Your Guide to Wisdom Tooth Removal
Everything you need to know about having a wisdom tooth removed: why it may be needed, what happens, and what recovery is like.
Urgent help: who to contact
Call 999 or go to A&E now if, after wisdom tooth removal, you have swelling spreading to your neck or eye, difficulty breathing or swallowing, or difficulty opening your mouth. These can be signs of a spreading infection.
Contact your dental team if you develop a high fever (above 38°C). If you cannot reach them, call NHS 111.
What are wisdom teeth?
Wisdom teeth are the four back teeth (molars), one in each corner of your mouth. They are the last teeth to come through, usually between the ages of 17 and 25. Many people do not have enough room in their jaw for wisdom teeth to come through fully. This can cause problems.
A wisdom tooth that cannot come through properly is called impacted. It may be partly through the gum, growing at an angle, or fully buried in the jawbone.
Why might I need a wisdom tooth removed?
NICE guidance says wisdom teeth should only be removed when there is disease or repeated problems. They should not be removed just because they are impacted. Reasons for removal include:
- Pericoronitis — repeated infection and swelling (inflammation) of the gum flap over a wisdom tooth that is partly through
- Decay — the wisdom tooth, or the tooth in front of it, has a lot of decay. This cannot be treated properly because of where the tooth is.
- Abscess or cyst — an infection, or a sac of fluid, forming around an impacted tooth
- Damage to the next tooth — the wisdom tooth is pressing into the molar in front of it and damaging it
- Gum disease — around the wisdom tooth or the tooth in front of it
What are my other options?
- Keeping an eye on it (monitoring) — if the tooth causes no problems, it can be checked at regular check-ups. Not all impacted wisdom teeth need to come out.
- Antibiotics — for a sudden infection (pericoronitis). This deals with the current flare-up. But the infection may come back if the cause is not treated.
- Removing the gum flap (operculectomy) — this sometimes works for mild pericoronitis that keeps coming back. It is not always a long-term fix.
- No treatment — this is fine if check-ups show the problem is not getting worse. Your dental team will be honest with you about the risk of problems later.
What happens during the removal?
Wisdom tooth removal can be simple or complex. A wisdom tooth that has fully come through may take just a few minutes. A deeply impacted tooth may need minor mouth surgery and take 30–45 minutes.
- Numbing — the area is fully numbed with an injection (local anaesthetic). You may also be offered sedation if you feel anxious.
- A cut in the gum (if needed) — for buried teeth, or teeth that are partly through, a small cut is made in the gum to reach the tooth.
- Removing bone (if needed) — some bone around a deeply impacted tooth may be removed to reach it.
- Cutting the tooth into pieces (sectioning) — this can make removal easier and safer.
- Removal — the tooth, or its pieces, is taken out.
- Stitches — the wound is usually closed with stitches that dissolve.
Risks and possible complications
Wisdom tooth removal has more risks than a routine extraction. This is especially true for surgery on impacted lower wisdom teeth. Your dental team must talk these through with you before you agree to treatment (give consent).
Common (affect more than 1 in 10 people):
- A lot of swelling, bruising and soreness, lasting 4–7 days or more
- Difficulty opening your mouth wide (trismus) for about a week
- Some bleeding from the socket
- Dry socket — the most common problem after wisdom tooth surgery. It affects up to about 3 in 10 surgical removals of lower wisdom teeth. It is more common in smokers. It causes bad pain from around day 1–3, and the socket needs a dressing.
Uncommon (affect about 1 in 10 to 1 in 100 people):
- Infection that needs antibiotics
- Temporary inferior alveolar nerve damage (lower jaw) — this nerve gives feeling to your lower lip, chin and teeth. It runs close to the roots of lower wisdom teeth. Changed feeling (paraesthesia) for a while happens in about 1–5% of surgical removals (up to 1 in 20 in some cases). This usually gets better, but can last a few weeks or months.
Rare but important (affect fewer than 1 in 100 people):
- Permanent inferior alveolar nerve damage (lower jaw) — permanent numbness of the lower lip and chin is rare. It affects about 1 in 200 to 1 in 500 cases. The risk is higher when the roots touch the nerve canal. Your surgeon will check this on your X-ray or scan.
- Lingual nerve damage — this can cause changed feeling in your tongue or the floor of your mouth. This may be temporary, or rarely permanent. Temporary effects happen in about 1% of cases. Permanent damage is rare (about 1 in 200 or fewer).
- Damage to the next tooth
- A hole between the socket and the sinus (oro-antral communication). This only happens with upper wisdom teeth.
Recovery
Recovery from wisdom tooth surgery takes longer than from a simple extraction. Plan to rest for at least 2–3 days afterwards:
- Take prescribed or recommended painkillers regularly for the first 48 hours. Do not wait for the pain to build.
- Hold an ice pack against the outside of your cheek in the first few hours to reduce swelling
- Eat soft foods, like soup, yoghurt or mashed potato, for several days
- Do not smoke for at least 72 hours, and ideally longer. Smoking is the biggest risk factor for dry socket.
- Do not rinse on the first day. From day two, rinse gently with warm salt water after eating.
- Most people with desk jobs can go back to work or normal activities within 3–5 days. Physical work may need longer.
Questions to ask your dental team
- How impacted is my wisdom tooth, and how complex will removal be?
- What is my own risk of nerve damage, given where the roots are?
- Would sedation suit me?
- Should I have all four wisdom teeth out at once, or one at a time?
- How long should I take off work or avoid hard physical 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 dental team about your individual options, risks, and treatment plan. Treatment outcomes vary between patients depending on individual circumstances. Your dental team will confirm exact fees and what is suitable for your specific circumstances before you agree to any treatment.
Sources
- Guidance on the extraction of wisdom teeth (TA1). National Institute for Health and Care Excellence (NICE), 2000.
- Parameters of care for patients undergoing mandibular third molar surgery. Faculty of Dental Surgery, Royal College of Surgeons of England, 2020.
- Wisdom tooth removal. NHS website (nhs.uk), reviewed June 2024.
Links checked 18 October 2026.
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