They’re the last teeth to arrive—and often the first to cause problems. Wisdom teeth can stay hidden for years before suddenly sparking pain, swelling, or infection. But what really happens during impacted wisdom teeth removal? From the moment you sit in the chair to the final stages of recovery, here’s what you need to know before it catches you off guard.
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When Is Surgery for Impacted Wisdom Teeth Necessary?
Surgery for impacted wisdom teeth becomes necessary when the teeth don’t have enough space to emerge correctly or begin growing in the wrong direction. This misalignment can lead to a variety of issues, including pain, swelling, and infection. In some cases, impacted wisdom teeth may also harm neighboring teeth or surrounding bone, making early intervention important.
Dentists often recommend removal before symptoms appear—especially in younger adults—because the roots of the teeth are not yet fully developed. This typically leads to a smoother procedure and quicker recovery. Even if there are no immediate problems, preventive surgery may be suggested to avoid future complications.
Common signs that surgery may be needed include persistent jaw pain or swelling at the back of the mouth, infection or gum inflammation near the wisdom teeth, difficulty opening the mouth or chewing, and crowding or shifting of nearby teeth. In more serious cases, cysts or tumors can form around the impacted tooth, making removal essential to protect overall oral health.
Impacted Wisdom Teeth Removal Surgery: Step-by-Step
The removal of impacted wisdom teeth is a common outpatient procedure typically performed by an oral surgeon or dentist. While each case may vary slightly, the general steps remain consistent to ensure a safe and effective extraction process.
- Initial Evaluation: The process begins with a thorough review of dental X-rays. This helps the oral surgeon or dentist assess the position of the impacted teeth and plan the best approach for removal.
- Anesthesia: Depending on the complexity of the case and the patient’s comfort level, local anesthesia, sedation, or general anesthesia will be administered. This ensures the procedure is as comfortable and pain-free as possible.
- Incision and Bone Removal: An incision is made in the gum tissue to expose the tooth and surrounding bone. If the tooth is partially or fully covered by bone, a small portion of the bone may be removed to access the tooth.
- Tooth Sectioning and Removal: If the tooth cannot be extracted in one piece, it may be sectioned into smaller fragments for easier removal. Once the tooth is fully removed, the area is cleaned to eliminate any remaining debris.
- Stitches and Gauze Placement: The incision site is then closed with either dissolvable or removable stitches. Gauze is placed over the extraction site to help control bleeding and promote the formation of a protective blood clot.
The entire procedure usually takes about 45 minutes to an hour, depending on how many teeth are being removed and their level of impaction.
What Is the Recovery Like After Surgery?
Recovery from impacted wisdom tooth surgery generally takes about 1 to 2 weeks, though most people are able to resume normal daily activities within 3 to 5 days. Full healing of the surgical area may take a bit longer. Here’s a breakdown of what to expect during the recovery process:
- First 24–48 Hours
Swelling, bruising, and mild to moderate pain are common during the initial phase. Patients are typically advised to rest, apply ice packs to reduce swelling, and use prescribed or over-the-counter pain relievers to manage discomfort. - First Week
During this time, it’s important to stick to soft foods and stay hydrated. Good oral hygiene should be maintained, but care should be taken to avoid direct contact with the surgical site. Patients should not use straws, smoke, or rinse too vigorously, as these actions can increase the risk of developing a painful condition known as dry socket. - After One Week
Most swelling and pain begin to subside around this time. Any stitches placed during surgery may dissolve on their own or be removed during a follow-up appointment, depending on the type used.
While minor bleeding and jaw stiffness are normal, it’s important to watch for signs of infection. Symptoms such as fever, ongoing swelling, pus, or a foul odor from the mouth should be reported to the dentist immediately.
How Much Does Impacted Wisdom Tooth Removal Cost?
The cost of impacted wisdom tooth removal can vary significantly based on several factors, including the complexity of the extraction, your location, the type of anesthesia used, and the number of teeth being removed. Knowing these cost variables can help you plan for the procedure more effectively.
For a simple extraction of a non-impacted tooth, the price typically ranges from $75 to $200 per tooth. In contrast, a surgical extraction for an impacted tooth usually costs between $225 and $600 per tooth, depending on how deeply the tooth is embedded and how challenging the removal is.
If general anesthesia or sedation is required, this can add an additional $250 to $800 or more to the total cost. When all four impacted wisdom teeth are removed in a single session with sedation, the complete procedure may range from $1,000 to $3,000 or more.
Many dental insurance plans cover part or all of the cost, especially when the extraction is considered medically necessary. It’s important to check with your insurance provider beforehand to understand your specific coverage and any out-of-pocket expenses you may incur.
Risks and Complications of Wisdom Tooth Surgery
Wisdom tooth removal is generally safe, but like any surgical procedure, it carries some risks. One of the most common complications is dry socket, which happens when the blood clot at the extraction site is lost too early, exposing bone and nerves. This condition causes severe pain and requires prompt treatment. Infection is another concern, especially if aftercare instructions aren’t followed properly.
Less commonly, nerve injury can occur, potentially affecting the lips, tongue, or chin with temporary—or in rare cases, permanent—numbness or tingling. Sinus complications may also arise when removing upper wisdom teeth due to their proximity to the sinuses. Excessive bleeding, swelling, and jaw stiffness are typically mild but should be monitored.
Following post-operative care, attending follow-up visits, and choosing an experienced provider help minimize these risks and support a smooth, safe recovery.
Sources.
Samsudin, A. R., & Mason, D. A. (1994). Symptoms from impacted wisdom teeth. British Journal of Oral and Maxillofacial Surgery, 32(6), 380-383.Dodson, T. B., & Susarla, S. M. (2014). Impacted wisdom teeth. BMJ clinical evidence, 2014, 1302.