Wisdom Teeth Removal: What You Need to Know

Pros

• Wisdom tooth removal can help alleviate jaw pain, particularly if you’ve been having trouble opening your mouth.
• This oral surgery makes it easier to keep your teeth clean, since crooked molars are more apt to trap food.
• It reduces the likelihood that you’ll develop periodontal disease, which affects the gums, bone, and periodontal ligament surrounding teeth.
• You won’t miss your wisdom teeth; they aren’t necessary for chewing.
• Removing them won’t change the shape of your face or jawline, except in rare cases. 

Cons

• You should plan for a few days of downtime, which can be up to a week depending on how quickly you heal. Most people return to work or school within two to three days.
• Recovery can be painful, though your doctor can prescribe painkillers.  
• Potential surgical complications, though rare, include infection, nerve damage, and dry socket. Older adults may experience complications more frequently.
• You will have to avoid certain foods and drinks for the first couple of weeks, as you heal (see more below).

• Average Cost:
• $650

• Range:
• $600 - $2,900

A dental insurance plan will likely cover up to half the cost of wisdom teeth removal, assuming it’s medically necessary.

See our complete guide to wisdom teeth removal costs

People with diseased, impacted third molars are usually the best candidates for wisdom teeth removal. Some doctors recommend doing the procedure when you’re young (in your teens or early 20s), since fully formed roots are tougher to extract and chances of developing cysts and abscesses are higher. 

People who are undergoing chemotherapy and radiation, being treated for an infection, or dealing with uncontrolled diabetes should wait to have this surgery. If you’ve broken your jaw or have limited mobility of your jaw, you might need to keep your wisdom teeth (or opt for general anesthesia during a more difficult removal procedure).

If you’re pregnant, dentists usually recommend avoiding oral surgery and X-rays unless it’s an emergency. If your wisdom teeth are impacted and causing lots of pain or infection, there are ways to safely administer anesthesia and remove wisdom teeth; however, it’s still better to wait at least until the second trimester.

If you’re not confident that you’re a good candidate, talk with a general dentist or oral surgeon, and don’t be afraid to seek a second opinion.

RealSelf Tip: You can have your wisdom teeth extracted if you’re currently wearing braces. It won’t affect your recovery or straightening results.

In 2016, the American Association of Oral and Maxillofacial Surgeons (AAOMS) advised their members in a white paper titled Management of Third Molar Teeth that their “best evidence-based data” showed that while wisdom teeth that “in the absence of disease or significant risk of disease, active clinical and radiographic surveillance [not removal] is indicated.” This means that if you aren’t experiencing pain, severe overcrowding, or disease due to your wisdom teeth, you probably don’t need them removed after all. 

They go on to point out that “given the documented high incidence of problems associated with third molars over time, all patients should be evaluated by someone experienced and expert in third molar management.” Basically, ask your dentist or an oral surgeon if this surgery is right for you.

Complications from wisdom teeth removal are rare. Your dentist or surgeon will give you aftercare instructions for avoiding infections and dry socket, a painful condition in which the blood clot from the surgical wound is lost and the bone gets exposed (usually a risk only within the first few days). 

Very rarely, some patients experience nerve damage. It’s usually just temporary, but it can give you a “pins and needles” feeling for a few weeks or even months. There’s also a possibility that nearby teeth will be damaged during the procedure.

Even more rarely, patients who are given general anesthesia for wisdom teeth removal have died. The 2017 study Death Rate of Dental Anaesthesia, published in the Journal of Clinical and Diagnostic Research, puts the rate at 3 deaths per 1,000,000 patients.

Depending on how many wisdom teeth you’re having removed, the level of impaction, and your comfort level with dental procedures, your dentist or oral surgeon will choose the best form of sedation to keep you comfortable during the procedure. This may include nitrous oxide (laughing gas) inhaled through the nose, an intravenous (IV) line in the arm, oral medications like Valium or Halcion (for anxiety), or a combination, along with anesthesia to numb the pain.

Regardless of which type of anesthesia you’re given, you should feel relaxed and pain-free, with limited or no memory of the procedure. If you’re given general anesthesia, you’ll lose consciousness altogether. A surgical team will closely monitor your pulse, respiration, blood pressure, and fluids. 

It’s not recommended to undergo this procedure without any numbing agent.

If you’re going to have general anesthesia, you may need to avoid eating or drinking the night before your surgery so you don’t vomit. You should brush and floss your teeth prior to your surgical appointment, so your mouth will be as clean as possible. Just don’t swallow any water or toothpaste.

Ask your dentist or surgeon when you can take any prescription medication you’re on and if you should avoid supplements or nonprescription drugs.

Plan to have someone drive you home after your procedure, since you will be groggy. 

RealSelf Tip: Prior to your oral surgery, make sure you have extra gauze on hand. Biting down on steeped tea bags can also be beneficial. They contain tannic acid, which helps constrict blood vessels and reduce bleeding.

Your recovery experience will depend on how your body heals, how many teeth you had removed, and whether they were severely impacted. 

“Patients will generally experience discomfort for 7 to 10 days post-surgery, with the third day being the worst,” explains Dr. Scott Young, a dentist based in The Woodlands, Texas. Bruising on the cheeks could take several days to disappear.

 Some medical professionals will prescribe narcotics for the pain, but many recommend taking nonaddictive alternatives, such as ibuprofen and acetaminophen, until your symptoms begin to resolve. They’ll also probably prescribe antibiotics to prevent bacterial infection. 

 Holding an ice pack against your jawbone can help bring down the swelling and numb pain. After 48 hours, switch from ice to a heat pack, to ease any discomfort.

“One day after wisdom teeth surgery, and I feel totally fine. I have a minor, slightly uncomfortable feeling, but nothing that ice cream and Netflix can’t fix.”—BasyaW, RealSelf member

Call your dentist or surgeon if you experience difficulty swallowing or breathing, excessive bleeding, fever, severe pain, a worsening of swelling, numbness, or oozing from tooth sockets at any time during your recovery. 

Plan on resting for the remainder of the day of your surgery. You may find it more comfortable to sleep on your back with your head elevated rather than putting pressure on your face by sleeping on your side. 

It’s okay to brush your teeth on the night of your surgery, but rinse very gently and avoid brushing the incisions. 

Starting the day after, you’ll begin doing a warm salt water rinse six times a day (especially after eating). Your doctor should provide a syringe to gently irrigate the surgical sites. A study on drinking tap water post-wisdom teeth removal (Clinical Oral Investigations; February 2016) says it’s the most effective way to reduce inflammatory complications (so make your salt water rinse with tap water).

The most common complication with wisdom teeth extraction is dry socket, which develops when the blood clot within the excision site is dislodged or dissolves, exposing bone and nerve endings. Symptoms include severe pain, visible bone, bad breath, swollen lymph nodes, and fever. Following your oral surgeon’s dental care instructions will preserve good oral health, keeping the area clean, the blood clot intact, and infection at bay. 

For at least 72 hours after your surgery, avoid: 

• smoking cigarettes or marijuana (it can impede healing, and the suction can lead to dry socket) 
• using a straw (which can also cause dry socket)
• vigorous activity and exercise
• blowing your nose (just dab it with a tissue) 

Typically, bruising takes up to 10 days to fade. It takes up to three weeks for swelling and pain to completely subside, and four to six weeks before your sockets entirely heal after wisdom teeth removal. 

If your stitches are dissolvable, they should be gone in a few weeks; if not, you may need an appointment with your dentist to remove them.

For the first 24 hours after surgery, stick to soft foods like ice cream, soup, yogurt, applesauce, and mashed potatoes.  

After that first day, you can start trying soft foods like noodles, pancakes, eggs, soft pasta—basically, anything you can cut easily with a fork. 

For the first week, avoid:

• Crunchy or too-chewy foods like popcorn, nuts, jerky, gum, or chips, which could open up your stitches.
• Grains (including rice and quinoa) or seeds, which can easily get trapped in the extraction site. 
• Alcohol or carbonated (soda) beverages.
• Other chewy foods with many layers, like pizza or sandwiches.
• Hot or spicy foods, which can be painful.

After seven days, you should be able to return to eating your favorite comfort foods like french fries, pizza, or salads.

A correctonomy can remove the crown of the tooth only, leaving the roots intact in your jawbone. This is especially helpful when the roots of a wisdom tooth are too close to the nerve, and there’s concern that surgical extraction could cause nerve damage and a temporary or permanent loss of feeling near the extracted area. Your dentist or oral surgeon can determine whether a correctonomy would be a good alternative for you.