Wisdom Teeth Removal: Your Complete Guide

Wisdom teeth removal is a common dental procedure for many young adults and teens and is one of the most common surgeries that people undergo. The pain associated with developing wisdom teeth is one that many people experience. Sometimes this pain goes away as the teeth erupt, but other times the condition results in the need to have a wisdom teeth extraction procedure. Each year, about 5 million people have their wisdom teeth removed in the United States alone.

Why do Wisdom Teeth Need to be Removed?

Sometimes wisdom teeth may appear completely healthy without any form of decay, yet cause many problems due to their positioning and how they related to the adjacent teeth. If a wisdom tooth is impacted against the next molar, it can cause decay or trauma to the adjacent tooth. Their positioning often makes them difficult to keep clean, leading to dental decay even in patients that have very good oral hygiene. If the tooth is only partially erupted, food and bacteria may become impacted under the gums, causing infections, abscesses, bone loss and gum disease. Wisdom tooth extraction rids the body of the decay and makes these areas easier to keep healthy and clean, preventing the spread of dental disease to other teeth.

The American Dental Association recommends wisdom teeth removal when the following conditions exist:

  • Pain
  • Infections
  • Tumors
  • Damage to adjacent teeth
  • Gum disease
  • Tooth decay

Most people will become aware of issues regarding their wisdom teeth due to discomfort, pain or swelling in the back of the mouth. A visit with their dentist will typically include an x-ray of the entire jaw so that the development of the wisdom teeth can be observed, as well as any pathology around the area.

Wisdom tooth extraction is one of the most common dental surgical procedures that is performed.  Your dentist will only recommend this procedure if other alternatives to maintaining oral health and comfort do not exist.

 

Wisdom Teeth Removal Procedure

Dentists choose to perform extractions as last resort, when dental disease just can’t be avoided or corrected. Depending on how the tooth is in the mouth it may require surgical extraction instead of a simple extraction. A surgical extraction is usually performed by an oral surgeon and may include complete sedation so that the patient is completely unaware of the procedure and enjoys the most comfort as possible. Sedation is usually done using IV drugs or an orally administered prescription sedatives. The entire procedure may only last 30 minutes to an hour based on the current condition of the teeth.

What to Expect

Part of preparing for a wisdom teeth removal procedure is knowing what to expect. On the day of your appointment your dentist will most likely ask that you not eat anything, or have a very light breakfast. You will need to have someone escort you to the office and drive you home, and you will need to take a day or two off of work depending on how involved your extraction will be.

Types of Extractions

Simple

A simple extraction is done on teeth that are fully erupted into the mouth. Usually only local anesthetic is used to numb the area around the tooth. Nitrous oxide may be used as well to help the patient relax and alleviate any anxiety that they are experiencing. During a simple extraction the tooth is taken out as a whole piece.

Surgical

Surgical extractions are for removing teeth that are only partially erupted, unerupted or have become impacted. There is usually an incision in the gum area to retract the surrounding tissues so that the tooth can be exposed. The tooth is usually sectioned into multiple pieces so that it can easily be removed. Most of the time surgical extractions use general anesthesia so the patient is unaware of the procedure as it is being performed.

Types of Anesthetic, Sedation and Analgesia

Local Anesthetic

Local anesthetic is the injection that dentists use to numb an area of the mouth during a wisdom teeth removal procedure. This type of anesthetic usually wears off after about 3 or 4 hours, providing more than enough time for the procedure to be completed. There will typically be some soreness at the sight of injection.

Nitrous Oxide (Laughing Gas)

Nitrous oxide is one of the most commonly used analgesics in dentistry. It is very easy to administer and helps alleviate patient’s anxiety, nervousness and perception to pain during a wisdom teeth removal procedure. The patient usually has a very warm feeling and their fingers slightly tingle. In some cases nitrous oxide may be contraindicated, such as for patients that have sinus problems and are not able to breath well through their nose. Nitrous oxide wears off very quickly and usually leaves the person’s system within about 5 minutes.

Oral Sedation

Your dentist may offer oral sedation for your wisdom teeth removal procedure appointment. Usually these medications are taken exactly one hour prior to the appointment, and the patient is driven to the office and then back home by a friend. In some cases a 2nd pill or dose may be needed at the time of the appointment. Patients act very sleeping and respond when asked a question, but they are not alert and will usually not remember the procedure. It will take a few hours for the drug to quit working

IV Sedation

IV sedation is very common in oral surgery offices and is typically a part of all wisdom teeth removal procedures that require surgical extractions in a specialist’s office. IV sedation is administered through a line in the arm and sets in very rapidly. The sedative flows through the system until the extraction is completed, when the medication is then turned off after the wisdom teeth removal procedure and the patient comes back into consciousness, fully alert. The patient will most likely still feel groggy and will need to be driven home by a family member or friend.

Possible Complications

Every surgery or dental procedure has some risks associated with it. While these are not typically normal, they may occur on some occasions. Complications can range from nerve damage due to the relationship of the tooth roots to the nerve, or even fracture of the jaw due to a difficult extraction. To help prevent complications such as infection and dry socket, always be sure to follow home care instructions adequately.

  • Infection
  • Dry socket
  • Prolonged bleeding
  • Nerve damage
  • Swelling and/or bruising
  • Difficulty opening the jaw
  • Penetration of the nasal sinus
  • Fracture of the jaw or bone structures
  • Injury to adjacent teeth
  • Remainder of root fragments

Wisdom Teeth Removal Recovery

It is typical to expect 10-14 days to completely recover from having your wisdom teeth extracted. While the majority of any discomfort or swelling will occur in the first few days following the procedure, there may still be some long-term recovery that needs to occur depending on your situation.

Short Term Wisdom Teeth Removal Recovery

  • Proper cleansing is essential when it comes to the surgical site healing. Your dentist may give you a syringe to use in order to irrigate the surgical site and keep it clean. Typically this will not be used for the first day or two, until a blood clot has formed.
  • Rinsing with warm salt water and taking care to not disrupt the surgical site with a toothbrush will help the extraction area heal more quickly and prevent creation of dry socket.
  • Follow all of your home care instructions. Smoking or drinking through a straw can prevent adequate healing, and is likely to cause a very painful condition known as dry socket, which may take weeks to resolve. The pressure from the straw can cause the blood clot to dislodge, while smoking may prevent it from forming at all in the first place. If you are a woman that takes oral contraceptive medication you may be at an increased risk to develop a dry socket.
  • Expect bleeding during the first 24 hours until a blood clot has formed. Leave your gauze in place unless it has become completely saturated with blood. Apply firm pressure to the area to encourage clotting. Once 24 hours has lapsed, you may want to bite down on a tea bag, as the ingredients can encourage blood clotting and healing of the site.
  • Take medications as directed to alleviate your symptoms. Pain medication and an anti- inflammatory are usually prescribed. Some patients that have had joint replacements or an artificial heart valve may also need to take an antibiotic to prevent a systemic infection.
  • It may be difficult to open the mouth when you are experiencing wisdom teeth removal recovery. Typically this will improve after 10-14 days.
  • If sutures are not of the dissolvable variety, you will need to see your dentist for their removal at a follow-up appointment.Wisdom Teeth Removal Recovery

Long Term Wisdom Teeth Removal Recovery

There are some possible long-term effects that may occur during your wisdom tooth removal recovery. Here are some things to look for and discuss with your doctor if they continue to exist several weeks after your procedure:

  • Bone fragments
  • Tooth fragments
  • Jaw pain or fracture
  • Dry socket
  • Damage to surrounding teeth or restorations
  • Prolonged soreness or swelling

If something doesn’t seem to be healing quite right, or you experience some of these symptoms weeks after your extraction, then you ought to see your dentist for a follow up appointment. In very rare cases a person may experience fracture of the jaw or the teeth near the extraction site. Though this is not common, it is a major concern should it happen. Proper steps will need to be taken to restore the effective teeth and to correct a fracture in the jawbone so that normal functions can be restored.

Plan Ahead

Typically you should be able to return back to your normal routine after a week into your wisdom teeth removal. This includes eating normal foods (just avoid harder foods around the extraction site for a while). For the best possible wisdom teeth removal recovery, stock up on everything you need before your appointment: soft foods, pain medication and some good reading material for when you are resting up on the sofa! You might find you feel best if you rest with your head elevated. Be sure to keep plenty of water handy as well as your medication.

Wisdom Teeth Removal After Care

After Wisdom Teeth RemovalAfter wisdom teeth removal procedures, having a proper aftercare routine is an essential part of promoting healing of the surgical site. Your dentist will usually review many home care steps with you before and after your surgery, but most likely you will not remember so they typically provide them to you in print as well. If you are taking pain medications or feel groggy then it is best to have someone helping you who is also familiar with the aftercare procedures as well.

  • Follow written home care instructions from your doctor
  • Have a family member assist you in the first day after wisdom teeth removal
  • Expect a general healing time of 10-14 days

Most of the special steps required after wisdom teeth removal will only last for a week or so. Generally healing time lasts between 10-14 days, and then normal oral care routines return to normal. Before that time special care needs to be taken so that healing can occur properly and side effects such as infections of dry sockets can be avoided.

Swelling or Bruising

  • Alternate a hot and cold compress on the first day
  • Use cold compress on the day or two following the procedure

Limiting recovery time after wisdom tooth removal greatly depends on how well you care for your mouth and body. During the first day alternating the use of hot and cold compresses on the side of the jaw can alleviate swelling and bruising that otherwise might occur after the surgery. After the first day then just use cold compresses on the area and alternate equal time with the compress on and off so that you do not cause any tissue irritation from ice inside of the compress.

Cleansing the AreaAftercare

  • Rinse with warm salt water
  • Wait 2-3 days before brushing your teeth after wisdom teeth removal

On the first day, do not rinse the mouth or brush the teeth, as irritation might occur at the surgical site. After the first day has passed, rinse with warm salt water every 3-4 hours to alleviate swelling and cleanse the mouth. Continue rinsing for several days. Wait at least a day before resuming toothbrushing, so as not to introduce bacteria into the surgical site. Then, only brush the surrounding teeth paying close attention to avoid the surgical site.

Medication After Teeth Removal

  • Take an anti inflammatory such as ibuprophen
  • Take all medication with food
  • Take all medication as directed

Take an anti inflammatory medication such as iburophen as directed after wisdom teeth removal, to decrease swelling of the surgical site. Your dentist may prescribe a prescription strength pain reliever to use to manage discomfort, or will direct you to take a certain amount of over the counter ibuprophen throughout the day.

Do not take medication on an empty stomach. Doing so can cause severe stomach cramping or nausea depending on what medication is being taken. Many people may suspect they are allergic to a medication because it causes stomach cramps, when in reality they just need to have more food in the stomach when they take the medication. If you do experience allergic reaction symptoms such as rash, difficulty breathing, or diarrhea, then speak with your dentist to find an alternative medication to manage your symptoms.

Preventing Dry Socket

  • Dry sockets can take 2 or more weeks for pain to subside
  • Do not smoke
  • Do not drink through a straw
  • Some people may be more predisposed to developing dry socket

Please be extremely careful to follow home care instructions so as not to increase the risk of developing dry sockets, a painful condition that is a fairly common side effect after teeth removal. They typically take 2 or more weeks for the pain to subside if they happen to occur.

Things like drinking through a straw or smoking can contribute to the chance of dry socket, though the condition may just happen to occur even in patients that do not do this. Using a straw following extraction may cause the blood clot to dislodge, exposing the jawbone and allowing for infection to occur.

Smoking causes inadequate blood circulation in the mouth by encouraging atrophy of the blood vessels. This makes it extremely difficult for the body to heal surgical sites such as extractions and will also contribute to other oral diseases such as periodontal or gum disease.

Women that take oral contraceptive medication may be at an increased risk to develop dry sockets. Please do not discontinue taking your contraceptive medication without consulting your medical practitioner.

 

Foods to Eat After Wisdom Teeth Removal

Best Foods to Eat

After having your wisdom teeth extracted it is important to only eat foods that will not cause sensitivity or harm to the surgical site. The best foods to eat for the first few days after wisdom tooth removal are going to be soft foods, soups and also drinking lots of liquids. Remember, it’s important to eat so that your body has energy and does not become too weak as it heals. Try to eat foods that do not require you to chew them before swallowing. Examples include:

  • Jello
  • Pudding
  • Yogurt
  • Ice cream
  • Soup
  • Mashed potatoes
  • Smoothies, Shakes or Malts
  • Applesauce

Drinking nutritional shakes is a good way to get enough calories and nutrients into your system when you do not feel up to having thicker foods in your mouth. Swallowing liquids is also easier than solids following wisdom teeth removal surgery, and the cold temperature will be comfortable. Liquid diets will also prevent solid food from becoming lodged into the surgical site.

Foods to Avoid

Try not to have anything hot, and to let cooked foods cool to room temperature before eating them. Cold foods are good to have as they help relieve some of the discomfort or pain in the surgical site as you eat them. Avoid small grains during the first few days following the wisdom teeth extraction surgery so that they do not get caught in the surgical area. Examples include rice, grits or oatmeal.

Do not drink with a straw for at least 2 weeks after your procedure. Using a straw can cause pressure changes in the mouth that may cause the blood clot in the surgical site to dislodge and create a dry socket. Instead of using a straw, spoon thicker liquids with a spoon, or just drink them slowly from a cup.

Food Intake While Taking Medicine

Your food intake will most likely be decreased over the first few days following the procedure. Drink lots of liquid so as to be sure you do not become dehydrated, and do not skip meals. However, most pain medication prescribed following wisdom teeth removal needs to be taken with some food on the stomach. Taking pain meds on an empty stomach can make you feel even worse, and cause symptoms like nausea or vomiting. Most of the time when people complain that their medicine gives them a stomachache it is because they do not take it with enough food.

Wisdom Teeth Removal Cost

Wisdom Teeth Removal CostEstimated Wisdom Teeth Removal Cost

Depending on what type of extraction you are having, who is performing the procedure, what type of insurance you carry and the location of the dentist, the extraction of a wisdom tooth will typically range from just over a hundred dollars to several hundred dollars. Much of this will depend on how the tooth is positioned in the jaw, if a simple or surgical extraction is needed, if the tooth is impacted, and if your provider is a member of your insurance plan.

A wisdom tooth that is partially impacted may only cost $100 to extract through your dental plan. However, if you are receiving sedation therapy and surgery through an oral surgeons office, or you don’t have a dental insurance plan, the total wisdom teeth removal cost may range from $250 to $400. Only a consultation and x-ray with your dentist can determine exactly how much your extraction needs will impact your wallet. Each person is different, and so are the procedures that they need.

Choose The Right Provider

When possible, having your general dentist perform a wisdom tooth extraction is much more affordable than having it performed by a specialist such as an oral surgeon. Specialist offices typically have a higher overhead and use many more advanced procedures when needed, which inflates the cost of treatment. While many people do need to have their wisdom teeth extracted by an oral surgeon, others may be able to simply have them taken out in their normal dentist’s office. Even if the fees between the practitioners are not very different, your insurance plan may actually offer financial incentives to cover the procedure at a higher percentage through the general provider, greatly reducing your wisdom teeth removal cost. The price of the extraction will also depend on the experience of the dentist and the location of the office. Offices located in major cities tend to be higher in price than dental offices in more rural locations. And, specialists with more experience on wisdom teeth extraction generally charge more than those with less experience.

Some dental schools offer wisdom teeth extraction at a deeply discounted rate to allow dental students to practice pulling teeth. All students are overseen by instructors, who are usually licensed dentists, during the procedure. You may consider having your wisdom teeth removed there if you really have a tight budget.

Dental Insurance and Dental Plans Coverage

Dental insurance can greatly reduce the overall out of pocket expenses that you may incur when figuring out your wisdom teeth removal cost. Some insurance plans cover as much as 80% of the cost! The reduction may be hundreds of dollars even over a thousand dollars different. While this may not make sense, it does for your dental care providers. By them participating in insurance networks they are able to maintain a steady supply of dental patients, and in turn offer a significant discount to patients that participate in those plans. If you are currently shopping dental insurance, please note that there may be a waiting period where new subscribers must wait several months before completing major dental work such as a surgical extraction.

Sample costs of wisdom tooth extraction with a discount dental plan.
Sample costs of wisdom tooth removal with a discount dental plan.

Discount dental plans or dental savings plans, which are an alternative to dental insurance, are available through sites like DentalPlans.com starting as low as $80 a year for individuals and $130 a year for families. And, their plans are generally activated quickly and don’t have any health restrictions, you won’t need to wait months to receive the dental care you need. This kind of dental discount program is more affordable and can be a better choice for your wisdom teeth removal need.

It will be costly if you have your wisdom teeth removed without dental insurance or dental plans. You are going to pay over $1000 dollars easily for extracting four wisdom teeth.

Other Expenses to Consider

In addition to extracting the teeth, an initial examination and x-rays will need to be performed in order to diagnose the proper procedures and make a treatment plan. The use of local anesthetic is typically covered in dental procedure fees, but alternatives like nitrous oxide (laughing gas) or sedation dentistry come at an added fee. Nitrous oxide may only be $20 more, and sedation would depend on what method is used. Prescription oral medications will be much more affordable than IV sedation in-office.

Ways To Bring Down The Wisdom Tooth Removal Cost

  • Select a provider in your network (if you have dental insurance), for optimal insurance benefit coverage. If you don’t have dental insurance, discount dental plans may be a better choice as they are cheaper and activated quickly.
  • When possible, have a general dentist perform your extraction, as the teeth removal cost will be less expensive than a procedure in the oral surgeon’s office.
  • Bring a copy of your old x-rays from your last dentist. Sometimes x-rays are still recent enough that a new set does not need to be taken. Panoramic x-rays are taken only about every 3-5 years.
  • Receiving local anesthetic and nitrous oxide is a great alternative to sedation dentistry. Many people are comfortable and relaxed during routine extractions using these methods.
  • Call a dental school in your area to see if they offer wisdom teeth extraction at a low price.

 

Frequently Asked Questions

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