Wisdom teeth begin to affect teenagers as early as 16, although many adults don’t experience complications until their early twenties. In many cases, it becomes necessary to remove wisdom teeth. For those who are having the procedure done, it is understandable to have some anxiety and concerns before surgery. Overall, serious risks of wisdom tooth extraction are extremely rare. Most common discomfort will cease within the first week of healing. 

What Happens When Wisdom Teeth Are Removed?

Not all wisdom teeth need to be pulled, but there are many instances when the dentist will recommend extraction. The procedure itself is a minor surgery. Usually, only a local anesthetic is required, although patients often choose sedation or general anesthesia. 

If a tooth does not have enough room to emerge from the gum, it may become impacted. This makes the removal procedure slightly more complicated. The surgeon first cuts into the gum tissue. In some cases, bone can also partially cover the tooth. Using a drill, the surgeon will remove a small portion of the bone in order to expose the tooth and pull it out.  

It is common for at least one tooth to become impacted in adults. With routine visits, dentists can often anticipate if a tooth will become impacted and will recommend removal. During this procedure, patients are put under anesthesia to ensure their comfort. 

After the wisdom teeth are extracted, the dentist may use dissolvable stitches at the extraction site. If the dentist or oral surgeon uses traditional stitches, the patient will need to return later to have them removed.

Dentist or Oral Surgeon: Who Removes Wisdom Teeth?

Dentists will generally refer patients to an oral surgeon for wisdom teeth extraction. That being said, either a dentist or oral surgeon can perform the surgery. 

Common Issues after Wisdom Tooth Extraction

Patients can expect some discomfort and sensitivity after having wisdom teeth removed. It takes at least 3-5 days for people to recover completely from wisdom tooth extraction. During this time, the following are relatively normal issues that will go away with healing. If any of these issues persist beyond a reasonable amount of time, call your dentist or oral surgeon.

Pain and swelling in gums and at extraction points. The tooth removal process is traumatic on the gums and tissue of the mouth. During the healing process, over-the-counter acetaminophen or ibuprofen can help reduce the aching and swelling. 

Difficulty opening jaw or pain from opening jaw. This is a common occurrence about 2-3 days after surgery. Generally, this will lessen within a week. 

Light to moderate bleeding for 24 hours. The dentist or oral surgeon who performs the extraction will provide instructions on how to care for the extraction site. It is important that patient’s follow this advice in order to allow blood to properly clot around the socket.

Patients will also need to arrange for someone else to drive them home. They will be numb and, if sedated, the fogginess of anesthesia will take a while to wear off. This will subside within three to five hours after surgery. 

Tips for Recovering from Wisdom Tooth Removal

Aside from choosing a trust-worthy dentist, the best way to avoid complications from wisdom teeth removal is to take proper care of dental hygiene after removal. A vital aspect of this is following the instructions provided by the dentist or oral surgeon after the procedure. 

The First 24 Hours After Surgery

Keep your head elevated. During this time, it’s important to prop your neck and head up with pillows. This is important to helping the bleeding stop. 

Continuously change your gauze. It’s wise to buy extra gauze before your procedure. Afterward, you will want to keep the gauze relatively clean. That means changing them each time they become soaked with blood. If bleeding has not stopped after 24 hours, contact your dentist or oral surgeon.

Use an ice pack on the outside of your mouth. This will help reduce the swelling as it occurs. 

Do not smoke. While this one isn’t easy for smokers, it is the single greatest thing a person can do to prevent dry socket. Do not smoke within the first 24 hours of having oral surgery. 

Avoid physical activity. Take time to relax after surgery. Exercise may increase bleeding.

The Next 2-3 Days of Recovery

Do not use a straw. This is a quick way to disrupt the healing process.

Gently rinse with warm salt water twice a day. This will help relieve pain and reduce swelling.

Eat soft foods. Slowly add more solid foods as you heal.

Carefully brush teeth and tongue. It’s important to continue regular dental hygiene practices, but be mindful of healing tissue.

Risks of Wisdom Tooth Extraction

In most cases, patients will heal within the week. Major complications from wisdom teeth removal are extremely rare. In general, the risks are mild. However, it’s always good to be aware of the possibilities so a patient knows when to call their dentist or oral surgeon.

Dry Socket (Alveolar Osteitis)

Dry socket is an uncommon complication of wisdom teeth removal. It occurs when blood does not properly clot around the socket. This leaves the nerves and bone exposed to air and food, which causes painful inflammation. 

If dry socket occurs, it will extend healing time up to two weeks and require medicated dressings to help the socket heal. This complication is more likely to occur in people over 25, as well as those who smoke or have poor dental hygiene habits.

Trismus 

Tightness and pain when opening the jaw is common immediately after wisdom teeth removal. However, it should go away as the extraction site heals. Trismus, also called lockjaw, occurs when the jaw muscles spasm. Though painful, it should subside in under two weeks.

Opening to the Maxillary Sinus 

This is only a risk when upper wisdom teeth are removed, and is very unlikely. It is possible that upon removal of the tooth, the sinus cavity is exposed. If the hole does not heal, the patient may need to return to have it closed. 

Post Operative Infections

If bacteria in the mouth is able to enter the bloodstream during surgery, it may cause an infection. Dentists and oral surgeons take precautions to prevent this from happening during surgery. Those who have trouble fighting infection may need to take antibiotics before or after oral surgery. Infections will cause a fever, pain, swelling, and redness and can occur within the first month after surgery. Call their dentist or oral surgeon immediately if any of these symptoms appear.

Nerve Damage

Numbness in the lip, tongue, or cheek sometimes lasts longer than expected after extraction. This could mean slight nerve damage and should resolve itself within 4-8 weeks. Permanent nerve injury is not common. Although in rare cases, the numbness may persist for more than a year.

Fractured Jaw

This is an exceptionally rare and severe complication that will require additional surgery. 

Adverse Reactions to Anesthesia

Only occurring in every 1 of 10,000 cases, serious and adverse reactions to anesthesia do occur, although they are extremely rare. Those concerned about having an anesthesia allergy should talk to their dentist or oral surgeon prior to removal.

When to Call Your Dentist

If any of the above complications occur beyond the normal healing time, speak with your dentist or oral surgeon. However, if any of the following symptoms occur—even during the healing process—contact your dentist or oral surgeon as soon as possible. These may indicate complications or infection and should be considered an emergency. 

• Fever
• Excessive bleeding
• Difficulty swallowing or breathing
• Swelling worsens after two or three days
• Bad taste in the mouth that salt water rinsing doesn’t remove
• Oozing of pus from the socket
• Severe pain not relieved by prescribed pain medications
• Blood or pus in nasal discharge

Wisdom Tooth Removal is Safe and Routine

Wisdom tooth removal is incredibly common and routine. It is, however, often the first oral surgery a person ever has, which can cause considerable anxiety.  While there are risks inherent to any surgery, serious complications are rare. 

The best way to minimize risks associated with extraction is to follow after-care instructions from the dentist or oral surgeon. This will often include not smoking for 24 hours, applying ice to the outside of the mouth and jaw, rinsing with warm salt water, and continuing gentle dental hygiene practices. If you do experience any complications outside of the norm, it is important to contact your dentist or oral surgeon as soon as possible. 

If you think it may be time to have your wisdom teeth removed and do not have a regular dentist, use our online search tool. We can help you find a qualified dental professional in your area.