Everything you need to know about having a wisdom tooth removed — why it might be needed, what the procedure involves, and what to expect during recovery.
Wisdom teeth are the four back molar teeth, one in each corner of the mouth. They are the last teeth to erupt, usually between the ages of 17 and 25. Many people do not have enough space in their jaw for wisdom teeth to come through fully, which can cause problems.
A wisdom tooth that cannot erupt properly is called an impacted wisdom tooth. It may be partially through the gum, growing at an angle, or entirely buried in the jawbone.
Why might I need a wisdom tooth removed?
NICE guidance states that wisdom teeth should only be removed when there is evidence of disease or repeated problems, not simply because they are impacted. Reasons for removal include:
Pericoronitis — repeated infection and inflammation of the gum flap over a partially erupted wisdom tooth
Decay — the wisdom tooth or the tooth in front of it has significant decay that cannot be properly treated due to the tooth's position
Abscess or cyst — infection or a fluid-filled sac forming around an impacted tooth
Damage to the adjacent tooth — the wisdom tooth is pressing into and damaging the molar in front of it
Gum disease — around the wisdom tooth or the tooth in front of it
What are my alternatives?
Monitoring — if the wisdom tooth is causing no problems, it can be reviewed at regular check-ups. Not all impacted wisdom teeth need to be removed.
Antibiotics — for acute infection (pericoronitis). This manages the immediate episode but the infection may recur if the underlying cause is not addressed.
Operculectomy — removal of the gum flap over the tooth. This is occasionally effective for mild, recurrent pericoronitis but is not always a long-term solution.
No treatment — acceptable if monitoring shows no disease progression. Your dentist will advise you honestly about the risk of future problems.
What does the procedure involve?
Wisdom tooth removal varies considerably in complexity. A simple erupted wisdom tooth may take just a few minutes; a deeply impacted tooth may require minor oral surgery and take 30–45 minutes.
Local anaesthetic — the area is thoroughly numbed. You may also be offered sedation if you are anxious.
Incision (if needed) — for buried or partially erupted teeth, a small cut is made in the gum to expose the tooth.
Bone removal (if needed) — some bone around a deeply impacted tooth may be removed to allow access.
Sectioning — the tooth may be divided into sections to make removal easier and safer.
Removal — the tooth (or sections) is extracted.
Sutures — the wound is usually closed with dissolving stitches.
Risks and possible complications
Wisdom tooth removal — especially surgical removal of impacted lower wisdom teeth — carries more risks than routine extraction. These must be discussed with you before you give consent.
Common (affect more than 1 in 10 people):
Significant swelling, bruising, and soreness lasting 4–7 days or more
Difficulty opening the mouth wide (trismus) for a week or so
Some bleeding from the socket
Uncommon (affect about 1 in 10 to 1 in 100 people):
Dry socket — affects around 1 in 8 surgical extractions. More common in smokers. Causes significant pain from around day 1–3 and requires dressing of the socket.
Infection requiring antibiotics
Rare but important (affect fewer than 1 in 100 people):
Inferior alveolar nerve damage (lower jaw) — the nerve that supplies feeling to the lower lip, chin, and teeth runs close to the roots of lower wisdom teeth. Temporary altered sensation (paraesthesia) occurs in approximately 1–5% of surgical removals (up to 1 in 20 in some cases). Permanent numbness is uncommon, affecting approximately 1 in 200 to 1 in 500 cases, though this risk is higher when roots are in close contact with the nerve canal (your surgeon will assess this from your X-ray or scan).
Lingual nerve damage — may cause temporary or rarely permanent altered sensation of the tongue or floor of the mouth. Temporary effects occur in approximately 1% of cases; permanent damage is rare (approximately 1 in 200 or fewer).
Damage to the adjacent tooth
Oro-antral communication (upper wisdom teeth only) — a connection between the socket and the sinus
Recovery
Recovery from surgical wisdom tooth removal takes longer than a simple extraction. Plan to rest for at least 2–3 days after the procedure:
Take prescribed or recommended painkillers regularly for the first 48 hours rather than waiting for pain to build
Apply an ice pack to the outside of your cheek in the first few hours to reduce swelling
Eat soft foods — soup, yoghurt, mashed potato — for several days
Do not smoke for at least 72 hours — ideally longer. Smoking is the biggest risk factor for dry socket.
Do not rinse on day one. From day two, rinse gently with warm salt water after eating.
Most people can return to work or normal activities within 3–5 days for desk work; physical work may require longer.
Questions to ask your dentist
How impacted is my wisdom tooth and how complex is the removal likely to be?
What is my personal risk of nerve damage, given the position of the roots?
Would sedation be appropriate for me?
Should I have all four wisdom teeth removed at once, or one at a time?
How long should I plan to take off work or avoid strenuous activity?
This leaflet is for general information only and does not replace professional dental advice. It is intended to support — not replace — the discussion with your dentist about your individual options, risks, and treatment plan. Treatment outcomes vary between patients depending on individual circumstances. Your dentist will confirm exact fees and what is suitable for your specific circumstances before you agree to any treatment.
When to Seek Urgent Help
If you develop swelling that is spreading to your neck or eye, difficulty breathing or swallowing, or a high fever after wisdom tooth removal, go to A&E immediately or call 999. These can be signs of spreading infection.
References
Aligned with guidance from: NICE, SDCEP, FGDP(UK), Faculty of Dental Surgery RCS.