Medically Reviewed by Evan Frisbee, DMD on October 31, 2021 Your dentist says it’s time to remove your wisdom teeth. They may refer
you to an oral surgeon, who will do the procedure in their office. It should only take a few days for you to heal and feel back to normal. Wisdom teeth are a third set of molars in the back of your mouth. They usually come in between the ages of 17 and 25, and they're spotted on X-rays. Most
people have them removed for one of these reasons: You’ll meet with the
oral surgeon to talk about the process. At this appointment, make sure you: Your surgery should take 45 minutes or less. You’ll get one of these types of anesthesia so you don’t feel pain during the removal: Your doctor may have to cut your gums or bone to get the teeth out. If so, they'll stitch the wounds shut so they heal quickly. These stitches usually dissolve after a few days. They
may also stuff gauze pads in your mouth to soak up some of the blood.Why Take Them Out?
Before Surgery
During Surgery
After Surgery
Everyone responds differently to anesthesia. If you had a local anesthetic and feel alert, you might be able to drive home to begin your recovery. You might even be able to go back to work or do your normal activities. If you had general anesthesia or still feel drowsy, you’ll need someone to drive you home.
Most people have little to no pain after surgery. You'll likely have swelling and mild discomfort for 3 or so days. Your mouth may need a few weeks to completely heal.
Follow your doctor’s instructions for a quicker recovery. Here are some tips for the first 3 days after surgery:
Dos:
- Use an ice pack on your face to curb swelling or skin color changes.
- Use moist heat for a sore jaw.
- Gently open and close your mouth to exercise your jaw.
- Eat soft foods like pasta, rice, or soup.
- Drink plenty of fluids.
- Brush your teeth starting the second day. Don’t brush against any blood clots.
- Take the drugs your doctor prescribes to ease pain or swelling.
- Call your doctor if you have a fever, or if your pain or swelling doesn’t improve.
Don’ts:
- Don’t drink through a straw. Sucking may loosen blood clots that help your mouth heal.
- Don’t rinse your mouth too harshly. Your doctor may suggest rinsing gently with saltwater.
- Don’t eat hard, crunchy, or sticky foods that may scratch your wounds.
- Don’t smoke. Smoking can slow your healing.
Get Well Soon
Helping you make a speedy recovery after removal of wisdom teeth
What to expect after the operation
Recovery after wisdom-tooth surgery is generally quite straightforward, but you are likely to experience pain and swelling, particularly in the first 2 days. Rarely, complications can occur, such as poor healing of the tooth socket or nerve injury. If you have had adult intravenous sedation or a general anaesthetic, you will require someone to escort you to and from surgery, and it is important to take it easy for a day or two after the operation.
Pain
You are likely to experience pain for the first 48 hours, although your mouth may well be sore for up to a week or so after the operation. Local anaesthetic injections given during the procedure ensure that you have no pain for the first 3–4 hours after surgery, but once the anaesthetic wears off, you need to take the painkillers given to you. You should take these regularly to ensure that you sleep well on the first night; this will maximise your recovery. You will normally be prescribed paracetamol and ibuprofen. When these two drugs are taken together, they enhance the effect of each other because they work in different ways. Be sure to follow the directions given to you by your surgeon or the pharmacist. Some patients may not be able to take these medications due to medical problems, but in these cases, alternatives will be provided.
The area around the extraction sites will be sore and you may find it difficult to clean your teeth. Follow the instructions for good oral hygiene as this is very important to minimise the risk of infection. Antibiotics will only be prescribed if there is active ongoing infection.
Swelling
Swelling, particularly in the cheek area and both inside and outside the mouth, is common. Again, it is worse for the first 2 days, after which it will gradually subside. It can be relieved by using ice packs, starting shortly after surgery. Bruising to the skin of the face may also occur.
Jaw stiffness
You may have difficulty opening your mouth and experience pain or stiffness of the jaw joint. This will normally disappear after a couple of days, but can occasionally last for up to 2 weeks. You may need to eat a soft diet for a week or so.
Be careful not to force your jaw open before it is ready and do allow time for the swelling to go down. Ibuprofen will help to relieve this pain.
Teeth sensitivity
Sensitivity of the teeth next to the wisdom-tooth socket is common; good oral hygiene will resolve this, although it may last for several weeks.
Bad breath
You may experience bad breath; this is unlikely to last more than a week.
Stitches
Stitches will dissolve by themselves and do not need removing, but it is important that 3–4 days after surgery you start brushing the sutures away to minimise food trapping.
When the tooth is removed the roots leave a ‘socket’ in the bone. This hole in the gum may last for up to 3 months. As your wound heals, blood clots form over the empty tooth sockets; it is important not to dislodge these.
Bleeding
If later bleeding occurs from the extraction site, you will need to bite on a cotton gauze or handkerchief for 3–5 minutes to stop it. Avoid drinking or eating food that is hot or very cold as this may restart
bleeding.
Follow-up appointments are not usually booked after wisdom-tooth surgery. However, if you have complications or your bleeding does not stop, you should contact your surgeon.
Tiredness
Your body is using energy to heal itself, so you may feel more tired than usual – this is perfectly normal.
Exercise and sport
It is important to avoid strenuous activity and exercise for the first few days. While you’re building up your activities, you probably won’t feel like doing much, but walking is the best way to return to fitness. If you play rugby or do martial arts, you should discuss returning to these activities with your surgeon before the operation.
Complications
Dry socket happens in 5–10% of patients; it presents as intense and persistent pain occurring 3–5 days after the initial pain has subsided. If this occurs, it is important that you contact your surgeon as soon as possible, who will wash out the socket and remove the trapped debris that is causing the pain.
Nerve injury is far less common and is normally caused by bruising of the nerve(s) that lie very close to the roots of the lower wisdom teeth. Rarely, it can be caused by the injections given during surgery. Nerve injury occurs in up to 2% of patients and is generally temporary, but it can be permanent in 0.5% (1 in 200) of patients.
Nerve injury can cause pain, tingling, altered sensation (pins and needles) or numbness, and may occur to the inferior alveolar nerve (the sensory nerve supplying your lower lip, inside and outside, and your lower gums and teeth) or lingual nerve (the nerve that supplies feeling to one or other side of your tongue and adjacent gums).
If your lower wisdom tooth is positioned close to the ‘lip’ nerve, you will be advised that the likelihood of nerve injury is more common (20% of patients are likely to experience temporary injury and 2% permanent injury). If this is the case, you may need an additional special X-ray investigation (cone beam CT scan) and be offered a different surgical approach to minimise the injury (coronectomy).
Damage to adjacent teeth may also occur if they are heavily restored.
It is very important that you maintain good oral hygiene and brush your teeth as usual as best you can, gradually brushing nearer to the wound day by day, eventually brushing away the stitches after several days. You may be recommended to use an antimicrobial mouthwash and often you will be prescribed salt-water rinses to help with wound healing. Do this gently on the first postoperative day to avoid dislodging the clots that will have formed over the wounds.