Wisdom Teeth Removal

Overview

What is wisdom teeth removal?

Wisdom teeth removal is the extraction of your third molars — the four permanent adult teeth located in the very back of your mouth, in the upper and lower jaws. Wisdom teeth usually erupt between the ages of 17 and 21. Most people have all four of their wisdom teeth. It’s estimated that 5% to 37% of people only have some of their wisdom teeth — or in some cases, none at all.

Why do we have wisdom teeth?

Researchers believe that wisdom teeth were necessary for our ancestors, as their diet mostly consisted of hard nuts, crunchy leaves and uncooked meat. Today, however, we eat more cooked food and use forks and knives to cut our food up into smaller pieces. As a result, wisdom teeth are widely regarded as vestigial structures (parts of the human body that have become unnecessary).

How do I know if I need to get my wisdom teeth removed?

Sometimes all four wisdom teeth erupt normally and don’t cause any problems at all. But oftentimes wisdom teeth grow in at an angle or stay fully or partially trapped (impacted) in the jawbone or under the gum tissue. This can cause a range of problems. Your dentist may recommend wisdom teeth extraction if you:

  • Have dental pain near the back of your mouth.
  • Trap food and debris around your wisdom teeth.
  • Develop gum disease, particularly around your molars.
  • Have tooth decay (cavities) in a partially erupted wisdom tooth.
  • Develop a cyst (fluid-filled sac) around one or more wisdom teeth.
  • Have sustained damage to nearby teeth or surrounding bone.

In many cases, healthcare providers recommend wisdom teeth extraction as a preventative measure. As a result, your dentist may suggest removing your wisdom teeth even if you don’t have any symptoms. This can help reduce your risk for future problems, including infection and tooth decay.

At what age should I have my wisdom teeth extracted?

People of all ages can have their wisdom teeth removed. However, many dentists recommend having them extracted in your late teens or early 20s. During this stage of development, your wisdom teeth are still forming. For this reason, they may be easier to remove with less risk of complications.

Procedure Details

What happens before wisdom teeth extraction?

Your dentist will refer you to an oral surgeon for a consultation. During this visit, the surgeon will assess the health of your wisdom teeth and take dental X-rays to determine their exact location. They’ll also discuss sedation options with you. Wisdom teeth extraction is typically performed under local anesthesia, IV sedation or general anesthesia, depending on your specific needs.

Be sure to tell your surgeon about any medications, vitamins or supplements you’re currently taking. This is also a good time to ask any questions you have about the procedure.

What happens during wisdom teeth removal?

Once sedation medications have been given, your surgeon will administer local anesthesia to numb the teeth and gums. Impacted wisdom teeth (wisdom teeth trapped in the gums or bone) are exposed with incisions, giving your surgeon adequate access. Once the wisdom teeth are visible, your oral surgeon carefully loosens and lifts them from their sockets, cleans the areas and places stitches. In most cases, the stitches will fall out on their own in a few days.

How long does wisdom teeth removal take?

Typically, wisdom teeth extraction takes about one hour or less. More complex cases may take longer.

What happens after wisdom teeth removal?

After wisdom teeth removal, you can expect mild discomfort accompanied by slight bleeding and swelling. Your oral surgeon will give you instructions for wisdom teeth management to ease these side effects. Once your sedation wears off enough, a friend or family member will drive you home.

Care at Cleveland Clinic

Risks / Benefits

What are the advantages of wisdom teeth removal?

The most significant benefit of wisdom teeth extraction is that it reduces the risk for future oral health problems such as gum disease, tooth decay, damage to adjacent teeth, bone loss and jaw damage. If you’ve already developed pain because of your wisdom teeth, then extraction can alleviate discomfort almost immediately and get you back on track to optimal oral health.

What are the risks or complications of wisdom teeth extraction?

Most of the time, wisdom teeth removal doesn’t result in long-term complications. In rare instances, people may develop:

  • Infection.
  • Dry sockets (loss of blood clot resulting in exposed bone).
  • Damage to other oral structures, including the jawbone, nerves, sinuses or nearby teeth.

Recovery and Outlook

How long does it take to recover from wisdom tooth removal?

Most people are comfortable in three to four days, but it can take a couple of weeks for your gums to completely heal. Your oral surgeon will provide you with detailed post-surgical instructions to keep you comfortable.

Wisdom teeth removal aftercare

Here are some general guidelines to help foster a comfortable recovery 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.
  • Don’t swish vigorously, as this can dislodge blood clots and cause dry sockets.
  • Brush the rest of your teeth normally.
  • Take all medications, including antibiotics and pain relievers, as prescribed.

What to eat after wisdom teeth removal

Stock your kitchen with soft foods like pasta, rice, eggs, pudding and yogurt. Additionally, cool foods like ice cream can help soothe the surgical areas. Steer clear of hard, crunchy and spicy foods, as these things can irritate your tissues. Finally, avoid drinking through straws. The suction can dislodge blood clots, which are essential for healing.

When can I go back to work or school?

Most people can go back to work or school in two to three days after wisdom teeth extraction. However, if your job requires physical labor or heavy lifting, you may need to take a few extra days off of work.

When to Call the Doctor

When should I see my healthcare provider?

Most of the time, wisdom teeth extraction doesn’t cause major complications. However, you should call your oral surgeon if you have:

  • A fever of 100.4 degrees Fahrenheit or higher.
  • Infection (pus) coming out of one or more extraction site.
  • Heavy bleeding.
  • Pain that doesn’t improve with medication.
  • Swelling that worsens after three days.
  • Facial numbness.
  • Difficulty swallowing or breathing.
  • Blood or pus in nasal drainage.

A note from Cleveland Clinic

Wisdom teeth removal is a common oral surgery procedure that can reduce your risk for dental problems. The decision to remove your wisdom teeth is an important one, and the choice may not always be clear. Talk with your healthcare provider about whether wisdom tooth extraction is right for you.

Last reviewed by a Cleveland Clinic medical professional on 11/30/2021.

References

  • American Academy of Oral and Maxillofacial Surgeons. Wisdom Teeth Management. (https://www.aaoms.org/images/uploads/pdfs/Ebook_Wisdom_Teeth_R.pdf) Accessed 11/30/21.
  • Candotto V, Oberti L, Gabrione F, Scarano A, Rossi D, Romano M. Complication in third molar extractions. (https://pubmed.ncbi.nlm.nih.gov/31538464/) J Biol Regul Homeost Agents. 2019 May-Jun;33(3 Suppl. 1):169-172. Accessed 11/30/21.
  • Dodson TB, Susarla SM. Impacted wisdom teeth. (https://pubmed.ncbi.nlm.nih.gov/25170946/) BMJ Clin Evid. 2014 Aug 29;2014:1302. Accessed 11/30/21.
  • Ghaeminia H, Perry J, Nienhuijs ME, Toedtling V, Tummers M, Hoppenreijs TJ, Van der Sanden WJ, Mettes TG. Surgical removal versus retention for the management of asymptomatic disease-free impacted wisdom teeth. (https://pubmed.ncbi.nlm.nih.gov/27578151/) Cochrane Database Syst Rev. 2016 Aug 31. Cochrane Database Syst Rev. 2020 May 4;5:CD003879. Accessed 11/30/21.
  • Rakhshan V. Congenitally missing teeth (hypodontia): A review of the literature concerning the etiology, prevalence, risk factors, patterns and treatment. (https://pubmed.ncbi.nlm.nih.gov/25709668/) Dent Res J (Isfahan). 2015 Jan-Feb;12(1):1-13. Accessed 11/30/21.

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