Having Wisdom Teeth Out

Wisdom teeth are the last molars to arrive, usually in the late teens or early twenties, and they cause trouble when there is not enough room for them. Removal is common, but it is not automatic: plenty of wisdom teeth are left alone and monitored for years without incident.

If yours are coming out, the useful thing to know is what the week afterwards is really like. Here is who tends to need it, what happens at the appointment, and the signs that mean you should pick up the phone.

Not every wisdom tooth needs to go

A wisdom tooth that has come through straight, meets a tooth in the opposite jaw and can be cleaned is generally left alone. Removal is usually recommended when the tooth is repeatedly infected, when decay has reached it or the tooth in front, when it is pressing on the neighboring molar, or when a cyst has formed around it.

Partly erupted teeth cause the most problems because the gum flap over them traps bacteria, which produces the swollen, sore gum known as pericoronitis. If a dentist recommends removal, it is fair to ask what specifically is wrong with each tooth and what they expect to happen if it stays.

Simple, surgical and impacted are three different appointments

An upper wisdom tooth that has erupted often comes out in a few minutes with local anesthetic and a little pressure. A lower tooth still buried in bone is a different job: the gum is lifted, some bone is removed, the tooth is often sectioned into pieces to bring it out through a smaller opening, and the gum is stitched.

The scan tells the dentist which one you have and how close the tooth sits to the nerve in the lower jaw. That proximity is the main reason a general dentist refers some cases to an oral surgeon, and a referral is a sign of caution rather than a bad omen.

• Local anesthetic alone is enough for many extractions
• Nitrous oxide, oral sedation or IV sedation are options for anxiety or longer cases
• A single simple extraction may take ten minutes, a full impacted case up to an hour
• Stitches are often dissolvable and disappear within one to two weeks

The first three days are the ones you plan around

Expect swelling that peaks around day two, some bruising on the outside, jaw stiffness that makes opening wide awkward, and soreness that ordinary painkillers you would take for a headache will usually handle. Take it easy, sleep with your head raised and use an ice pack on and off for the first day.

Clear the schedule for two or three days if you can. Most people go back to work or school within a couple of days for simple extractions, and after three or four days for impacted lower teeth. Full comfort takes a week or two, and the gum takes several weeks to close over properly.

What you do at home decides how smoothly it goes

The blood clot in the socket is the dressing. Everything you are told to avoid in the first day or two is about not dislodging it: no rinsing hard, no straws, no smoking, no spitting, and no poking at the site. After the first day, gentle salt water rinses after meals help keep it clean.

Eat soft, cool food for a couple of days and keep drinking. Keep brushing your other teeth normally, staying gently away from the socket. If your dentist has given you specific instructions, they override anything general written here, because they know what was done.

• No smoking or vaping, which markedly raises the risk of dry socket
• No straws or forceful rinsing for the first twenty four hours
• Soft, cool food such as yogurt, eggs, soup that is not hot, and mashed potato
• Rest for the first day, and no hard exercise for a few days

Dry socket announces itself around day three

Dry socket happens when the clot is lost early and the bone is left exposed. The signature is pain that was settling and then gets distinctly worse around the third to fifth day, often a deep ache spreading toward the ear, with a bad taste or smell. Painkillers help less than you expect.

It is not an infection and it is not dangerous, but it is genuinely painful and it does not resolve quickly on its own. The treatment is simple: the office cleans the socket and places a medicated dressing, often with noticeable relief within an hour. Call rather than waiting it out, because there is no prize for enduring it.

When to call, and when to go to an emergency room

Call the office for bleeding that has not settled after firm pressure on gauze for an hour, pain that climbs after day three, a fever, numbness of the lip or tongue that persists beyond the day of surgery, or swelling that is still growing after day three rather than shrinking. These are all things that get handled better early.

Some symptoms mean an emergency room rather than a dental appointment: swelling spreading toward your eye or down your neck, trouble breathing or swallowing, inability to open your mouth more than a little, or a fever alongside facial swelling. Go now, and do not wait for morning. If you do not have a dentist for follow up care, the directory searches every dental practice in the United States by town or ZIP code and shows the closest first, free and with no account.

Frequently asked

This is general information to help you ask better questions, not a diagnosis. Anything happening in your own mouth needs a dentist who can look at it.