Wisdom Teeth Removal Surgery: Everything You Need to Know

X ray of teeth

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If you have wisdom teeth (and most people do), your dentist may talk with you about when and how they should be removed. Wisdom teeth removal surgery is a procedure to remove the third set of molars, which typically appear when you’re between 17 and 25 years old.

Most people have at least one impacted wisdom tooth, meaning it doesn’t have enough room to grow naturally. By getting your wisdom teeth removed, you can ensure they don’t damage the surrounding teeth and bones.

What Is Wisdom Teeth Removal Surgery?

Wisdom teeth removal surgery is an outpatient procedure that is typically performed by a dentist or oral surgeon. In this oral surgery, you’ll be under anesthesia as the surgeon cuts into the gums and removes the tooth, either as a whole tooth or in pieces.

A dentist will recommend this surgery if an exam and x-rays reveal that your wisdom teeth are impacted or may cause dental problems for you in the future.

Contraindications

Wisdom tooth removal surgery before age 20 is typically easier than those performed at a later age. That’s because the roots aren’t fully formed, which makes them easier to remove and faster to heal. As you get older, the roots become longer, curved, and more difficult to extract.

Potential Risks

Complications of wisdom teeth removal surgery can include:

  • Dry socket, a painful condition when bones and nerves are exposed
  • Irritated nerves
  • Sinus problems
  • Infection

Purpose of Wisdom Tooth Removal Surgery

Your dentist will monitor the development of your wisdom teeth during routine appointments and with dental X-rays. They may discuss removing them if they’ve become impacted or if they have the potential to cause problems, such as the following:

  • Infection
  • Tooth decay
  • Damage to surrounding teeth
  • Periodontal disease
  • Bone loss
  • Tooth loss

Your dentist may suggest having wisdom teeth removal surgery even if you aren’t experiencing any current symptoms in order to stop potential problems before they start. Wisdom teeth can be hard to maintain good hygiene, since they’re in an area that’s challenging to clean.

You may be referred to an oral surgeon to perform the procedure. The surgeon will schedule a consultation before the surgery to go over your dental records, take additional x-rays, and answer any of your questions about the surgery. They’ll review the type of anesthesia to be used and how you’ll feel during and after the procedure.

The cost for wisdom teeth removal surgery will depend on the level of impaction and the number of teeth that are being removed. Check with your dentist, surgeon, and insurance provider on your benefits and what will be covered.

Call your dentist or surgeon if you’re experiencing a dental emergency, such as severe pain, fever, or loose teeth.

How to Prepare

Ask your surgeon about any concerns you have before the procedure. They can tell you what to do in the days before surgery and how to plan for recovery time afterward. They can also talk to you about the type of anesthesia that will be used and how you’ll feel after the surgery.

Your surgeon will probably advise you to make arrangements for someone to bring you home from the surgery, since you’ll be groggy after anesthesia.

You can also prepare for recovery by buying some soft or liquid-based foods that are easy to eat after surgery. These could include smoothies, applesauce, oatmeal, soup, and other foods that are easy to eat without chewing.

Location

Wisdom teeth removal surgery is performed in a dentist’s or oral surgeon’s office.

What to Wear

Wear loose, comfortable clothes for the procedure. If you’re getting intravenous anesthesia, wear a shirt with short sleeves or one that’s easy to roll the sleeves up. You won’t need to change into anything for the surgery.

Food and Drink

Follow your surgeon’s directions for eating and drinking before surgery. Instructions may vary depending on the sedation used. If you are getting intravenous anesthesia, you won’t be able to eat or drink anything after midnight the night before the procedure so your stomach is empty.

Medications

Your surgeon will let you know if you can keep taking your current medications or if you should stop taking them in preparation for surgery.

To avoid complications, let your doctor know about all of your medications, including prescription or over-the-counter drugs, vitamins, or other supplements.

What to Bring

Be sure to bring any necessary paperwork and your dental insurance card. Also remember to make arrangements for someone to bring you home after surgery.

Pre-Op Lifestyle Changes

Avoid tobacco and alcohol for at least eight hours before the surgery.

What to Expect on the Day of Surgery

Arrive on time for your appointment at the oral surgeon’s office. Your dentist or surgeon may perform dental x-rays again on the day of surgery if necessary.

During the Surgery

The surgery should take about 45 minutes. With anesthesia, you shouldn’t feel any pain or discomfort. Depending on what type of sedation is used, you may be asleep or conscious during the surgery. These are the steps for a typical procedure:

  • Sedation: Your surgeon will decide which sedation to use based on your comfort level as well as the extractions required. These could include nitrous oxide (laughing gas), which you breathe through a mask, allowing you to be awake but remain relaxed. Intravenous (IV) sedation is generally considered the most comfortable since you drift in an out of consciousness and are unlikely to remember the procedure afterward.
  • Numbing: After sedation, your surgeon starts by numbing the wisdom teeth and their surrounding tissues with a local anesthetic.
  • Tissue removal: The dentist removes any gum tissue covering the area where the wisdom tooth is located to access the tooth.
  • Bone removal: An impacted wisdom tooth could be fully or partially covered in bone. If this is the case, a high-speed handpiece is used to drill through and remove the bone covering the tooth. If the wisdom tooth has already erupted into your mouth, the dentist will loosen the connective tissue from around the wisdom tooth.
  • Loosening and sectioning of the tooth: When the impacted wisdom teeth are visible to the dentist, various surgical instruments are used to gently loosen them from any connective tissue in the tooth's socket. The dentist may also cut the tooth into sections to allow removal.
  • Tooth removal: Once the wisdom tooth is loose or has been completely sectioned, it is ready to be removed. The dentist will use surgical instruments specially designed to fully remove the tooth.
  • Stitches: Now that the wisdom teeth are gone, the dentist may add stitches to close up the area. This is sometimes necessary when impacted wisdom teeth are removed, or when the dentist feels the patient will better heal with stitches in place.

After the Surgery

With removal complete, 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.

Recovery

After the surgery, you’ll likely experience some pain and bleeding as well as swelling in your mouth and cheeks for up to several days after the surgery. You may not be able to open your mouth all of the way during this time. The extraction site can take up to six weeks to heal, but most people can resume normal activities the next day.

Healing

Your dentist or surgeon will give you gauze to use on the extraction site after surgery. If you have bleeding after this gauze is removed, fold another piece of clean gauze into a pad. Dampen the pad with warm water and gently hold it between your teeth in the area of the extraction. Avoid chewing on the gauze. Keep it in place for about 30 minutes and replace it if it becomes soaked with blood. If bleeding becomes heavy, contact your dentist. 

To help with discomfort, your dentist may prescribe pain medicine. You might also try putting a bag of ice or a cold damp washcloth on your face to help with swelling and pain.

Follow your surgeon’s instructions for what and when you can eat after surgery. The soft tissues in your mouth will likely be sensitive for several weeks. Usually you can start eating soft or liquid-based foods and slowly start adding more solid foods. Avoid foods that are spicy, chewy, or small hard foods like nuts, seeds, and granola, which can irritate the site.

For 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, particularly those next to the site

The day after surgery, you can gently brush and floss your teeth. Use a manual toothbrush, rather than electric, which can be harder on the extraction site.

Your dentist may also suggest gently rinsing your mouth with warm salt water (1/2 teaspoon of salt in 8 ounces of warm water) after meals, being careful not to dislodge the blood clot.

Avoid strenuous activity for a week after the surgery to avoid breaking off the blood clot.

Avoid smoking during the healing process.

A painful condition called “dry socket” can occur if the blood clot gets dislodged from the extraction site. This causes the bone and nerves underneath to become exposed, which can be very painful. Symptoms include:

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

Contact your surgeon immediately if you have any symptoms of dry socket, heavy bleeding, or significant pain.

A Word From Verywell

Wisdom tooth removal is a common dental procedure, and complications are rare. For a successful recovery, it's important to closely follow the post-operative instructions you receive, particularly during the first seven to 10 days following your procedure. Take time to ask any questions you have so you fully understand how to care for your healing socket.

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Article Sources
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  1. Cleveland Clinic. Wisdom Teeth Management. July 2018.

  2. American Association of Oral and Maxillofacial Surgeons. Wisdom Teeth Management.

  3. U.S. National Library of Medicine. Impacted tooth. MedlinePlus.

  4. American Association of Oral and Maxillofacial Surgeons. Types of Anesthesia.

  5. Johns Hopkins Medicine. Wisdom Teeth Extraction

  6. Institute for Quality and Efficiency in Health Care. Should You Have Your Wisdom Teeth Removed?

  7. American Dental Association. Tooth Extraction. 2013.

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