Wisdom Tooth Extraction


Megan Freedman

What is a wisdom tooth extraction?

Wisdom tooth extraction is a procedure to remove a wisdom tooth. Wisdom teeth are the four molars at the back corners of your jaw. They are the last teeth to grow in, usually in young adulthood. Wisdom teeth are often removed because they frequently cause problems, including infection, gum disease, and damage to other teeth. 

Some people do not have wisdom teeth. Other people may have fewer than four of them. Wisdom teeth typically grow in between 16 and 25 years of age. 

Wisdom tooth extraction is generally considered safe, but there are risks and potential complications. Oral surgeons and dentists frequently recommend wisdom tooth extraction before problems begin, but not everyone needs to have their wisdom teeth removed. Ask your provider if keeping your wisdom teeth is an option for you. 

Why are wisdom teeth extracted? 

A dentist, orthodontist, or oral and maxillofacial surgeon may recommend wisdom tooth extraction to treat a current problem with a wisdom tooth or to prevent problems from happening in the future. Problems caused by wisdom teeth include:

  • Decay or infection occurs often in wisdom teeth because they are in the back of your mouth. This makes them harder to clean. Gum disease can also occur in the gums around the wisdom tooth. Gum disease causes gums to become red, swollen, and painful. An infection can also form small tumors or cysts (fluid-filled sacs) around the wisdom tooth.

  • Impaction occurs when wisdom teeth do not fully emerge above the gums. You may not see impacted wisdom teeth at all, or you may see part of them. Impacted wisdom teeth can grow into and damage other teeth’s roots, and they can become infected.

  • Overcrowding occurs when there is not enough space for all your teeth.

Who performs a wisdom tooth extraction?

The following providers perform wisdom tooth extraction:

  • General dentists prevent, diagnose, and treat diseases and conditions of the teeth, gums, mouth, and associated structures of the jaw and face.

  • Oral and maxillofacial surgeons perform surgery on the teeth, jaw, gums and face.

  • Pediatric dentists specialize in caring for the dental needs of children and teens.

  • Periodontists specialize in treating gum disease (periodontitis) including procedures that regenerate bone and gum tissue lost due to gum disease.

How is a wisdom tooth extracted?

An oral and maxillofacial surgeon, or sometimes a dentist, will perform your wisdom tooth extraction in a medical or dental clinic or office. 

Types of anesthesia that may be used

Wisdom tooth extractions may be performed using one or more different types of anesthesia. Your provider will decide what type of anesthesia is best for you.

  • General anesthesia is generally a combination of intravenous (IV) medications and gases that are used to put you in a deep sleep. You are unaware of the procedure and will not feel any pain. Your vital signs will be monitored during general anesthesia.

  • Intravenous (IV) sedation is a type of conscious sedation or twilight sedation. With IV sedation, your care team gives you sedation medication intravenously (through an IV). You will be very relaxed and unaware of the procedure and unable to remember it. Your vital signs will be monitored during IV sedation.

  • Local anesthesia is the injection of anesthetics into the gums near your tooth. This temporarily eliminates pain in your mouth while the procedure is performed. Your provider may apply a painless topical anesthetic to numb the gums partially before the injection. With local anesthesia, you may be awake during the procedure, or you may not. This will depend on which other types of anesthesia your care team uses to help you feel most comfortable.

What to expect during your wisdom tooth extraction

Wisdom tooth extraction generally includes these steps:

  1. You will sit in a reclining position in a chair and wear a clear shield over your eyes. The shield protects your eyes from spraying liquids and dental instruments.

  2. Your provider will give you one or more types of anesthetic to keep you comfortable during the procedure.

  3. Your provider will make a small cut in your gums if your wisdom tooth is not visible above the gums. This gives your provider access to the tooth.

  4. Your provider will loosen and pull out the tooth with forceps. If necessary, your provider will break up the tooth and pull out the pieces of the tooth with forceps.

  5. Your provider will clean the empty space left by the extracted tooth (socket) and stitch up the gums as needed.

  6. Your provider will pack the area with gauze. You may bite on gauze to help stop the bleeding.

Will I feel pain?

Your comfort and relaxation is important to you and your care team. You may feel brief sharp pinches when your surgeon or dentist injects your gums with local anesthetic. Ask if your gums can be partially numbed with a painless topical anesthetic before the injections. 

You may also feel pressure if you are awake during your procedure. Take a few long, deep breaths to help yourself relax. Tell your provider if any discomfort does not pass quickly.

What are the risks and potential complications of wisdom tooth extraction?  

Any dental procedure involves risks and the potential complications that may become serious. Complications can develop during the procedure or your recovery. 

Risks and potential complications of a wisdom tooth extraction include:

  • Allergic reaction to the anesthetic

  • Damage to the nerves in your lower jaw

  • Damage to the teeth near the extraction site

  • Dry socket, which occurs when the bone under the tooth socket is exposed because a blood clot does not form to seal the socket

  • Infection at the extraction site

  • Injury to the mouth

  • Jaw fracture, due to pressure used to extract tooth

  • Sinus injury. The upper wisdom teeth lie just below the sinus cavity.

  • Trismus, which is difficulty opening your mouth

Reducing your risk of complications

You can reduce the risk of certain complications by:

  • Following activity, dietary and lifestyle restrictions and recommendations before your wisdom tooth extraction and during recovery

  • Informing your provider if you are nursing or if there is any possibility of pregnancy

  • Notifying your provider immediately of any concerns after the extraction such as pain, fever, and difficulty chewing

  • Taking your medications exactly as directed

  • Telling all members of your care team if you have any allergies

How do I prepare for my wisdom tooth extraction? 

You are an important member of your own dental care team. The steps you take before your procedure can improve your comfort and outcome. 

You can prepare for a tooth extraction by:

  • Answering all questions about your medical history and medications. This includes prescriptions, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, medications and allergies at all times.

  • Taking or stopping medications exactly as directed. This may include taking