Wisdom teeth are the last to erupt and typically do so between ages 17 and 25. But according to the American Dental Association, they may grow sideways, emerge only partially or remain completely trapped under gum and bone, which either produces no symptoms or causes these problems:
- Swollen, red, tender or bleeding gums.
- Swelling around the jaw.
- Bad breath.
- An unpleasant taste in the mouth near the affected area.
- Headache or jaw ache.
- Occasional difficulty opening the mouth.
- Occasional swollen lymph nodes in the neck.
What you can expect
During the procedure
Your doctor or oral surgeon may use one of three types of anesthesia. The appropriate anesthesia for you depends on the expected complexity of the wisdom tooth extraction and your own comfort level. Your options include:
- Local anesthesia. Your doctor or oral surgeon administers local anesthesia with one or more injections near the site of each extraction. Before you receive an injection, your dentist or surgeon will likely apply a substance to the gums that numbs the site. You’re awake during the tooth extraction. Although you’ll feel some pressure and movement, you shouldn’t experience pain.
- Sedation anesthesia. Your doctor or oral surgeon gives you sedation anesthesia through an intravenous line in your arm. Sedation anesthesia suppresses your consciousness during the procedure and you don’t feel any pain. You will also receive local anesthesia to numb your gums.
- General anesthesia. In special situations, you may be offered general anesthesia. For general anesthesia, you inhale medication through your nose. This type of anesthesia makes you lose consciousness, and you don’t feel any pain during the procedure. Your surgical team closely monitors your medication, breathing, temperature, fluids and blood pressure during general anesthesia.
During wisdom tooth extraction, your dentist or oral surgeon:
- Makes an incision in the gum, creating flaps to expose the tooth and bone
- Removes any bone that blocks access to the tooth
- Divides the tooth into sections if it’s easier to remove in pieces
- Removes the tooth
- Cleans the site of the removed tooth of any debris from the tooth or bone
- Stitches the wound closed to promote healing, though this isn’t always necessary
- Places gauze over the extraction site to control bleeding and to help a blood clot form
After the procedure
If you receive sedation anesthesia or general anesthesia, you’re taken to a recovery room after the procedure. If you have local anesthesia, your brief recovery time is likely in the dental chair.
As you heal from your surgery, follow your doctor’s instructions on:
- Activity. After your surgery, plan to rest for the remainder of the day. Resume normal activities the next day, but for at least a week, avoid strenuous activity that might result in dislodging the blood clot from the socket.
- Beverages. Drink lots of water after the surgery. Don’t drink alcoholic, caffeinated, carbonated or hot beverages in the first 24 hours. Don’t drink with a straw for at least a week because the sucking action can dislodge the blood clot from the socket.
- Food. Eat only soft foods, such as yogurt or applesauce, for the first 24 hours. Start eating semisoft foods when you can tolerate them. Avoid hard, chewy, hot or spicy foods that might get stuck in the socket or irritate the wound.
- Pain management. You may be able to manage pain with a prescription pain medication — given by your doctor or oral surgeon — or an over-the-counter pain reliever, such as acetaminophen (Tylenol, others). Holding a cold pack against your jaw also may relieve pain.
- Bleeding. Some oozing of blood may occur the first day after wisdom tooth removal. Try to avoid excessive spitting so that you don’t dislodge the blood clot from the socket. Replace gauze over the extraction site as directed by your dentist or oral surgeon.
- Swelling and bruising. Swelling and bruising of your cheeks usually improves in two or three days. Use an ice pack as directed by your dentist or surgeon.
- Cleaning your mouth. Don’t brush your teeth, rinse your mouth, spit or use a mouthwash during the first 24 hours after the surgery. After that time, gently rinse your mouth with warm salt water every two hours and after meals for a week after your surgery. Mix 1/2 teaspoon (2.5 milliliters) of table salt in 8 ounces (237 milliliters) of water. After the first 24 hours, resume brushing your teeth, being particularly gentle near the surgical wound to avoid disrupting any stitches.
- Tobacco use. If you smoke, don’t do so for at least 24 hours after surgery — and wait longer than that if possible. If you chew tobacco, don’t use it for at least a week. Using tobacco products after oral surgery can delay healing and increase the risk of complications.
- Stitches. You may have stitches that dissolve within a few weeks or no stitches at all. If your stitches need to be removed, schedule an appointment to have them taken out.
When to call your dentist or surgeon
Call your dentist or oral surgeon if you experience any of the following signs or symptoms, which could indicate an infection, nerve damage or other serious complication:
- Swelling that worsens after two or three days
- Severe pain not relieved by prescribed pain medications
- A bad taste in your mouth not removed with saltwater rinsing
- Pus in or oozing from the socket
- Blood in nasal discharge
- Persistent numbness or loss of feeling
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