Overview
Wisdom tooth extraction is a surgical procedure to remove one or more wisdom teeth — the four permanent adult teeth located at the back corners of your mouth on the top and bottom.
If a wisdom tooth doesn't have room to grow (impacted wisdom tooth), resulting in pain, infection or other dental problems, you'll likely need to have it pulled. Wisdom tooth extraction may be done by a dentist or an oral surgeon.
To prevent potential future problems, some dentists and oral surgeons recommend wisdom tooth extraction even if impacted teeth aren't currently causing problems.
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Why it's done
Impacted wisdom teeth
Impacted wisdom teeth
Wisdom teeth are the last of your teeth to appear (erupt) in the mouth. Sometimes a wisdom tooth becomes stuck below the surface of your gums (impacted), and grows at an odd angle, possibly causing complications.
Wisdom teeth, or third molars, are the last permanent teeth to appear (erupt) in the mouth. These teeth usually appear between the ages of 17 and 25. Some people never develop wisdom teeth. For others, wisdom teeth erupt normally — just as their other molars did — and cause no problems.
Many people develop impacted wisdom teeth — teeth that don't have enough room to erupt into the mouth or develop normally. Impacted wisdom teeth may erupt only partially or not at all.
An impacted wisdom tooth may:
- Grow at an angle toward the next tooth (second molar)
- Grow at an angle toward the back of the mouth
- Grow at a right angle to the other teeth, as if the wisdom tooth is "lying down" within the jawbone
- Grow straight up or down like other teeth but stay trapped within the jawbone
Problems with impacted wisdom teeth
You'll likely need your impacted wisdom tooth pulled if it results in problems such as:
- Pain
- Trapping food and debris behind the wisdom tooth
- Infection or gum disease (periodontal disease)
- Tooth decay in a partially erupted wisdom tooth
- Damage to a nearby tooth or surrounding bone
- Development of a fluid-filled sac (cyst) around the wisdom tooth
- Complications with orthodontic treatments to straighten other teeth
Preventing future dental problems
Dental specialists disagree about the value of extracting impacted wisdom teeth that aren't causing problems (asymptomatic).
It's difficult to predict future problems with impacted wisdom teeth. However, here's the rationale for preventive extraction:
- Symptom-free wisdom teeth could still harbor disease.
- If there isn't enough space for the tooth to erupt, it's often hard to get to it and clean it properly.
- Serious complications with wisdom teeth happen less often in younger adults.
- Older adults may experience difficulty with surgery and complications after surgery.
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Risks
Most wisdom tooth extractions don't result in long-term complications. However, removal of impacted wisdom teeth occasionally requires a surgical approach that involves making an incision in the gum tissue and removing bone. Rarely, complications can include:
- Painful dry socket, or exposure of bone when the post-surgical blood clot is lost from the site of the surgical wound (socket)
- Infection in the socket from bacteria or trapped food particles
- Damage to nearby teeth, nerves, jawbone or sinuses
How you prepare
Your dentist may perform the procedure in the office. However, if your tooth is deeply impacted or if the extraction requires an in-depth surgical approach, your dentist may suggest you see an oral surgeon. In addition to making the area numb with local anesthetic, your surgeon may suggest sedation to allow you to be more comfortable during the procedure.
Questions to ask
Questions you may want to ask your dentist or oral surgeon include:
- How many wisdom teeth need to be removed?
- What type of anesthesia will I receive?
- How complicated do you expect the procedure to be?
- How long is the procedure likely to last?
- Have the impacted wisdom teeth caused damage to other teeth?
- Is there a risk that I might have nerve damage?
- What other dental treatments might I need at a later date?
- How long does it take to completely heal and return to normal activity?
Preparing for surgery
A wisdom tooth extraction is almost always performed as an outpatient procedure. This means that you go home the same day.
You'll receive instructions from the hospital or dental clinic staff on what to do before the surgery and the day of your scheduled surgery. Ask these questions:
- Will I need to make arrangements for someone to drive me home after the procedure?
- When do I need to arrive at the dental clinic or hospital?
- Do I need to avoid eating food or drinking fluids or both (fast)? If so, when do I begin?
- Can I take my prescription medications before the surgery? If so, how soon before the surgery can I take a dose?
- Should I avoid any nonprescription drugs before the surgery?
What you can expect
During the procedure
Your dentist or oral surgeon may use one of three types of anesthesia, depending on the expected complexity of the wisdom tooth extraction and your comfort level. Options include:
- Local anesthesia. Your dentist or oral surgeon administers local anesthesia with one or more injections near the site of each extraction. Before you receive an injection, your dentist or surgeon will likely apply a substance to your gums to numb them. You're awake during the tooth extraction. Although you'll feel some pressure and movement, you shouldn't experience pain.
- Sedation anesthesia. Your dentist or oral surgeon gives you sedation anesthesia through an intravenous (IV) line in your arm. Sedation anesthesia suppresses your consciousness during the procedure. You don't feel any pain and will have limited memory of the procedure. You'll also receive local anesthesia to numb your gums.
- General anesthesia. In special situations, you may be offered general anesthesia. You may inhale medication through your nose or have an IV line in your arm, or both. Then you lose consciousness. Your surgical team closely monitors your medication, breathing, temperature, fluids and blood pressure. You'll experience no pain and have no memory of the procedure. Local anesthesia is also given to help with postoperative discomfort.
During wisdom tooth extraction, your dentist or oral surgeon:
- Makes an incision in the gum tissue to expose the tooth and bone
- Removes bone that blocks access to the tooth root
- Divides the tooth into sections if it's easier to remove in pieces
- Removes the tooth
- Cleans the site of the removed tooth of any debris from the tooth or bone
- Stitches the wound closed to promote healing, though this isn't always necessary
- Places gauze over the extraction site to control bleeding and to help a blood clot form
After the procedure
If you receive sedation anesthesia or general anesthesia, you're taken to a recovery room after the procedure. If you have local anesthesia, your brief recovery time is likely in the dental chair.
As you heal from your surgery, follow your dentist's instructions on:
- Bleeding. Some oozing of blood may occur the first day after wisdom tooth removal. Try to avoid excessive spitting so that you don't dislodge the blood clot from the socket. Replace gauze over the extraction site as directed by your dentist or oral surgeon.
- Pain management. You may be able to manage pain with an over-the-counter pain reliever, such as acetaminophen (Tylenol, others), or a prescription pain medication from your dentist or oral surgeon. Prescription pain medication may be especially helpful if bone has been removed during the procedure. Holding a cold pack against your jaw also may relieve pain.
- Swelling and bruising. Use an ice pack as directed by your dentist or surgeon. Any swelling of your cheeks usually improves in two or three days. Bruising may take several more days to resolve.
- Activity. After your surgery, plan to rest for the remainder of the day. Resume normal activities the next day, but for at least a week, avoid strenuous activity that might result in losing the blood clot from the socket.
- Beverages. Drink lots of water after the surgery. Don't drink alcoholic, caffeinated, carbonated or hot beverages in the first 24 hours. Don't drink with a straw for at least a week because the sucking action can dislodge the blood clot from the socket.
- Food. Eat only soft foods, such as yogurt or applesauce, for the first 24 hours. Start eating semisoft foods when you can tolerate them. Avoid hard, chewy, hot or spicy foods that might get stuck in the socket or irritate the wound.
- Cleaning your mouth. Don't brush your teeth, rinse your mouth, spit or use mouthwash during the first 24 hours after surgery. Typically you'll be told to resume brushing your teeth after the first 24 hours. Be particularly gentle near the surgical wound when brushing and gently rinse your mouth with warm salt water every two hours and after meals for a week.
- Tobacco use. If you smoke, don't do so for at least 72 hours after surgery — and wait longer than that if possible. If you chew tobacco, don't use it for at least a week. Using tobacco products after oral surgery can delay healing and increase the risk of complications.
- Stitches. You may have stitches that dissolve within a few weeks or no stitches at all. If your stitches need to be removed, schedule an appointment to have them taken out.
When to call your dentist or surgeon
Call your dentist or oral surgeon if you experience any of the following signs or symptoms, which could indicate an infection, nerve damage or other serious complication:
- Difficulty swallowing or breathing
- Excessive bleeding
- Fever
- Severe pain not relieved by prescribed pain medications
- Swelling that worsens after two or three days
- A bad taste in your mouth not removed with saltwater rinsing
- Pus in or oozing from the socket
- Persistent numbness or loss of feeling
- Blood or pus in nasal discharge
Results
You probably won't need a follow-up appointment after a wisdom tooth extraction if:
- You don't need stitches removed
- No complications arose during the procedure
- You don't experience persistent problems, such as pain, swelling, numbness or bleeding — complications that might indicate infection, nerve damage or other problems
If complications develop, contact your dentist or oral surgeon to discuss treatment options.
By Mayo Clinic Staff
Jan. 31, 2018
FAQs
Which is the most difficult wisdom tooth extraction? ›
Full-Bony Impacted: This type of wisdom tooth removal is the most difficult because the wisdom tooth is completely stuck in the jaw.
What are red flags for wisdom tooth removal? ›Warning Signs –when to See a Dentist
Other red flags to watch out for include: Pus between teeth and gum. Swelling around wisdom teeth. Red, irritated gum around the wisdom tooth.
According to the American Dental Association, wisdom teeth removal may be necessary if you experience changes in the area of those teeth, such as: Pain. Repeated infection of soft tissue behind the lower last tooth.
What makes a wisdom tooth extraction complicated? ›Nerve injury. Although far less common than dry socket, injury to sections of a nerve called the trigeminal nerve is another possible complication of wisdom tooth removal. It can cause pain, a tingling sensation and numbness in your tongue, lower lip, chin, teeth and gums.
What is the number 1 wisdom tooth? ›Tooth Numbering System
#1 is your upper right wisdom tooth. Each tooth then progresses up one number all the way across to the 3rd molar (wisdom tooth) on the left side of the mouth (#16). #17 will be the lower left wisdom tooth and counting clockwise, the last tooth will be #32, the lower right wisdom tooth.
With a typical wisdom tooth extraction, discomfort typically improves after 3 or 4 days, with day three usually being the most noticeable in regard to discomfort. If you are developing an infection or dry socket, the pain may last as long as two weeks without professional treatment.
What should it look like 5 days after wisdom teeth removal? ›Days 5-7: By now, most of the swelling, discoloration, and soreness should be minimal. If you were given antibiotics to prevent infection, be sure to finish the entire 7-day course.
What should wisdom teeth healing look like day 4? ›– Day 4. This is the final tooth extraction healing process, happening around seven to ten days after the extraction. The hole in the socket has, in most cases, closed up, the swelling has completely gone away, and the patient can now resume eating solid foods 4 days after tooth extraction.
What does a healthy wisdom tooth extraction site look like? ›So, what does normal healing look like after a Tooth Extraction? A healthy tooth extraction site should look deep red with white gelatinous tissues forming over time.
What are the disadvantages of removing wisdom teeth? ›Nerves and blood vessels can be damaged during the procedure. This can cause bleeding and usually temporary numbness in the tongue or face. In very rare cases serious infections may occur. Up to 1 out of 100 people may have permanent problems as a result of the procedure, such as numbness or damage to nearby teeth.
What type of wisdom tooth extraction is the easiest? ›
Nonimpacted wisdom teeth removal
This is a more standard tooth extraction that will take place when wisdom teeth erupt above your gums and are visible. It's perhaps the simplest of the procedures.
Wisdom teeth served a purpose long, long ago when we foraged for foods like twigs and tough, raw meats. Since we no longer need that extra grinding power our bodies have evolved away from them. Our jawbones have decreased in size as well.
What is the most painful wisdom tooth impaction? ›Horizontal impaction is when your wisdom tooth is lying completely on its side, trapped beneath your gums. Horizontally impacted wisdom teeth are often painful because they place excess pressure on the teeth in front of them.
Can I go to work the next day after wisdom tooth extraction? ›It's usually recommended that you take a day or two off work after having a wisdom tooth removed. You won't need a sick note from your doctor or dentist for this.
What makes wisdom teeth removal feel better? ›Ice It. Wisdom teeth removal pain relief strategies often include icing the jaw and cheek. This also helps ease the bruising and swelling that may follow your surgery. Apply an ice pack to the side of the extraction site for 15 to 20 minutes.
Are top or bottom wisdom teeth more common? ›Wisdom teeth are the last adult teeth to come into the mouth (erupt). Most people have four wisdom teeth at the back of the mouth — two on the top, two on the bottom.
How many wisdom teeth do they pull at one time? ›Most patients will be able to have all four of their wisdom teeth removed at the same time if they choose to do so. Discuss your preferences with your oral surgeon, and feel free to ask any questions that you may have about the treatment.
Is number 2 tooth a wisdom tooth? ›Number 1: 3rd Molar commonly known as wisdom tooth. Number 2: 2nd Molar. Number 3: 1st Molar. Number 4: 2nd Bicuspid also known as 2nd premolar.
How can I make my tooth extraction heal faster? ›- Rest. It is crucial to get adequate rest after your tooth extraction. ...
- Eat a Soft Food Diet. ...
- Avoid Using a Straw or Smoking. ...
- Cold Therapy. ...
- Use Over-the-Counter Medications. ...
- Maintain Good Oral Hygiene.
Often times after wisdom tooth removal we will prescribe a higher dose ibuprofen. This should be taken in consistent doses the first 3-5 days if tolerated to help keep inflammation down as well as help control discomfort.
What to do for the first few days after wisdom teeth removal? ›
Rest as much as you can for the first few days. Avoid strenuous activity for 48 to 72 hours. Place a cold compress or ice pack on your face to help reduce swelling. Keep the surgical sites clean by gently soaking them with an antimicrobial mouthwash.
How do I know if my wisdom tooth site is healing? ›After about 3 days, the empty tooth socket will have mostly healed. There should be no more bleeding present, and swelling should be minimal at this point. You may still experience some tenderness or soreness, but you should no longer feel pain or discomfort.
What to expect 3 days after having your wisdom teeth pulled? ›On the third day, you will notice that your jaw muscles are stiff, and it is difficult to open your mouth normally. You can apply moist heat to your face on the second and third day allowing your muscles to relax more and open wider. Most of the time you will want to limit your activities for a few days.
Should I still be in pain on day 4 of wisdom teeth removal? ›As already stated, some degree of discomfort after a wisdom tooth extraction is normal and typically dissipates within 3-4 days.
What is the white stuff in my wisdom tooth socket? ›Typically, the white stuff is granulation tissue. It is essential to the healing process of the extraction site. Other times, the white stuff is pus or a dry socket. A dry socket is often painful, and it occurs when the blood clot does not form correctly.
How do I know if my tooth extraction is infected? ›Signs of infection after extraction
Instead of the pain getting better from the extraction, it gets worse. The bleeding continues for more than 24 hours. Experiencing an unpleasant or foul smell coming from the mouth. Seeing discharge in or around the area.
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.
How do you know if you lost the blood clot after tooth extraction? ›After a tooth extraction, you should develop a blood clot in the socket (hole) that's left behind. It'll look like a dark-colored scab. But if you have a dry socket, the clot will be absent and you'll be able to see bone. For this reason, dry sockets usually appear white.
What happens if I accidentally rinse my mouth after tooth extraction? ›No, it will not affect the healing of the tissue unless you rinsed rigorously. You should avoid rigorous rinses or gargles because it will remove the clot of the wound leading to dry socket often times.
What are the long term effects of not removing wisdom teeth? ›In fact, they often cause more problems because they are at risk for impaction, a condition in which the tooth is partially or fully trapped beneath the gums, other teeth, or both. Impaction increases the risks of bacterial infections, tooth decay, gum disease, and other harmful health conditions.
What hurts more tooth extraction or wisdom tooth extraction? ›
Wisdom tooth extractions are performed every day in dental practices around the world, and in reality, they are no more painful than having any other tooth extracted, but so many patients are concerned about feeling pain afterwards.
How long does a simple wisdom tooth extraction take? ›Your surgery should take 45 minutes or less. You'll get one of these types of anesthesia so you don't feel pain during the removal: Local: Your doctor will numb your mouth with a shot of local anesthetic such as novocaine, lidocaine or mepivicaine.
Does a simple wisdom tooth extraction hurt? ›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.
What did ancient people do about wisdom teeth? ›Wisdom Teeth Extraction Through the Ages
But before the development of surgical dentistry, infected or impacted wisdom teeth had to be removed without advanced techniques or instruments. Originally, patients underwent extraction with imprecise hand tools and had no anesthesia.
Our Early Ancestors Needed Wisdom Teeth
Because early humans needed to chew coarse, hearty foods, they required a broader jaw. Wisdom teeth grew in to give them more chewing power for this purpose. Because the jaw was wider, the wisdom teeth were able to grow in with no difficulties.
Our ancestors' primitive diet consisted of a lot of raw plants, hard nuts and tough meats — and wisdom teeth were necessary to grind these foods for proper digestion. Today, modern food preparation and eating utensils have eliminated our need for wisdom teeth.
Are top or bottom wisdom teeth harder to remove? ›Upper wisdom teeth are often easier to remove than lower ones, which are more likely to be impacted. Your dentist will say whether the tooth should be taken out at the dental practice, or whether you should be referred to a specialist (oral surgeon) at a hospital.
Which 3rd molar extraction is most difficult? ›Distoangular impacted 3rd molars are very difficult to remove because of lack of space distal to the tooth and lack of interdental space available for the application of elevator.
Which 3rd molar extraction is hardest? ›Among them, horizontal mandibular third molars are usually deep impacted and are most difficult to extract due to the following features: ①large coronal bone resistance; ②large adjacent tooth resistance; ③the proximity to inferior alveolar canal(IAC); ④mandible fracture risk due to the deep impaction.
How many days do you need off for wisdom teeth? ›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.
What kind of anesthesia is best for wisdom teeth removal? ›
Local anesthesia is one of the most commonly-used sedatives. Lidocaine is injected into the target area to temporarily prevent nerves from transmitting the feeling of pain.
Do you need someone to stay with you after wisdom teeth removal? ›Home Instructions After Wisdom Teeth Extraction
Please make sure someone stays with you for at least the first 4 hours after you arrive home. If you suddenly stand from a lying position, you may become dizzy or nauseated. You will need someone to watch you carefully during the transition period after surgery.
The most commonly reported postoperative complication of third molar removal in the literature are dry socket, infection, bleeding and sensory disturbances due to nerve injuries. 11–23 In the present study, the overall postoperative complication rate was 8.3%.
What are the disadvantages of removing third molar? ›Nerves and blood vessels can be damaged during the procedure. This can cause bleeding and usually temporary numbness in the tongue or face. In very rare cases serious infections may occur. Up to 1 out of 100 people may have permanent problems as a result of the procedure, such as numbness or damage to nearby teeth.
How painful is 3rd molar extraction? ›So, wisdom tooth removal does it hurt? During the procedure, you should feel no pain and barely any (if at all) discomfort. After the procedure, the extraction site may feel a little tender for several days but with a little rest and recuperation, you should be back to normal within 7 days.
What is the ideal time for 3rd molar extraction? ›Is quite wide. Wisdom teeth can emerge anywhere from late adolescence up to the mid-twenties — or even later, in rare cases — so oral surgeons don't have a specific timeline for completing the procedure. However, as a general rule, ages 18 to 24 is considered ideal for third-molar extraction.
Which teeth have the most impaction? ›Excluding the third molars, maxillary canine is the most commonly impacted tooth followed by mandibular canines.
What nerve is damaged after third molar extraction? ›The surgical removal of lower third molars endangers both the lingual and inferior alveolar nerves. Patients sustaining an injury to either of these nerves must be managed correctly, and this requires a diagnosis of the injury type and regular monitoring of the recovery of sensation.
Is wisdom tooth extraction worse than normal tooth extraction? ›Wisdom teeth recovery can be a little more difficult than other tooth extractions. The reasons for this include the fact that the procedure is more likely to be more complex. The size of the hole (or “socket”) left when the larger tooth is extracted will be bigger and therefore need more attention and time to heal.