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Updated on September 29, 2022

Wisdom Teeth Removal Procedure, Aftercare & Costs

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What are Wisdom Teeth?

Wisdom teeth removal is the surgical extraction of third molars, more commonly known as wisdom teeth.

There are 32 teeth in a permanent set of teeth. This includes:

  • Incisors
  • Canines
  • Premolars
  • Molars

Wisdom teeth are the last teeth to erupt. They come out behind the 12-year-molars (second molars) about five to nine years later.

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

Dentists and oral surgeons extract ten million third molars from five million people in the U.S. every year.

Symptoms of Erupting Wisdom Teeth

Wisdom teeth pain is typically quite intense. It usually feels like pain in the back of your mouth or in your jaw. Some people experience a throbbing feeling or pressure in the back of their mouths.

Signs that your new set of molars are coming out include:

  • Pain or discomfort in the surrounding soft tissue
  • Jaw pain or discomfort
  • Nearby toothaches
  • Swollen or cut gums
  • Teeth poking out through the gums
  • Overcrowding/shifting teeth if there’s not enough space in the back of your mouth

Signs of Impacted Wisdom Teeth

When teeth are stuck under the gums or blocked by other teeth, they are called impacted teeth.

Impacted wisdom teeth may partially erupt so that part of the crown is visible. This is known as partially impacted.

Sometimes, a tooth may never break through the gums. This means it is fully impacted.

When wisdom teeth lead to ear pain, this is a solid indication that they are impacted. Ear pain resulting from wisdom teeth is caused by the tooth being blocked from erupting through the gums.

Many people don’t notice any wisdom teeth pain at first. However, if the pain is ignored, more serious dental conditions may develop over time.

Dentists recommend extracting impacted wisdom teeth to reduce the chances of:

  • Cysts
  • Jaw pain
  • Tooth decay
  • Tooth and/or tooth infection

The force from wisdom teeth is not strong enough to make the front teeth crooked. Crowding is a natural process of aging. Over time, everyone's teeth will become more crooked, whether they have wisdom teeth or not. People can wear retainers to hold the teeth in place.

Home Remedies for Wisdom Teeth Pain

Impacted wisdom teeth may lead to pain, aches, and tenderness. Removing wisdom teeth is usually the best way to resolve these problems.

In the meantime, there are various over-the-counter medical treatments and home remedies available. These include:

  • Numbing gel
  • Ibuprofen
  • Placing an ice pack against your jaw
  • Rinsing your mouth with salt water

Common Signs Wisdom Teeth Need to Be Extracted

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

Partial emergence through the gums

If a wisdom tooth partially erupts through the gums, a serious oral infection or gum disease can develop. The tooth is hard to clean and brush, making it more prone to bacteria and decay.

Hidden in the gums

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

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 

When Is Wisdom Tooth Removal Not Necessary?

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

35 percent of Americans are born without wisdom teeth.

Wisdom teeth removal may not be necessary if the 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

Who Does Wisdom Teeth Removal?

Two types of dentists can safely remove wisdom teeth:

Oral and Maxillofacial Surgeons

Oral and maxillofacial surgeons commonly remove wisdom teeth.

They are highly trained in performing these procedures. If a patient is at a higher risk for serious complications or prefers an I.V. sedation, oral surgeons are the ideal option. This is because they are qualified to use deeper levels of sedation and understand how to do it safely.

General Dentists

General dentists also perform wisdom teeth extractions.

The main difference between an oral surgeon and a dentist, in terms of third molar removal, is the level of sedation they are qualified to use on patients.

Wisdom Teeth Procedure

Typically, wisdom teeth removal consists of five steps:

1. Local Anesthesia & Sedation

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

It may be used by itself or in combination with nitrous oxide (laughing gas), an oral premedication, or I.V. sedation. The surgery does not start until it is in full effect. Patients will not feel any pain during the procedure.

2. Tooth Access

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.

3. Tooth Extraction

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. The entire procedure takes 30 minutes or less.

How painful is wisdom teeth removal?

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

4. Post 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.

5. Post Surgery

You will bite on gauze or a bite pack directly after the procedure to ensure the sockets are isolated and help stop any bleeding. Antibiotics, pain medications, and anti-inflammatory medications will be prescribed to prevent infection and manage postoperative pain.

Wisdom Teeth Aftercare

Aftercare tips include:

Recovery Time and Activity

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 two to three weeks.

The following stages usually occur during the healing process:

First 24 hours: Blood clots form.

Two to Three Days: Swelling of the mouth and cheeks should improve.

Seven Days: A dentist can take out any remaining stitches.

Seven to Ten Days: Jaw stiffness and soreness should go away.

Two Weeks: Any bruising on the face should heal. 

Food and Drink Restrictions

Only soft food should be ingested during the first two days, such as smoothies, soups, mashed potatoes, and scrambled eggs.

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

Pain Management

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:

  • Ibuprofen
  • Lornoxicam
  • Acetaminophen
  • Aspirin

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

Tobacco Use

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

Oral Care

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.

Stitches

Most extraction stitches dissolve within 7 to 10 days.

Wisdom Teeth Removal Risks

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

Dry socket

A dry socket, also known as alveolar osteitis, is a painful dental condition that occurs in only 2 to 5 percent of extraction patients. After a tooth is removed, a blood clot normally forms to protect the underlying bone, tissues, and nerve.

In rare cases, a dry socket may form within 3 to 5 days of surgery, which results in the exposure of the bone and nerves.

Severe pain, bad breath, and a bad taste in the mouth are common symptoms. Bleeding should not continue because the socket is dry. Treatment includes returning to the dentist for a dry socket dressing to seal and protect the healing extraction site.

Other side effects and risks of tooth extractions include:

  • An infection that results in swelling and bleeding of the gums
  • Long-term numbness in the lower lip, tongue, or chin
  • Weakness in the jawbone

Cost of Wisdom Teeth Removal

Depending on how many teeth need to be extracted, the price for treatment varies:

Simple Wisdom Tooth Extraction Impacted Wisdom Tooth Removal
Per Tooth $75-$200 $225-$600
All 4 Teeth $300-$800 $250-$800

Insurance Coverage

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

5 Sources Cited
Last updated on September 29, 2022
All NewMouth content is medically reviewed and fact-checked by a licensed dentist or orthodontist to ensure the information is factual, current, and relevant.

We have strict sourcing guidelines and only cite from current scientific research, such as scholarly articles, dentistry textbooks, government agencies, and medical journals. This also includes information provided by the American Dental Association (ADA), the American Association of Orthodontics (AAO), and the American Academy of Pediatrics (AAP).
  1. Friedman, Jay W. “The Prophylactic Extraction of Third Molars: a Public Health Hazard.” American Journal of Public Health, © American Journal of Public Health 2007, Sept. 2007, www.ncbi.nlm.nih.gov/pmc/articles/PMC1963310/.
  2. Hollins, Carole. Basic Guide to Dental Procedures. John Wiley & Sons, Inc., 2015.
  3. Koerner, Karl R. Manual of Minor Oral Surgery for the General Dentist. Blackwell Munksgaard, 2006.
  4. “Who Should Remove My Wisdom Teeth?” U Of U Health, healthcare.utah.edu/the-scope/shows.php?shows=0_kbsgyupm.
  5. Syrbu, John DDS. The Complete Pre-Dental Guide to Modern Dentistry. 2013.
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