Wisdom Tooth Extraction

Wisdom tooth extraction, also called removal, is a surgical procedure to take out one or more wisdom teeth. These are the four permanent adult teeth located at the back corners of your mouth on the top and bottom.
If a wisdom tooth, also known as a third molar, doesn’t have room to grow, it can become impacted. If an impacted wisdom tooth causes pain, infection or other dental problems, you’ll likely need to have a dentist or an oral surgeon remove it. Some dentists and oral surgeons recommend removing your wisdom teeth, even if they aren’t causing problems. That’s because these teeth can lead to problems later in life.

Why it’s done

Impacted wisdom teethEnlarge image Wisdom teeth are the last permanent teeth to appear or erupt in the mouth. These teeth usually come through the gums between the ages of 17 and 25. They may come through partially or not at all. Some people’s wisdom teeth never come through. For others, wisdom teeth appear just as their other molars did, causing no problems.
Many people have impacted wisdom teeth. These teeth don’t have enough room to appear in the mouth as usual.
An impacted wisdom tooth may:

  • Grow at an angle toward the next tooth, the 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 removed if it causes problems such as:

  • Pain.
  • Trapping food and debris behind the wisdom tooth.
  • Infection or gum disease, also known as periodontal disease.
    Tooth decay in a wisdom
  • tooth that partially comes through the gums.
  • Damage to a nearby tooth or surrounding bone.
  • Development of a fluid-filled sac around the wisdom tooth. This sac also is known as a cyst.
  • Complications with braces to straighten other teeth.

How you prepare

Your dentist may do the procedure in the office. But if your tooth is deeply impacted or if removing it is tougher than usual, your dentist may suggest that you see
an oral surgeon. In addition to numbing the area of your impacted tooth, your surgeon may suggest medicines to help you feel calm or less anxious during the procedure. Or your surgeon will provide you with sedation medicines. These medicines help you sleep through the procedure. They are different from medicines used for general anesthesia, where you are asleep and need to be put on a ventilator to breathe for you. Most wisdom tooth removal procedures occur with
sedation where you feel sleepy, but you breathe on your own.

After the procedure

If you get sedation anesthesia or general anesthesia, you’re taken to a recovery room after the procedure. If you have local anesthesia, you’ll likely recover in the dental chair. As you heal from your surgery, follow your dentist’s instructions on:

  • Bleeding. Some blood may ooze the first day after a wisdom tooth is removed. Try not to spit too much so that you don’t remove the blood clot from the socket. Replace gauze over the surgical site as directed by your dentist or oral surgeon.
  • Pain management. You may be able to manage pain with a pain reliever available without a prescription, such as ibuprofen (Advil, Motrin IB, others) or acetaminophen (Tylenol, others), or a mix of both. Or you may take a medicine that your dentist or oral surgeon prescribes. Prescription pain medicine may help if bone was removed during the procedure. Holding an ice pack against your jaw also may ease pain.
  • Swelling and bruising. Use an ice pack as directed by your dentist or surgeon. Any swelling of your cheeks usually gets better in two or three days. Bruising may take several more days to get better.
  • Activity. After your surgery, plan to relax for the rest of the day. Go back to your usual activities the next day. But for at least a week, don’t take part in activities that require a lot of energy that might remove the blood clot from the socket.
  • Beverages. Drink a lot 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 pull the blood clot from the socket.
  • Food. Eat only soft foods, such as yogurt or applesauce, for the first 24 hours. Start eating foods that are somewhat soft when you can tolerate them. Do not eat 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. Usually, you’ll be told to go back to brushing your teeth after the first 24 hours. Be gentle near the surgical wound when brushing. Gently rinse your mouth with warm saltwater 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. Wait longer 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 raise the risk of complications.
  • Stitches. You may have stitches that dissolve within a few weeks. Or you may not have any stitches. If your stitches need to be removed, schedule an appointment to have them taken out.