Wisdom Tooth Removal: What to Expect Before, During, and After

What Are Wisdom Teeth?

Wisdom teeth are the third and final set of molars, one in each corner of the mouth, that typically erupt between the ages of 17 and 25. Most adults develop four wisdom teeth, though some people develop fewer or none at all. In an ideal situation, wisdom teeth erupt fully upright, have enough space in the jaw, and function just like any other molar.

In reality, the modern human jaw has become smaller over thousands of years of evolution — and there is often simply not enough room for the wisdom teeth to emerge properly. The result is impaction, where the tooth is trapped partially or fully within the jawbone, often tilted at an angle toward the adjacent molar.

When Do Wisdom Teeth Need to Be Removed?

Not every wisdom tooth needs extraction. If a wisdom tooth has fully erupted, is properly aligned, easy to clean, and not causing any problems, it can be left in place. Removal is recommended in the following situations:

• •Impaction: The tooth is partially or fully trapped in the jawbone and unable to erupt into the correct position
• •Pericoronitis: Repeated infection around the gum flap covering a partially erupted wisdom tooth, causing pain, swelling, and difficulty opening the mouth
• •Decay: The wisdom tooth or the adjacent second molar has developed decay because the area is difficult to clean
• •Cyst formation: A fluid-filled sac develops around the crown of an impacted wisdom tooth, which can damage surrounding bone and teeth
• •Crowding: An erupting wisdom tooth pushes against the adjacent molar, causing pain or damaging the second molar
• •Orthodontic reasons: Wisdom teeth may be extracted as part of a treatment plan to prevent relapse after braces or Invisalign

The Extraction Procedure

Wisdom tooth removal is performed under local anaesthesia at The Tooth Stop as an outpatient procedure. You will be numb throughout — you may feel pressure but not pain. For fully erupted wisdom teeth, a simple extraction (similar to removing any other tooth) is performed. For impacted teeth, a surgical extraction is required:

• •A small incision is made in the gum to access the tooth and bone
• •The overlying bone may be removed with a dental drill to expose the tooth crown
• •The tooth may be divided into sections (sectioning) to make it easier to remove in pieces rather than whole
• •The socket is cleaned and irrigated, and the gum is sutured closed
• •The entire procedure typically takes 20–60 minutes per tooth depending on complexity

Recovery: What to Expect

Recovery from wisdom tooth removal is generally straightforward if the aftercare instructions are followed carefully:

• •Day 1: Rest and bite on gauze for 30–45 minutes. Minor oozing is normal for the first few hours. Keep your head elevated.
• •Days 1–2: Soft diet — yogurt, mashed potatoes, soups, scrambled eggs, smoothies. Avoid hot foods and drinks.
• •Days 2–3: Swelling typically peaks on day 2–3. Apply a cold pack (wrapped in cloth) to the outside of the face for 20 minutes on / 20 minutes off for the first 24 hours.
• •Days 3–7: Gentle warm salt-water rinses 3–4 times daily from day 2 onwards to keep the socket clean. Avoid rinsing vigorously on day 1.
• •Days 5–10: Sutures (if placed) are typically removed or dissolve on their own. Follow up with Dr. P Meghana if any concern arises.
• •Full healing: The socket fully closes over 4–8 weeks, and the underlying bone remodels over several months.

Dry Socket: The Most Common Complication

Dry socket (alveolar osteitis) occurs when the blood clot that forms in the extraction socket is dislodged or dissolves before the wound has healed, exposing the underlying bone. It affects approximately 2–5% of patients after simple extractions and up to 25% after impacted lower wisdom tooth removal.

Dry socket typically presents on days 3–5 as a sudden increase in pain after an initial period of improvement. The pain can be severe and may radiate to the ear or jaw. It is not an infection but causes significant discomfort. Risk factors include smoking, spitting forcefully, using a straw, poor oral hygiene, and prior history of dry socket.

When to Call the Dentist Immediately

• •Fever above 38.5°C persisting beyond day 2
• •Increasing pain after day 3 (instead of gradual improvement)
• •Pus, foul taste, or odour from the socket
• •Persistent numbness of the lower lip, chin, or tongue after 24 hours
• •Bleeding that does not slow after 1 hour of firm gauze pressure
• •Difficulty swallowing or breathing (rare — indicates spreading infection)