Wisdom teeth removal surgery is a procedure to remove the third set of molars, which typically appear between ages 17 and 25. Most people have at least one impacted wisdom tooth, meaning it doesn’t have enough room to grow naturally. By getting your wisdom teeth removed—either because an impaction has been identified or the potential for them to cause issues—you can ensure they don’t damage the surrounding teeth and bones.

Wisdom teeth removal surgery is an outpatient procedure that is typically performed by a dentist or oral surgeon.

A dentist will recommend this surgery if an exam and X-rays reveal that your wisdom teeth are impacted or may cause dental problems for you in the future. (Not everyone has wisdom teeth, but most people have one to four.)

The surgeon will cut into the gums and remove the tooth, either as a whole tooth or in pieces. You’ll be under anesthesia, which could include nitrous oxide (laughing gas) or intravenous (IV) sedation. Your surgeon will decide which sedation to use based on your comfort level as well as the complexity and number of extractions required.

Wisdom tooth removal surgery before age 20 is typically easier than a procedure performed at a later age. While age doesn't preclude someone from getting their wisdom teeth removed, it can complicate matters.

Tooth roots aren’t fully formed in younger people, which makes them easier to remove and faster to heal. As you get older, roots become longer, curved, and more difficult to extract.

Complications of wisdom teeth removal surgery can include:

Your dentist will monitor the development of your wisdom teeth during routine appointments and with dental X-rays. They may discuss removing them if they’ve become impacted or if they have the potential to cause problems, such as the following:

Your dentist may suggest having wisdom teeth removal surgery even if you aren’t experiencing any current symptoms in order to stop potential problems before they start. Since wisdom teeth are in an area that’s challenging to clean, it can be hard to maintain good oral hygiene with them in place.

You may be referred to an oral surgeon to perform the procedure. The surgeon will schedule a consultation before the surgery to go over your dental records and take additional X-rays to confirm the scope of your surgical needs.

Call your dentist or surgeon if you’re experiencing a dental emergency, such as severe pain, fever, or loose teeth. Do not wait for your surgery date.

Ask your surgeon about any concerns you have before the procedure. They can tell you what to do in the days before surgery and how to plan for recovery time afterward. They can also talk to you about the type of anesthesia that will be used and how you’ll feel after the surgery.

The cost for wisdom teeth removal surgery will depend on the level of impaction and the number of teeth that are being removed. Check with your dentist, surgeon, and insurance provider on your benefits and what will be covered.

You can prepare for recovery by buying some soft or liquid-based foods that are easy to eat after surgery. These could include smoothies, applesauce, oatmeal, yogurt, and other foods that are easy to eat without chewing.

Wisdom teeth removal surgery is performed in a dentist’s or oral surgeon’s office.

Wear loose, comfortable clothes for the procedure. If you’re getting intravenous anesthesia, wear a shirt with short sleeves or one that’s easy to roll the sleeves up. You won’t need to change into anything for the surgery.

Follow your surgeon’s directions for eating and drinking before surgery. Instructions may vary depending on the sedation used.

If you are getting intravenous anesthesia, you won’t be able to eat or drink anything after midnight the night before the procedure so your stomach is empty.

The risk of bleeding problems can increase with medications such as aspirin, Coumadin (warfarin), and Advil (ibuprofen).

Let your healthcare provider and dentist know if you're taking these or any other medications before dental surgery. They will let you know if you can keep taking your current medications or if (and when) you should stop taking them in preparation for surgery.

To avoid complications, let your healthcare provider know about all of your medications, including prescription or over-the-counter drugs, vitamins, or other supplements.

Be sure to bring any necessary paperwork and your dental insurance card.

Your surgeon will probably advise you to make arrangements for someone to bring you home from the surgery, since you’ll be groggy after anesthesia. This person can wait for you in the waiting room, if desired.

Avoid tobacco and alcohol for at least eight hours before the surgery.

Arrive on time for your appointment at the oral surgeon’s office. Your healthcare provider may perform dental X-rays again on the day of surgery if necessary.

The surgery should take about 45 minutes. With anesthesia, you shouldn’t feel any pain or discomfort. Depending on what type of sedation is used, you may be asleep or conscious during the surgery.

These are the steps for a typical procedure:

After the procedure is complete, the nitrous oxide gas or IV drip is stopped and you'll be brought slowly out of sedation.

The dentist will provide gauze for you to bite down on to help blood clot in the area. Immediately after surgery, you may feel mild effects of the anesthesia, including nausea, dizziness, and shivering.

You'll be brought to a recovery room where you will be monitored. Once a specialist has determined that you are stable and breathing normally, you'll be cleared to go home. Usually you'll spend less than an hour in the recovery room.

After surgery, you will feel groggy and swollen. You may not feel much pain immediately, but it will probably increase as the local anesthetic wears off in the hours after surgery.

For the first 24 hours after the surgery:

Some pain, bleeding, and swelling in your mouth and cheeks are likely to persist for up to several days after the surgery. You may not be able to open your mouth all of the way during this time.

The extraction site can take up to six weeks to heal, but most people can resume normal activities the next day. That said, avoid strenuous activity for a week after the surgery to avoid breaking off the blood clot.

Avoid smoking during the healing process.

Your dentist or surgeon will give you extra gauze to use on the extraction site at home.

If you have bleeding after this gauze is removed, fold another piece of clean gauze into a pad. Dampen the pad with warm water and gently hold it between your teeth in the area of the extraction. Avoid chewing on the gauze. Keep it in place for about 30 minutes and replace it if it becomes soaked with blood.

Your dentist may also suggest moistening a tea bag and gently biting down on it for 30 minutes to control bleeding. Tea contains tannins, compounds that can constrict blood vessels to help stop bleeding.

In a 2014 study, researchers gave patients regular gauze or gauze moistened with green tea extract to use on their gums after tooth extraction. They found that the gauze with green tea extract was more effective at stopping bleeding than the regular gauze.

As you heal, be on the lookout for symptoms of dry socket, which include:

Contact your surgeon immediately if you have any symptoms of dry socket, heavy bleeding, or significant pain.

Over-the-counter pain medicine such as Tylenol (acetaminophen) and Advil (ibuprofen) are usually effective for pain after wisdom tooth extraction. You might also try putting a bag of ice or a cold damp washcloth on your face to help with swelling and pain.

In some cases, your surgeon may prescribe pain medicine, which can include opioids such as hydrocodone and oxycodone. These medications can be safe if used as directed for a short amount of time. It's important to follow your surgeon's instructions because misuse can lead to overdose, addiction, or death.

Your dentist will give you suggestions for what and when you can eat after surgery. The soft tissues in your mouth will likely be sensitive for several weeks. Usually you can start eating soft or liquid-based foods and slowly start adding more solid foods when you feel ready. Avoid foods that are spicy, acidic, chewy, or small and hard (e.g., nuts, seeds, and granola), which can irritate the site.

Your dentist may suggest gently rinsing your mouth with warm salt water (1/2 teaspoon of salt in 8 ounces of warm water) after meals, being careful not to dislodge any blood clots.

Wisdom tooth removal is a common dental procedure and complications are rare. For a successful recovery, it's important to closely follow the post-operative instructions you receive, particularly during the first seven to 10 days following your procedure. Take time to ask any questions you have so you fully understand how to care for yourself during this time.

Smoking can lead to a dry socket after the tooth is removed and an increased risk of bleeding. It is recommended to avoid smoking for as long as possible after the extraction.

It is important to avoid alcohol for at least 48 hours following surgery, especially when taking the prescription pain medication that is usually given after oral surgery.

Some stitches dissolve on their own after tooth extraction and others are removed between three and 14 days after surgery.

Pain medication or non-steroidal anti-inflammatory medication will help with discomfort. It is also recommended that you elevate your head above your heart for the first couple of nights to control bleeding.

At a minimum, you must wait at least 24 hours to allow the anesthesia to fully wear off before driving. If you are also taking prescription pain medication, you may need to continue avoiding driving.

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