rays.

Purpose of Wisdom Tooth Removal Surgery

A dentist will recommend wisdom tooth removal surgery if an examination reveals that your wisdom teeth are impacted or may cause problems in the future.

Beyond impaction, other reasons for wisdom tooth extraction include:

  • Infection
  • Signs of tooth decay
  • Damage to surrounding teeth
  • Periodontal (gum) disease
  • Bone loss around the underlying socket

How to Prepare

Your dentist may perform the surgery or refer you to a periodontal surgeon. The surgeon will tell you how to prepare for the surgery and recovery afterward. They may also discuss which type of anesthesia they intend to use and why. If they don't tell you, ask.

The cost of wisdom teeth removal surgery will depend on the level of impaction and the number of teeth that are being removed. Check with your insurance provider to determine your benefits, including what will be and will not be covered.

You can prepare for recovery by buying soft or liquid foods that are easy to eat. These include smoothies, applesauce, oatmeal, yogurt, and other foods that don't require chewing.

What to Wear

Wear loose, comfortable clothes for the procedure. If you’re getting intravenous (IV) anesthesia, wear a shirt with short sleeves or sleeves you can easily roll up. You won’t need to change into anything for the surgery.

Food and Drink

Follow your surgeon’s directions about eating and drinking before surgery. Instructions vary depending on the type of anesthesia used.

If you are getting intravenous anesthesia, you won’t be able to eat or drink anything after midnight the night before the procedure. This ensures your stomach is empty in the unlikely event the anesthesia causes vomiting.

Medications

The risk of bleeding problems can increase with certain medications, such as:

  • Advil (ibuprofen)
  • Aleve (naproxen)
  • Aspirin
  • Coumadin (warfarin)
  • Plavix (clopidogrel)

You may need to stop these anywhere from four to seven days before surgery.

You should also avoid tobacco and alcohol for at least eight hours before the surgery.

Let your surgeon know about any prescription or over-the-counter drugs, vitamins, or supplements you take. They will let you know if you can continue taking them or need to temporarily stop for several days.

What to Bring

Bring any necessary paperwork and your dental insurance card with you to your appointment. You will also need to arrange for someone to bring you home since you will be groggy after receiving anesthesia and won't be able to drive yourself.

What to Expect on the Day of Surgery

Arrive at least 15 to 30 minutes prior to your appointment to settle in and fill out any necessary forms. Your surgeon may also want to perform additional X-rays.

During the Surgery

The surgery should take around 45 minutes. With anesthesia, you shouldn’t feel any pain and may experience what some describe as "twilight sleep."

Here are the general steps to performing a wisdom tooth extraction:

  • Sedation: If you are receiving nitrous oxide (laughing gas), you will be fitted with a small mask fitted over your nose to inhale the anesthesia. If intravenous (IV) sedation is used, a needle is placed in the vein in your arm to administer the sedative.
  • Local numbing: After administering sedation, your surgeon will start numbing the wisdom tooth and gums with a local anesthetic delivered by injection.
  • Tissue resection: Using a scalpel, the surgeon will remove (resect) gum tissue to better expose the wisdom tooth.
  • Bone resection: An impacted wisdom tooth may be fully or partially covered with bone. In such cases, a high-speed tool can drill through and remove the covering bone.
  • Loosening and sectioning: After the wisdom tooth is fully exposed, various surgical instruments can gently loosen it from connective tissue in the tooth's socket. The surgeon may cut the tooth into sections for easier removal.
  • Tooth extraction: Once loosened and sectioned, the surgeon will use instruments specially designed to extract the tooth.
  • Closure: Stitches are used to close the wound. Today, most oral surgeons used dissolvable stitches that don't need to be removed.

After the Surgery

After the procedure is complete, the nitrous oxide gas or IV drip is stopped, and you'll be brought slowly out of sedation.

The dentist will provide gauze for you to bite down on to help blood clot in the area. Immediately after surgery, you may feel mild effects of the anesthesia, including nausea, dizziness, and shivering.

You'll be brought to a recovery room where you will be monitored. Once a specialist has determined that you are stable and breathing normally, you'll be cleared to go home. You'll usually spend less than an hour in the recovery room.

After surgery, you will feel groggy and swollen. You may not feel much pain immediately, but it will probably increase as the anesthetic wears off in the hours following the surgery.

Wisdom Teeth Removal Recovery

For the first 24 hours after the surgery:

  • Avoid rinsing your mouth vigorously or drinking through a straw.
  • Don’t drink alcohol or use mouthwash with alcohol.
  • Avoid brushing your teeth next to the extraction site.
  • Use a soft manual toothbrush rather than an electric one.

Some pain, bleeding, and swelling are likely for several days following the surgery. You may not be able to open your mouth all the way during this time.

The extraction site can take up to six weeks to heal, but most people can resume normal activities within the next one to two days.

At a minimum, wait 24 hours before driving to allow the anesthesia to fully wear off. If you are taking prescription painkillers, you would need to wait longer. Speak with your surgeon.

Healing

Your surgeon will give you extra gauze to take home. If you start to bleed after the gauze is removed, fold another piece into a pad, moisten it with water, and hold it over the bleeding until it stops. Do not bite down as this can make the bleeding worse.

You can also try moistening a tea bag and holding it over the wound for 30 minutes to control bleeding. Tea contains tannins that can constrict (narrow) blood vessels and help slow bleeding.

It is important to avoid alcohol for at least 48 hours following surgery, especially if taking prescription pain medication.

You would also need to avoid strenuous activity for a week after the surgery. The increased blood pressure may cause the wound to break open and bleed.

Smoking should also be avoided as it directly irritates the wound and can cause blood vessels to constrict, impeding healing.

If non-dissolvable stitches are used, you will need to have them removed at your surgeon's office three to 14 days after the surgery.

Coping With Recovery

Over-the-counter pain medicine such as Tylenol (acetaminophen) and Advil (ibuprofen) are usually effective for pain after a wisdom tooth extraction. You can also try putting a cold compress on your face to help with swelling.

To help with sleep the first two days, place extra pillows behind your head to elevate it above your heart. This reduces blood flow to the mouth and can ease throbbing pain.

If the surgery was extensive, your surgeon may prescribe opioids painkillers such as Vicodin (hydrocodone and acetaminophen). These are intended for short-term use and should never be taken with alcohol or sedatives.

Eating and Drinking

In the first 24 hours after surgery, you should eat only soft foods like applesauce and yogurt. You can then move on to semi-soft foods like eggs, soft bread, and oatmeal over the next day or two.

Until you've fully healed, avoid foods that are spicy, acidic, chewy, or crunchy.

It also helps to gently rinse your mouth with warm salt water (1/2 teaspoon of salt to one cup of warm water) after eating. This helps clear debris from the wound and reduces bacterial exposure.

Complications

Complications of wisdom teeth removal surgery include:

  • Dry socket (a painful condition caused when the blood clot in the tooth socket gets dislodged, exposing bone and nerves)
  • Shooting nerve pain
  • Sinus infection
  • Infection

Symptoms of Dry Socket

Symptoms of dry socket include:

  • Severe pain radiating out from the socket toward the neck or side of the face
  • Visible bone in the extraction site
  • Bad breath
  • Bad taste in the mouth

When to Call Your Dentist

Call your dentist right away if you have excessive bleeding or symptoms of dry socket.

Seek immediate care if you have signs of infection, including:

  • High fever with chills
  • Worsening swelling of the gum or face
  • Pain that doesn't improve with medication
  • A pus-like discharge from the wound

Summary

Wisdom tooth removal surgery is a common dental procedure used to extract teeth from the third set of molars, called your "wisdom teeth." It is an outpatient procedure performed under mild anesthesia.

Recovery from a wisdom tooth extraction takes around six weeks, but you can usually return to work in a day or so. Pain can be treated with over-the-counter drugs like Tylenol or Advil. Alcohol should be avoided for at least 48 hours, and smoking should ideally to stopped until the wound is fully healed.

Call your surgeon if you have excessive bleeding or signs of infection such as high fever, chills, increased swelling, and a pus-like discharge.

11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. American Association of Oral and Maxillofacial Surgeons. Wisdom teeth management.

  2. American Association of Oral and Maxillofacial Surgeons. Types of anesthesia.

  3. MedlinePlus. Impacted tooth.

  4. Institute for Quality and Efficiency in Health Care. Should you have your wisdom teeth removed?

  5. American Dental Association. Nitrous Oxide.

  6. Johns Hopkins Medicine. Wisdom teeth extraction

  7. American Dental Association. Tooth extraction.

  8. Soltani R, Haghighat A, Fanaei M, Asghari G. Evaluation of the effect of green tea extract on the prevention of gingival bleeding after posterior mandibular teeth extraction: a randomized controlled trialEvidence-Based Complementary Alternative Med. 2014;2014:1-4. doi:10.1155/2014/857651

  9. Oral Health Foundation. What to do following an extraction.

  10. National Institute of Dental and Craniofacial Research. Opioids & dental pain.

  11. Akinbami BO, Godspower T. Dry socket: incidence, clinical features, and predisposing factors. Int J Dentistry. 2014;2014:796102. doi:10.1155/2014/796102

By Shawn Watson
Shawn Watson is an orthodontic dental assistant and writer with over 10 years of experience working in the field of dentistry.