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.
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 grow in naturally. 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.
Gum Surgery: Everything You Need to Know
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.
FAQs
How long does wisdom teeth removal take to recover? ›
It can take up to 2 weeks to recover from the surgery for having your wisdom tooth or teeth removed. During this time, you may have: a swollen mouth and cheeks – this will be worse for the first few days but will gradually improve; gently pressing a cold cloth to your face helps reduce the swelling.
How painful is wisdom teeth removal? ›You shouldn't feel any pain as your wisdom teeth are removed because the area will be numb. However, if you do feel pain during the procedure, tell your dentist or oral surgeon so they can give you more anaesthetic. How long it takes to remove the tooth will vary.
When is the most painful part of wisdom teeth removal? ›Remember, the first two days after surgery are usually the worst. On the first day, the sedatives and painkillers used during surgery are still in your bloodstream, so you won't feel as much pain as you will on day two.
Can I go to work the next day after wisdom tooth extraction? ›Most people can go back to work or school in two to three days after wisdom teeth extraction. However, if your job requires physical labor or heavy lifting, you may need to take a few extra days off of work.
Can I drink water after getting my wisdom teeth out? ›How soon can I drink water after tooth extraction? Except for taking medications, you should avoid all food and drink for at least 24 hours after wisdom tooth removal. This allows your surgical site to heal. It's best to drink plenty of water the next day to remain hydrated and stick to a soft, liquid-based diet.
What is the most painful tooth to extract? ›What is the most difficult tooth to extract? Impacted wisdom teeth are wisdom teeth that have failed to erupt properly. They are generally considered to be the most difficult teeth to extract.
Can you eat after wisdom teeth removal? ›For the first 24 to 48 hours, eat only liquid and soft foods like yogurt, apple sauce, and ice cream. Cold foods may help with some of the discomfort. As you start to feel better, you can try incorporating more solid foods. On the third day after surgery, try foods like eggs, toast, or oatmeal.
What not to do after wisdom teeth removal? ›After Your Wisdom Teeth Extraction, Don't:
Use straws, suck, spit, or smoke. Avoiding these activities helps maintain the blood clot that forms over the wisdom teeth extraction site. If the clot becomes dislodged, you may have more bleeding, more pain, and a potential side effect called dry sockets.
Don't eat or drink anything, including water, after midnight of the evening before your surgery. Remember to dress comfortably. You'll feel better overall and will be ready to rest after your surgery.
Do you brush your teeth the morning of wisdom teeth removal? ›Brush your teeth gently, but avoid the area of surgery for the first 24 hours.
Why is day 3 after wisdom teeth removal the worst? ›
Dry socket (alveolar osteitis) is one of the most common complications of wisdom tooth removal. It's where a blood clot fails to develop in the tooth socket, or if the blood clot becomes dislodged or disappears. This can happen 3 to 5 days after surgery.
How long does it take to remove 4 wisdom teeth? ›Most wisdom tooth removal surgeries last about 40-90 minutes. Even if you're having all four of your wisdom teeth removed at once, the procedure typically takes an hour. If your wisdom teeth are in a difficult position or there are unexpected difficulties, the surgery may take a bit longer.
How long until I can talk after tooth extraction? ›Can You Talk the Day After Wisdom Teeth Removal? You can speak after having your wisdom teeth removed, just try to limit how much you talk immediately following surgery. When you talk, your tongue and mouth muscles move around, which can disturb the blood clots forming within the empty tooth sockets.
Why experts now say not to remove your wisdom teeth? ›That exposes the underlying bone and nerves and results in severe pain. More serious risks, which become more common with age, include nerve and blood-vessel damage. As with any surgery, wisdom-tooth removal does carry the very rare risk of death.
What if I can't get food out of extraction site? ›Dislodge the food by gently rinsing your mouth with warm salt water (saline) solution. Avoid swishing the water around and don't spit—this can lead to painful dry sockets. If you received a syringe from your clinician, you can use warm water or salt water to gently flush the socket clean.
What can I eat first day of wisdom teeth removal? ›Eat only liquid and soft foods such as yogurt, apple sauce, and ice cream for the first 24 to 48 hours. With some of the discomfort, cold foods can help. You can have solid foods gradually when you feel better. Try foods like eggs or toast or oatmeal from the day after surgery.
Do I eat with gauze in mouth after extraction? ›Please remove the gauze when you eat or drink. Do not sleep with the gauze in your mouth. Pay special attention to the placement of the gauze , making sure it is over the surgical site and not just between the teeth.
What happens if you get food stuck in wisdom tooth hole? ›Food will probably get stuck in the sockets until they close over completely. This may cause problems with bad breath and a bad taste in your mouth. You can rinse with salt water as described on page 4 to help keep your mouth clean. Infection can sometimes happen after having wisdom teeth taken out.
What hurts more root canal or wisdom teeth removal? ›Root canals can be a painful procedure. In fact, many find it to be more painful than an extraction, but the use of local anesthesia can reduce the pain. The procedure starts by first examining the patient's mouth with X-rays. These help to determine the severity of the infection and the number of teeth infected.
What is the best painkiller for tooth extraction? ›Pain After Tooth Extraction
Ibuprofen will help with pain relief and as an anti-inflammatory. If you cannot take ibuprofen, then 1–2 tablets of regular Tylenol® should be taken every 4 hours.
Is it dry socket or just pain? ›
For most people, the main symptom of dry socket is severe pain. However, pain tolerance and perceptions differ from person to person. Therefore, some people may experience less pain than others. Dentists will typically diagnose dry socket based on the presence of pain and breakdown of the clot after a tooth extraction.
Can I eat mac and cheese after wisdom teeth removal? ›Macaroni and cheese is perfect because you can swallow the tiny noodles whole or chew them with your front teeth. You can also overcook your pasta noodles to make sure they are soft and easy to chew.
How long after wisdom teeth removal can I brush my teeth? ›On the same day of surgery, you should not brush near the extraction site. However, you should start normal brushing again the very next day, according to the American Dental Association. You will certainly want to be careful and gentle, but you should resume full brushing the day right after wisdom tooth extraction.
Why can't I eat dairy after tooth extraction? ›So, why no dairy? Dairy causes an inflammatory response in the oral tissues and this is not desirable after you have had dental implant surgery. Dairy has also been known to trigger nausea and vomiting.
Are you on bed rest after wisdom teeth removal? ›Bed rest the first 2 days is essential after surgery to hasten recovery and prevent complications. Stay down with your head elevated all day the first day, mild activity on the second day, and do what you feel like you are up to on days 3 and 4.
Why can't you spit after wisdom teeth? ›Spit. You may have some bleeding for the first day, which is normal. It's important that you try to avoid spitting, which can dislodge a blood clot in the socket. Your doctor or oral surgeon will supply you with gauze to absorb any excess blood.
How scared should I be for a wisdom teeth removal? ›The process of removing your wisdom teeth does not need to be a terrifying and frightful experience. With a professional dental team and various anesthesia and sedation options available nowadays, you can have a safe, easy, and pain-free dental experience at your surgeon's office.
Should I stay up all night before wisdom teeth removal? ›There is no simple answer to the question, “Should I stay awake or sleep, while my wisdom teeth are extracted?” It is important to consider your pain tolerance level and severity of dental anxiety. If the answer is high to one or both, you should definitely consider a type of sedation.
What drugs should you avoid before tooth extraction? ›Important Oral Surgery Pre-operative Instructions
Avoid the use of aspirin products such as Anacin, Bufferin, or Alka-Seltzer or non-steroidal anti-inflammatory medicines like Ibuprofen (Motrin), for at least three days prior to surgery; Tylenol is OK to use instead.
It is always important to get a good night's sleep prior to your procedure. Ask your dentist if there are any sleeping positions they recommend in order to avoid placing pressure on your mouth (if it is relevant to your particular procedure).
Can I wear deodorant before wisdom teeth surgery? ›
Do not wear makeup, lotion, powder, deodorant or nail polish. It is important to remove your nail polish so that the doctors and nurses can see your true color during the surgery and in the Post Anesthesia Care Unit. The color of the skin and nail beds is an important sign of blood circulation.
How long does bad breath last after wisdom teeth removal? ›This change in your oral hygiene routine will likely lead to more bacterial plaque growth — and smelly breath — during that first week after your procedure. Once you've fully healed, you can go back to brushing, flossing, and rinsing as usual.
What is the hardest day after wisdom teeth removal? ›The pain and swelling should subside more and more each day following surgery. The second day following surgery is usually the worst day for swelling.
What does dry socket taste like? ›Unpleasant Taste. Another common symptom of a dry socket is a bad or sour taste in your mouth. This can be one of the first signs of infection, so don't let that smell linger without taking swift action.
Is it OK to remove all 4 wisdom teeth at once? ›It's Better to Take Out All Wisdom Teeth at the Same Time
Even if they emerge from your gums without any problems, they can force the surrounding teeth to become misaligned, which leads to some discomfort and makes them harder to keep clean because they are so far back in your mouth.
You may also experience some blurring of vision following anesthesia. For these reasons, we recommend that you do not drive or operate machinery for the first 24 hours after surgery.
What not to eat after wisdom teeth removal? ›- Chewy, crunchy, fried, hard, or sticky food – Can break into pieces while you chew, irritate the surgical site, or dislodge blood clots. ...
- Acidic food – gum tissue and can cause inflammation and pain. ...
- Spicy food – Irritates your gums and surgical site and may cause pain.
You can expect your recovery time after wisdom teeth removal to be three to four days. However, if your wisdom teeth were impacted, this could increase your recovery time to about a week to heal. You may experience discomfort or pain after wisdom teeth extraction for three days to one week.
Is 5 days enough to recover from wisdom teeth removal? ›Most patients have fully recovered by day 5, following the extraction. If you haven't progressed as outlined in the timeline above, it many be a good idea to consult your doctor, as you may experience a non-healing condition called Dry Socket.
How long does wisdom teeth removal pain last? ›You can expect some pain and swelling from the wisdom tooth extraction to last for about 3 to 7 days, depending on the type of extraction necessary and your body's natural healing process. However, thanks to over-the-counter pain medications, you don't have to suffer through that pain.
When can I stop worrying about dry socket? ›
When Can I Stop Worrying About Dry Socket? Until the full recovery of your extraction site, a dry socket can form if you fail to follow the care tips. Usually, a week (7-8 days) after wisdom tooth extraction, you can stop worrying about a dry socket as gums take this much time to close fully.
Is the 3rd day the worst day after wisdom teeth removal? ›The swelling will build over the first 48 to 72 hours and then plateau for 2-3 days making the 3rd-5th days the worst for pain and swelling. However, the swelling may be minimized by the immediate use of ice packs.
Why is day 4 the worst after wisdom teeth removal? ›Days 3-4: While swelling will peak during this time, the throbbing pain will give way to general soreness. Don't be alarmed if it's difficult to open your mouth completely. This will soon subside. Oral hygiene is important to keep the extraction sites clean.
What not to do after getting wisdom teeth out? ›After Your Wisdom Teeth Extraction, Don't:
Use straws, suck, spit, or smoke. Avoiding these activities helps maintain the blood clot that forms over the wisdom teeth extraction site. If the clot becomes dislodged, you may have more bleeding, more pain, and a potential side effect called dry sockets.
Apply ice packs to your face for 15 minutes on and then 15 minutes off to reduce swelling. Don't eat or drink anything, including water, after midnight of the evening before your surgery. Remember to dress comfortably. You'll feel better overall and will be ready to rest after your surgery.
Can I brush my teeth after wisdom teeth removal? ›On the same day of surgery, you should not brush near the extraction site. However, you should start normal brushing again the very next day, according to the American Dental Association. You will certainly want to be careful and gentle, but you should resume full brushing the day right after wisdom tooth extraction.