Your Complete Guide to Wisdom Teeth Removal 

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Each year in the United States, about five million people have at least one wisdom tooth, or third molar, removed.  

Are you wondering if you need your wisdom teeth removed? Perhaps your dentist referring you to an oral surgeon, and you want to know what to expect?  

Our complete guide to wisdom teeth removal explains how to identify if you need your wisdom teeth removed and what you can expect before, during, and after oral surgery. 

Do You Need Wisdom Teeth Extraction?

You may need your wisdom teeth removed if you are experiencing signs or symptoms of problematic teeth. It is also possible that you may not be experiencing any symptoms at all. X-rays can reveal whether the position of your wisdom teeth will eventually be a cause for concern. 

Signs And Symptoms That You May Need Wisdom Teeth Removal 

  • Cavities that your dentist cannot restore 
  • Pain 
  • Infection 
  • Swollen gums 

Tooth Position Prompting Wisdom Teeth Removal 

  • Impacted – Wisdom teeth that grow sideways or cannot fully erupt can become infected or harm other teeth. 
  • Crowding nearby teeth – Fully erupted wisdom teeth can sometimes push against other teeth and cause misalignment. 
  • Too far back to clean – When wisdom teeth are so far back in your mouth that they are challenging to clean, bacteria can cause tooth or gum disease and lead to bone loss. 

To avoid future dental issues, the American Dental Association recommends monitoring wisdom teeth that appear healthy as the risk of wisdom teeth increases as we age. 

When Should You Have Wisdom Teeth Removed?

You should have your wisdom teeth removed before they start hurting and as soon as possible if x-rays reveal that the teeth are a concern to your oral health. Although an oral surgeon can remove wisdom teeth at any age, removing them is easier when you are younger for these reasons: 

  • Tooth roots are shorter and not entangled with nerves or your jawbone. 
  • The bone around the tooth roots is softer. 
  • Nerves and surrounding structures are less likely to be disturbed during removal. 

What Can You Expect Before Wisdom Teeth Removal? 

Before wisdom teeth removal, you will have a consultation with an oral surgeon to discuss the condition of your teeth and what to expect with surgery. The surgeon will also discuss the required maintenance and challenges you might experience if you have impacted wisdom teeth and decide to keep them. 

Your Consultation 

During a consultation, you and your surgeon will discuss: 

  • Your concerns and questions 
  • Your x-rays 
  • Your health history and current medications or supplements 
  • Reasons you need wisdom teeth removal 
  • Surgery steps 
  • Sedation options 
  • How to prepare for surgery 
  • What to expect during your recovery 

Preparing for Wisdom Teeth Surgery 

Preparing for wisdom teeth surgery can ease some anxiety and help you recover comfortably at home. 

Shop for Post-Surgery Foods 

You will need to drink plenty of liquids and eat soft foods after surgery. Grocery shopping in advance can help you stay relaxed and get the rest you need after your procedure. Your surgeon will give you a list of foods to eat and avoid. 

Make Your Surroundings At Home Comfortable 

Gather comfortable pillows, relaxing music, books, or movies to help your recovery time pass faster. 

Arrange For Transportation 

Ask a responsible adult to drive you to and from your appointment. 

Schedule Time Off 

It takes a few days to recover from wisdom teeth removal, so plan to rest and take time off from work, school, or other responsibilities. 

Pick Up Prescription Medication 

If your oral surgeon gives you prescriptions in advance, pick up the medication from your pharmacy before your surgery date. 

Wear Comfortable Clothing 

Plan to wear loose, comfortable clothing, including a short-sleeve shirt or one with sleeves that roll up easily. 

Avoid Eating And Drinking 

Remember not to eat or drink anything eight hours before your procedure if you are opting for IV sedation and 6 hours prior if you need local sedation. Fasting can minimize or prevent nausea before receiving sedation. 

Avoid Tobacco And Alcohol 

The American Association of Oral and Maxillofacial Surgeons recommends avoiding alcohol and tobacco use at least eight hours before wisdom teeth removal. Follow your oral surgeon’s recommendation. 

What Can You Expect During Wisdom Teeth Removal? 

Generally, wisdom teeth removal takes about an hour. Your surgeon will use local anesthesia or sedation to keep you comfortable during the procedure. 

Steps For Wisdom Teeth Removal 

Sedation Options 

  • Tooth numbing – Your surgeon will use a local anesthetic to numb your wisdom teeth and the surrounding gum tissue. 
  • Nitrous oxide – Breathing in nitrous oxide (laughing gas) reduces anxiety and discomfort during surgery. This option helps relax you without putting you to sleep. 
  • Intravenous (IV) sedation – Your oral surgeon can deliver sedation gently through a vein in your arm. This option works quickly and helps you maintain deep relaxation. IV sedation makes you drowsy, and you may not remember the procedure. 

In addition to sedation, we offer EXPAREL® for pain management. EXPAREL is a non-opioid, long-lasting pain medication that minimizes discomfort while limiting your exposure to potentially addictive meds. 

The Procedure 

  • Gum tissue removal – If any gum tissue is covering your wisdom teeth, your surgeon will remove it. 
  • Bone removal – Your surgeon will remove the bone if small amounts of bone fully or partially cover the impacted wisdom teeth. 
  • Tooth preparation – After loosening each tooth from connective tissue, your surgeon will cut the teeth into sections as needed for easier removal. 
  • Tooth removal – Your wisdom teeth will be ready to remove, and your surgeon will extract all pieces from the tooth sockets. 
  • Wound-numbing injections – Some oral surgeons inject a numbing agent into each wound to control pain over the next few days. At our practice, Dr. Gocke injects EXPAREL®, a slow-release, non-opioid pain blocker, into tooth sockets to numb the area, prevent the need for narcotics, and promote a healthy recovery. 
  • Stitches – You may need stitches to close your gum tissue in the case of impacted wisdom teeth. 

At Virginia Advanced Surgical Arts, we strive to make our patients as comfortable as possible, by providing the option to watch a Netflix movie during your procedure. 

What Can You Expect After Wisdom Teeth Removal? 

After wisdom teeth removal, you can expect to rest, adjust your diet temporarily, and enjoy a steady recovery by following your oral surgeon’s post-operative instructions carefully. 

Immediately After 

Your oral surgeon will place gauze over the extraction site, and a team member will take you to a recovery room to continue monitoring your vital signs. Once you are alert, your surgeon will discuss your results and a team member will notify you when it is time to go home. 

While visiting our practice, we will also give you a securely fitting head wrap with ice packs and a post-op care bag to increase your comfort while recovering at home. 

Recovering At Home 

  • Rest – Plan to rest at home for the remainder of the day. Avoid strenuous activity and exercise for at least a week after surgery to prevent blood clots from coming out of the tooth sockets. 
  • Discomfort – Take Tylenol or ibuprofen for moderate discomfort. For severe discomfort, take pain medication and/or antibiotics to prevent infection as prescribed by your oral surgeon. 
  • Nausea – If you experience nausea after wisdom teeth removal, do not take anything by mouth, including prescription medication from your surgeon. Wait an hour, then slowly sip mild tea, ginger ale, or cola to calm your stomach. Nausea usually improves within four to six hours. 
  • Swelling – After oral surgery, swelling is your body’s reaction to the procedure and a natural phase in the healing process. You can decrease swelling by applying a cold pack to the sides of your face every 30-40 minutes for 24 hours after surgery. You can continue to use cold packs as needed for swelling and stiffness for up to 36 hours. After 36 hours, apply moist heat to the sides of your face instead of cold packs. 
  • Mild bleeding – You can control slight bleeding or discharge from the tooth sockets by changing the gauze pads every 30 minutes for several hours. Bite firmly on the gauze for 30 minutes if bleeding continues. 
  • Oral hygiene – During the first 24 hours after surgery, use warm salt water to gently rinse your mouth after eating, but avoid spitting as it can dislodge blood clots. After the first 24 hours, you can gently brush your teeth with a soft toothbrush while avoiding the extraction sites. 
  • Tobacco use – Avoid tobacco use throughout the healing process. Tobacco can constrict blood vessels and interrupt healing. 

Your Follow-Up 

One week after your surgery, we will reach out for a post-op call to check on your recovery and give you instructions for continued at-home care. 

What Can You Eat and Drink After Wisdom Teeth Removal? 

For the first 24 to 48 hours after surgery, eat soft, cold, or lukewarm foods that are nutritious, easy to swallow, and require little to no chewing. Hot foods can dissolve blood clots, so please avoid them. If food gets stuck in any wisdom teeth sockets, gently rinse your mouth with warm salt water. 

Here is a list of foods to eat and those to avoid: 

Foods To Eat 

  • Applesauce 
  • Avocados 
  • Bananas 
  • Flaky fish 
  • Mango 
  • Mashed potatoes 
  • Smooth nut butter 
  • Soft, baked fruits, such as apples or peaches 
  • Soft steamed or pureed vegetables, such as green beans, peas, carrots, or squash 
  • Yogurt 

Foods To Avoid 

  • Acidic foods, including oranges, lemons, or tomatoes 
  • Apples and other crunchy fruits 
  • Chewy or sticky foods 
  • Crunchy vegetables 
  • Meats 
  • Nuts 
  • Popcorn 
  • Soft fruits with tiny seeds, such as strawberries or kiwi 
  • Spicy foods, including hot peppers or curry 


Drinking plenty of water will hydrate your body and promote healing. Smoothies can be nutritious while requiring little to no chewing. Just make sure to avoid drinking smoothies that contain nuts or seeds. 

What else should you avoid? 

  • Drinking through a straw for 24 to 48 hours after surgery 
  • Acidic or carbonated beverages 
  • Alcoholic beverages for at least 24 hours after surgery 

When Can You Return to Your Regular Diet? 

Two days after wisdom teeth removal, you can progress to eating foods that require a little more chewing. Your jaw stiffness may limit how much you can chew. However, your gum tissue, bone, and tooth sockets will still be sensitive for about two weeks. So, continue to avoid small crunchy foods, including nuts and seeds, that can get stuck in or irritate the surgical sites. 

How Long Is Healing Time After Wisdom Teeth Removal? 

Most of the healing after wisdom teeth removal occurs within two weeks, and many patients can resume normal activities within two or three days. Complete recovery of the surgical sites can take about six weeks. 

Healing Timeline 

  • 24 hours – Blood clots form and swelling begins 
  • Two to three days – Swelling peaks 
  • Four to seven days – Discomfort is minimal or gone, and sutures dissolve 
  • Eight to ten days – Stiffness and soreness goes away 
  • Two weeks – Mild facial bruising fades 
  • Three to four weeks – New tissue grows, and surgical sites close 

When Can You Return to Work or School? 

Most people can return to work or school two to three days after wisdom teeth removal. Your current medical condition and how well you follow post-surgery instructions can affect when your oral surgeon approves your return. 

Will You Experience Any Complications? 

Most cases of wisdom teeth removal do not have long-term complications. Many complications after surgery are common and not a cause for alarm. 

You may experience: 

  • Dizziness or lightheadedness if you stand up suddenly 
  • Dry or cracked lips 
  • Low fever 
  • Numbness in your lip, chin, or tongue 
  • Sore throat or pain while swallowing 

When Should You Call Your Oral Surgeon? 

Call your oral surgeon if you experience excessive bleeding, swelling, pain, or other symptoms that increase or last longer than indicated in your post-surgical instructions. 

Does Insurance Cover Wisdom Teeth Removal? 

Many dental insurance plans provide some coverage for wisdom teeth removal. However, copays, deductibles, and yearly maximums apply. Check with your dental insurance company for information on the level of benefits for wisdom teeth removal in your plan. 

Schedule A Wisdom Teeth Removal Consultation 

If you’re in the DC Metro Area or the surrounding areas and need wisdom teeth removal, come to Virginia Advanced Surgical Arts. Our oral surgeons are board-certified oral and maxillofacial surgeons with several years of combined surgical experience. Call us or complete our online form today to request a consultation with our surgeons