Dr. Holli Careswell is a board-certified general and cosmetic dentist with a private practice in Lee’s Summit, Missouri.
Holli Careswell, D.D.S. General Dentistry / Cosmetic Dentistry Updated: Jul 10, 2023, 4:56am Have a question we may not have answered?Ask our editors here
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If you’re a teenager, getting your wisdom teeth removed might feel like a rite of passage. But in reality, wisdom teeth removal isn’t always a given. In fact, many people never get them removed.
Whether you need your wisdom teeth removed depends on a few factors, including your dentist’s professional opinion. Below, we cover what wisdom teeth extraction involves, including its cost, recovery time and potential consequences of skipping it.
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Wisdom teeth are the third molars in the very back of the mouth, typically consisting of four teeth. However, wisdom teeth don’t always erupt, or grow out of the gums, like other adult teeth. Instead, they can remain impacted, which means they don’t come through gums or bone. Both erupted and impacted wisdom teeth are eligible for removal.
The behavior of wisdom teeth varies. You might never experience problems with your impacted teeth while another’s teeth may cause them pain. One person might have only two erupted wisdom teeth while the remaining teeth remain impacted. Some folks don’t have wisdom teeth at all.
Wisdom teeth typically appear between the ages of 16 and 21, and signs that you likely need them removed (or extracted) include:
“I strongly recommend removal before they start causing problems,” says Arun Narang D.D.S., a dentist and oral surgeon at Smile by Design in Ontario, Canada. This period often occurs in the late teen years because the removal procedure is much easier and more predictable at that point, he says. Teenagers don’t have fully formed wisdom teeth and the teeth’s roots are not yet well established. Plus, teenagers are more likely to have a shorter recovery time than adults.
“Hopefully patients are already going to the general dentist for checkups at any age,” says Olga Krikunenko, D.M.D., a dentist at Mint Dental of Franklin in Massachusetts. In these appointments, your dentist can monitor your teeth over the years. Dentists typically take panoramic x-rays every few years (although higher risk patients may need it done more often) to assess the positioning and growth of your wisdom teeth.
Not everyone needs wisdom tooth removal. Once someone reaches their mid-20s without their wisdom teeth bothering them, Dr. Narang recommends monitoring them and dealing with them only if they start to cause problems.
Wisdom teeth should be removed by a dentist or oral surgeon, also called a maxillofacial surgeon. The procedure usually happens in your dentist’s or surgeon’s office, but it could be moved to a hospital if you’re at risk for complications.
Before the surgery, a local anesthetic is typically administered to numb the area, but you may elect to receive a general anesthetic (which puts you to sleep) depending on your situation.
After anesthesia, your dentist makes an incision in the gums covering the tooth and removes any bone also covering the tooth. They detach the tissue that connects the tooth to the bone and remove the tooth. They may need to cut the tooth into smaller pieces to fully remove it.
Once the tooth is extracted, the gums are stitched closed. These stitches typically dissolve on their own; your dentist will tell you if you need to have any stitches removed. Gauze is placed over the stitches to help stop the bleeding.
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“Recovery is dependent on the extent of the surgery,” says Robert Stanton D.M.D., owner of Stanton Smiles in Fort Lauderdale, Florida. “For example, someone who has four fully erupted wisdom teeth is going to endure a much easier and shorter surgery than someone who has impacted wisdom teeth.”
Typically, wisdom teeth removal recovery lasts three to four days, but for some folks, it might take five to seven days. After that period of time, you can usually return to work or school, says Dr. Narang. You should also have a follow-up appointment within a week or two of the surgery.
Recovery usually involves some pain and swelling, which can be alleviated with painkillers, often prescribed after surgery, and a cold compress to the swollen area. If there’s risk of infection, your dentist may also prescribe antibiotics.
Your dentist will instruct you on what to eat after wisdom teeth removal as well, which is usually limited to soft foods like smoothies, soups and mashed potatoes.
The most common side effect of wisdom teeth removal is a dry socket, which occurs when the wounds don’t clot properly, leaving the nerves and bone exposed and causing pain. Food may also become trapped in the socket, further irritating the area. A dry socket is easily treated by another visit to the dentist, in which they clean it out, apply dry socket paste medication and restitch it, if necessary.
More serious side effects of wisdom teeth extraction include damage to the adjacent molar, nerve injury, numbness, broken roots and sinus aggravation. Your dentist should provide you with information about all of these risks beforehand so you can provide informed consent for the surgery.
The cost of wisdom teeth extraction varies greatly but typically starts around $1,000. Some dental offices quote about $75 to $200 per tooth, but that price varies as well.
Cost depends on:
Wisdom teeth extraction may be covered by your medical and/or dental insurance. “Insurance varies, but it’s considered a basic service and should be covered,” says Dr. Narang. “The extent just depends on your policy.”
In some cases, wisdom teeth don’t need to be removed and don’t cause any problems down the road. But for others, they can lead to unpleasant consequences if left unmonitored and untreated.
Partially impacted wisdom teeth can lead to cavities as a result of improper cleaning at the back of the mouth. Not only can the wisdom tooth grow a cavity, but the second molar can also be affected, which requires double the dental work.
Infection and gum disease can stem from partially erupted wisdom teeth. They not only trap food more easily, but also provide openings for bacteria to enter the gums. Infections can cause pain, swelling and stiffness in the jaw.
In worst-case scenarios, a cyst, or fluid-filled sac, can form on or near an impacted wisdom tooth. This growth can damage the roots of nearby teeth and the bone that supports your teeth.
Historically, crowding was a common concern for wisdom teeth. Nowadays, many dentists and studies find crowding is less of an issue than the concerns listed above.
