Wisdom tooth removal has a worse reputation than it deserves, mostly because everyone has heard one bad story. What follows is what actually happens, so there are no surprises.
First: do you even need it out?
Not every wisdom tooth needs removing, and we do not remove teeth for the sake of it. A wisdom tooth that has come through fully, that you can reach with a toothbrush, and that is not damaging anything can stay exactly where it is.
The ones that need to come out are:
- Partially erupted teeth, where a flap of gum traps food and bacteria. Antibiotics settle the infection for a few weeks and then it returns. That cycle does not break on its own.
- Impacted teeth pressing against the second molar. The pressure causes decay on a surface no toothbrush can reach, and you lose a healthy tooth to save a useless one.
- Teeth with recurring pain or swelling, or associated cysts on the X-ray.
The X-ray decides everything
Before anything else, we image the tooth. The X-ray shows the shape of the roots, how the tooth is angled, and how close it sits to the inferior alveolar nerve.
That determines whether this is a ten-minute simple extraction or a surgical removal, and it determines the price. Anyone quoting you a firm number before seeing an X-ray is guessing.
During the procedure
You are fully anaesthetised. You will feel firm pressure, because removing a tooth involves pressure, but you should not feel pain. If you do, we stop and give you more anaesthetic. Say so.
Depending on how the tooth sits, it comes out whole or in sections. Sectioning sounds worse than it is and is often gentler, because it means less force applied to the surrounding bone.
The socket is cleaned, sutured where needed, and you bite on gauze.
Most single extractions take 30 to 60 minutes including the anaesthetic.
The first 24 hours, which is the part that matters
Almost every bad wisdom tooth story is a dry socket story, and dry socket is largely avoidable.
A blood clot forms in the socket. That clot is the dressing. If it dislodges, the bone underneath is exposed, and that is genuinely painful in a way the extraction itself was not.
So, for the first 24 hours:
- Bite firmly on the gauze for a full hour. Do not keep lifting it to check.
- No rinsing. No spitting. No straws. All three create suction or turbulence that lifts the clot.
- No smoking for at least 72 hours. This is the single biggest risk factor.
- Ice on and off, twenty minutes at a time.
- Soft, cool food. Yoghurt, dal, mashed rice. Nothing hot, nothing crunchy.
From day two, warm salt-water rinses, gently.
The swelling timeline
This surprises people, so it is worth knowing in advance:
- Day 1: Some swelling, manageable with ice.
- Day 2: Peak swelling. This is normal. It is not an infection.
- Days 3 to 5: Steadily settling.
- Day 7: Largely resolved.
Bruising along the jawline is normal in some patients and looks more dramatic than it is.
When to actually call us
- Pain that gets worse from day three onwards rather than better
- A bad taste or smell with increasing pain, which suggests dry socket
- Bleeding that has not slowed after several hours of pressure
- Fever, or swelling that spreads toward the eye or the neck
- Numbness in the lip or chin that persists well beyond the day
None of these are common. All of them are worth a phone call rather than a night of worrying.
Both sides at once?
Usually yes, if both need doing. One recovery is easier than two, and you take one day off work instead of two. We will advise based on how difficult each side looks on the X-ray.
Planning it
Book a day when you can rest afterwards. Thursday works well for most working patients, giving you the weekend to get through the peak swelling.
Eat properly beforehand unless you have been told otherwise, because you will be on soft food for a couple of days. And tell us about blood thinners, diabetes or heart conditions well in advance rather than on the day.