What You Need to Know About Wisdom Teeth Removal
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Medically reviewed by Edmund Khoo, DDS
Your wisdom teeth are four molar teeth that grow in the back of your gums. Most people develop their wisdom teeth in late adolescence or early adulthood. As your wisdom teeth grow, they can damage surrounding teeth and gums—which may cause the need for wisdom teeth removal.
Wisdom teeth removal is an oral surgery that removes your wisdom teeth from your mouth. A dental care provider such as a dentist, periodontist, or oral surgeon will perform the surgical procedure. Depending on how many of your wisdom teeth need to be removed, you will either be under local anesthesia (numbing the gums while you remain awake) or general anesthesia (being completely asleep during the procedure).
What Is Wisdom Teeth Removal?
Wisdom teeth are the last of your teeth to develop in the back of your mouth. While most people eventually grow wisdom teeth, some people never have them—and that's normal. If you do develop wisdom teeth, they commonly grow between the ages of 17 and 25.
Sometimes, your mouth has enough room to accommodate the extra teeth. But oftentimes, people don't have enough space in their gums for wisdom teeth. When this happens, your wisdom teeth may be impacted—meaning, they grow in at an angle and push into the surrounding teeth or gums. This can cause pain, swelling, and crooked teeth. In such cases, your dental care provider may recommend wisdom teeth removal to prevent or treat dental problems.
During a wisdom teeth removal, your dental care provider will remove one or more of your wisdom teeth. Every case is different. While some people may only need to remove one tooth, others may need to remove all four. It's important to note that wisdom teeth surgeries are very common. In fact, about 50% of adults have had at least one wisdom tooth removed by age 25.
Purpose of Wisdom Teeth Removal
Wisdom teeth surgery isn't always necessary. If your wisdom teeth successfully grow in your mouth without causing symptoms or damage to your other teeth and gums, you may not need to undergo a removal procedure. However, an impacted wisdom tooth can cause bacteria and plaque to build up in the area, which can cause a variety of dental concerns including pain or infection.
Your dental care provider may recommend wisdom teeth removal to prevent or treat any of the following concerns that your wisdom teeth may cause:
Tooth decay or cavities
Periodontitis (gum infection)
Cellulitis (a bacterial infection of the gums, inner mouth, or throat tissue)
Abscess, or the build-up of pus around the teeth due to infection
Cysts (fluid-filled sacs) or benign (harmless) growths that develop around the affected teeth
Extreme dental or oral pain
Damage to the surrounding teeth
Poor overall dental health and hygiene
How to Prepare
A periodontist (gum specialist) or oral surgeon will typically perform a wisdom teeth removal. Dentists are also trained to remove wisdom teeth and may perform the procedure if it's a simple extraction (removal).
Prior to your surgery, you’ll have a dental consultation with the surgeon. During this appointment, your surgeon will evaluate your medical history, take X-rays, and walk you through the surgical process. At this appointment, come prepared with questions you have about the procedure and how to recover after the surgery.
You’ll need to prepare for the healing process and should purchase soft foods before the procedure. Be mindful of your provider’s instructions, which can differ based on whether you’ll be under general anesthesia (put to sleep) or local anesthesia. Generally, preparation involves the following guidelines:
Dietary restriction: If you’ll be going under general anesthesia, you shouldn’t eat for about six to eight hours before surgery and can have only clear fluids or water until about two hours before the procedure.
Personal habits: To improve healing and recovery, steer clear of any alcohol or tobacco products during the eight hours leading up to your procedure.
Medications: You may be advised to stop taking certain medications for up to seven days prior to the surgery. Talk to your surgeon about the medications that you're currently taking. They may advise you to avoid using Advil (ibuprofen), Aleve (naproxen), Coumadin (warfarin), and Plavix (clopidogrel) leading up to the procedure.
Teeth brushing: Before you go in for your surgery, make sure to brush your teeth properly and thoroughly.
Arrange transportation: You shouldn’t drive after your appointment, so it's essential to have a family member, friend, or medical transportation service ready to take you home.
Clothing: Wear comfortable, loose-fitting clothing to your appointment.
What to Expect
What happens during your wisdom teeth removal depends on your individual procedure, how many teeth need to be extracted (removed), and what type of anesthesia you'll be using. Generally, the surgery can take up to an hour to complete.
During the surgery, you shouldn't feel any pain—especially if you are under general anesthesia. If your procedure is using local anesthesia, you may feel some pressure in your mouth or around your back teeth as the surgeon removes the wisdom teeth.
Here's what you can expect your procedure to look like:
Anesthesia: Your provider may use local anesthesia via injecting anesthetics in your gums to numb the area or general anesthesia by putting you to sleep. If you receive general anesthesia, you will also be hooked up to a heart rate monitor to ensure your vital organs are functioning well during the procedure.
Simple extraction: If the wisdom tooth has fully grown through the gums, the surgeon should be able to extract the tooth directly without having to make a cut into your gums.
Complex extraction: If the tooth hasn’t fully grown, your surgeon will need to make an incision (cut) in the gum to pull the tooth out. Your surgeon can also break down the individual tooth into multiple pieces and extract each piece one at a time.
Cleaning: Once the removal is complete, your surgeon will clean the wisdom tooth socket (or, the hole in your gums after the wisdom tooth is taken out) to prevent infection.
Suturing: Following the extraction, your surgeon will sew the hole shut with sutures or stitches. These sutures typically dissolve on their own between seven and 10 days.
Bleeding control: To control bleeding, your surgeon can place gauze or cotton swabs over the socket. You may be instructed to bite down on the gauze for up to an hour after the procedure to keep pressure on the site as blood clots form. This is a normal part of the healing process.
After the surgery: You can go home on the same day of the procedure. But keep in mind that you will need someone to drive you home.
Healing and Recovery
It's important to note that wisdom teeth removal is a major surgery and can require a significant amount of time before you fully recover. Altogether, it can take up to two weeks to recover from a wisdom teeth removal. As your dentist or oral surgeon will tell you, you’ll need to take steps to manage your recovery and special precautions to avoid complications.
Precautions
Once the surgery is complete, your priority is to get rest and promote the healing of the socket—or, the hole or gap that develops where the wisdom tooth was before the extraction. Your dental care provider will guide you on the steps you need to take to ensure your healing. These may include:
Not driving for 24 to 48 hours after the procedure if you’ve had general anesthesia
Pausing strenuous physical activity or exercise
Brushing your teeth gently one day after the procedure
Limiting flossing near the affected areas
Avoiding spitting, rinsing your mouth, or drinking hot liquids as this can affect the healing of your socket
Stop drinking liquids with a straw as the suction damage the blood clot that is healing your socket
Steering clear of any alcohol or tobacco products for several days after the procedure
Gargling a solution of salt and warm water to help with inflammation
Reducing intake of small and hard foods such as nuts or seeds
The Recovery Process
When you get home from surgery—especially within the first 24 to 28 hours—you can expect swelling and bleeding to occur at the site of your extractions. As your gums and jawbone heal from wisdom teeth removal, there are several side effects that you can anticipate, such as:
Pain, which can be worse if you’ve had a complex wisdom tooth removal
Swelling in and around your mouth
Bruising on your cheek, which can take up to two weeks to disappear
Stiffness or tenderness in your jaw
Bad taste in your mouth
As the surgery medications wear off, you may need over-the-counter (OTC) or prescription pain medications to manage the discomfort. As your socket heals, symptoms should subside. You’ll also need to follow dietary restrictions, such as eating soft foods for up to five days after the procedure. In most cases, you will also need to come back in for a follow-up appointment one to two weeks after the procedure to ensure that your gums have healed properly.
Self-Care
You should plan on some time off following wisdom teeth removal, if possible. Dentists and surgeons typically advise taking three to five days off of work or school. You may consider waiting longer before returning to work if your job involves heavy lifting or physical exertion.
During your time off, it's essential to manage the side effects of your surgery with self-care. These methods may include:
Taking over-the-counter or prescribed pain medications, such as Motrin (ibuprofen)
Icing the affected area
Rinsing your mouth with antiseptic mouthwash, especially after eating
Gently gargling a solution of salt and warm water to help with inflammation
Using an extra pillow to elevate your head while sleeping to avoid swelling
Eating only soft foods or keeping a liquid diet for up to five days after the surgery
Gradually introducing harder-to-chew foods as your mouth starts to heal
Prioritizing sleep
Risks and Potential Complications
Though wisdom teeth removal is safe, there are still some risks and possible complications. These include:
Bleeding: In some cases, the bleeding from the extraction site can continue or become persistent.
Infection: If the extraction site becomes infected, you may develop symptoms such as swelling, fever, and yellow or white fluid that comes out of your mouth
Nerve damage: In rare cases, surrounding nerves can become damaged during the procedure, which can cause temporary or permanent tingling and numbness. This can occur in about 5.6% of wisdom teeth removals of the lower mouth.
When To See a Healthcare Provider
If you’ve recently had your wisdom teeth taken out, you should be aware of the following signs that may indicate something is wrong. If you notice any of the following signs, it's good practice to call your dental care provider:
Severe swelling or fluid leaking from the site of extraction
Extreme pain several hours after the procedure
Uncontrolled bleeding, even several hours after the surgery
Hives or a rash
Persistent cough, wheezing, shortness of breath, or chest pain
Difficulty swallowing food
A Quick Review
Wisdom teeth removal is a common, but major surgery that extracts your wisdom teeth. Some people may never need wisdom teeth surgery and those who do may need surgery when their teeth become impacted—or grow into surrounding teeth or gums. The surgery itself takes up to an hour to complete, but will usually require up to two weeks of recovery before your symptoms fully wear off.
As you heal, it's important to follow your dental care provider's instructions for recovery. This may include making dietary changes, taking your medications as prescribed, and incorporating other lifestyle habits. If you notice signs of an infection, develop a fever, or your symptoms don't subside after the procedure, it's best practice to contact your provider for medical care.
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