Wisdom Teeth Removal Procedure, Aftercare & Costs

Wisdom teeth extraction is an invasive yet often necessary procedure that most people undergo during their teen years. While the procedure is often quick and painless, it’s important to know what to expect during and after removal.

What are Wisdom Teeth?

Wisdom teeth (third molars) are the last teeth to erupt in the mouth. They come in behind the 12-year-molars (second molars) about 5 to 9 years later. 

Some people are born without wisdom teeth, while others have extra. But most people have four wisdom teeth in total. Wisdom teeth removal is the surgical extraction of these teeth. 

People typically get their wisdom teeth removed between ages 16 and 20 because they don’t have space to grow in properly. Wisdom teeth can grow in at various angles, even horizontally, when the jaw isn’t large enough for them to erupt naturally.

Why is Wisdom Teeth Removal Important?

Whether your wisdom teeth have emerged or are hiding under your gums, they will often cause oral issues. 

If your wisdom teeth are trapped or impacted under the gums, they can cause infections, cysts, and/or damage the surrounding teeth and bone.

If your wisdom teeth have partially emerged, you may have difficulty cleaning the area. This area can become a hot spot for bacteria, oral infection, and gum disease.

Finally, wisdom teeth removal is important because it helps avoid crowding. Most of the time, wisdom teeth don’t grow in straight. This means your other teeth may start to become crooked. 

Common Signs Your Wisdom Teeth Need to Be Extracted

For some people, wisdom teeth extractions are necessary. This is due to a few reasons:

Your Wisdom Teeth Have Partially Emerged Through the Gums

If a wisdom tooth partially erupted through the gums, a serious oral infection or gum disease can develop. These teeth are hard to clean and brush, making them more prone to bacteria buildup and decay.

Your Wisdom Teeth are Hidden Under the Gums

If a wisdom tooth cannot erupt, it will become trapped under your gums. A cyst or infection can develop if it is not removed. Damage to the roots of the nearest tooth can also occur.

You Have an Infected Wisdom Tooth

An infected wisdom tooth can cause further damage to surrounding teeth. Symptoms of this include:

• Mouth pain or discomfort
• Jaw pain or discomfort
• Nearby toothaches
• Poor breath
• Red or swollen gums 
• Tender or bleeding gums 
• Swelling around the jaw 
• An unpleasant taste in your mouth
• Challenges opening your mouth or swallowing

Wisdom Teeth Removal Procedure

Typically, wisdom teeth removal consists of three parts:

Before Wisdom Tooth Extraction

A local anesthetic (lidocaine) is administered, which numbs the surgical area.

It may be used by itself or with nitrous oxide (laughing gas), oral premedication with an anxiolytic, or I.V. sedation. The surgery does not start until it is in full effect. 

People do not feel any pain during the procedure.

During Wisdom Tooth Extraction

During the surgical extraction, the dentist cuts the gingiva (gums) surrounding each tooth with a scalpel.

The gums are peeled back from the underlying bone using surgical instruments. The dental nurse draws the soft tissues back and uses high-speed suction to keep the area clean and dry.

Next, the dentist removes the entire tooth, root pieces, and excess bone.

Once this step is complete, the socket is examined for any remaining fragments that need to be removed and is then closed up. The entire procedure takes 30 minutes or less.

After Wisdom Tooth Extraction

Once the extraction is complete, the gum tissue may be sutured back into place to cover the underlying bone and promote healing. Not all surgeons use stitches.

You will bite on gauze or a bite pack directly after the procedure to ensure the sockets are isolated and help stop bleeding. 

Antibiotics, pain medications, and anti-inflammatory medications may be prescribed to prevent infection and manage postoperative pain.

6 Wisdom Tooth Extraction Recovery Tips 

Aftercare tips include:

1. Allow time for recovery

The surgery often causes swelling, pain, and minor bleeding during the first week. Bruising and swelling of the facial region, such as the cheeks and chin, are also common.

Avoid strenuous activity for a week post-surgery. Everything should heal within 2 to 3 weeks.

The following stages usually occur during the healing process:

• First 24 hours to 3 days — Blood clots form, and swelling may occur. 
• 4 to 6 days — Swelling of the mouth and cheeks should improve.
• 7 days — A dentist can take out any remaining stitches.
• 7 to 10 days — Jaw stiffness and soreness should go away.
• 2 weeks — Any bruising on the face should heal. 

2. Be careful about what you eat

Only soft foods should be ingested during the first 2 days post-procedure, such as smoothies, soups, mashed potatoes, and scrambled eggs.

People should also refrain from using straws after surgery to reduce the chance of a dry socket forming. Do not drink alcohol, caffeine, or hot or carbonated beverages for at least a week.

3. Manage your pain

To relieve pain after the surgery, your dentist may recommend taking over-the-counter pain relievers, such as Tylenol (acetaminophen). Or, they may prescribe you a prescription pain reliever. This includes:

• Tylenol with codeine 
• Tramadol

Ice packs are also provided to reduce swelling and bruising of the facial region.

4. Don't smoke

Refrain from smoking for one week after surgery to prevent dry socket formation.

5. Take care of your oral health

Brushing, spitting, and rinsing the mouth are not recommended during the first 24 hours after surgery. However, your doctor may recommend gently rinsing your mouth with saltwater between meals.

6. Don't touch your stitches

Do not touch your stitches. Most extraction stitches dissolve on their own within 7 to 10 days. Your oral surgeon will let you know if non-dissolvable stitches were used. 

What Not to Do After Wisdom Teeth Extraction

After your wisdom tooth extraction, it’s important to follow guidelines to ensure you don’t run into issues. Until your mouth has healed after your extraction, do not:

• Smoke, drink alcohol, or use tobacco for at least 72 hours
• Touch or take out your stitches, as they will dissolve on their own, or your surgeon will remove them at a later time 
• Eat hard or chewy foods
• Drink from straws 
• Brush your teeth, rinse your mouth, or spit during the first 24 hours

Risks of Wisdom Teeth Removal

There are some risks associated with wisdom teeth removal, including:

• Dry socket
• An infection that results in swelling and bleeding of the gums
• Permanent numbness in the lower lip, tongue, or chin
• Weakness in the jawbone

How Much Does Wisdom Teeth Removal Cost?

A simple wisdom tooth extraction (non-impacted wisdom teeth) usually costs $75 to $200 per tooth.

For impacted wisdom teeth, you can expect to pay around $225 to $600 per tooth.

Will insurance cover my wisdom tooth extraction?

If the procedure is medically necessary, most dental insurance plans cover up to half the cost of wisdom teeth removal. Dental plans are usually capped at $1,000 to $1,500 annually.

Common Questions About Wisdom Teeth Removal

How painful is wisdom teeth removal?

If your doctor administers anesthesia and sedation before the procedure, you will not feel anything during the surgery. However, you will experience minor discomfort, swelling, and bleeding for a week or two post-op.

What is a dry socket?

A dry socket (alveolar osteitis) is a painful dental condition that occurs in only 2 to 5 percent of people. Dry sockets happen after a tooth is removed when a blood clot does not form to protect the underlying bone, tissues, and nerve.

In rare cases, a dry socket may form within 3 to 5 days of surgery due to smoking, drinking through a straw, or spitting, which results in the exposure of the bone and nerves.

Severe pain, bad breath, and a bad taste in the mouth are common symptoms. 

Who can perform wisdom teeth extractions?

The types of dentists who can safely remove wisdom teeth are oral and maxillofacial surgeons, periodontists, and general dentists.

Oral and maxillofacial surgeons are qualified to use deeper levels of sedation. For these reasons, they are recommended if a person is at a higher risk for serious complications or prefers I.V. sedation.

Periodontists are also surgeons qualified to use deeper levels of sedation and can also extract wisdom teeth. 

General dentists also perform wisdom teeth extractions. However, most general dentists can’t use higher levels of sedation when removing wisdom teeth.

Are wisdom tooth extractions always necessary?

Some people do not require wisdom teeth removal. This is because some people are born without third molars or have less than four of them.

In addition, wisdom teeth removal may not be necessary if your teeth:

• Caused minor pain or discomfort when growing in
• Have grown in completely and aren't crooked
• Do not affect your bite or nearby teeth
• Have enough room to be properly cleaned and brushed daily

Summary

• Wisdom teeth removal is the surgical extraction of third molars, more commonly known as wisdom teeth
• Removing your wisdom teeth is important if they are impacted, partially emerging, and growing in sideways
• Extractions are painless but require a fair amount of aftercare to avoid infection or further injury