Guide to Wisdom Teeth Removal and How to Prevent Dry Socket

Wisdom teeth are one of the greatest mouth mysteries – we’re not quite sure when and how they’ll show up or whether we’ll get to keep them or need an extraction.

Whether you’re wondering if your wisdom teeth are coming in, whether you’ll need a wisdom tooth extraction and what it’s like, or how to help your mouth heal after that oral surgery – this post is for you.

Read on for everything you need to know about wisdom teeth!

What are wisdom teeth?

Wisdom teeth are the third and final set of molars – flat-topped teeth found at the back of the mouth that help us grind down food before swallowing – and the last 4 teeth to come in at the back of the mouth (top and bottom).

What’s the purpose of wisdom teeth?

Many anthropologists believe that historically, wisdom teeth functioned to help our ancestors grind and chew food that was raw and hard to masticate.

Even though our modern diet, rich in tender, fully cooked food no longer requires these teeth, we’re still genetically programed to grow them, though some people never get wisdom teeth!

When do wisdom teeth come in?

Wisdom teeth usually appear long after the other adult teeth, with most breaking through the gum line between the ages of 17 and 25 (though they may be spotted on x-rays sooner).

Hence the word “wisdom” – which stems from the idea that these molars surface at a time we associate with increased maturity.

It’s important to note not all of your wisdom teeth may come in at the same time as other people you know, or for yourself!

little girl eating an apple

One tooth may come in first, followed by two more teeth in another year before the final tooth appears years after the first. Dental x-ray exams can help you stay aware of your wisdom teeth’s progress or lack thereof.

And as we mentioned above, not everyone gets all or any of their wisdom teeth – you may only get one or two or none at all; wisdom teeth are the most common teeth to be missing.

What are the symptoms of wisdom teeth coming in?

Here are a few signs of wisdom teeth coming in:

  • Swollen or visibly cut gums.
  • Pressure or throbbing in the gums toward the back of your mouth.
  • Jaw pain or pain in the back of your mouth (though it could also be TMJ).
  • Severe pain that radiates toward your eyes, ears, or head might mean an impacted wisdom tooth has become abscessed.
  • Persistent headaches or earaches might be caused by wisdom teeth emerging without enough room in your mouth; the pressure can build up in surrounding tissues and teeth causing wisdom tooth related pain.
Man with tooth pain from his wisdom teeth

Signs your symptoms probably aren’t due to wisdom teeth coming in:

  • Painfulness when you bite down along with a visible hole in a tooth or staining is likely a cavity.
  • Persistent toothaches or sensitivity that lasts a few minutes or more after eating or drinking hot, cold, or sweet foods might be a sign of nerve damage.
  • Non-lingering sensitivity to the above types of food might indicate an exposed tooth root.

Ultimately pain, along with noticeable breaks and tears in the gums at the back of your mouth between the ages of 17 and 25 are the most obvious signs of wisdom teeth coming in.

However, it’s important to note that not everyone experiences wisdom tooth pain – so if you’re unsure, consult with your dentist!

Why remove wisdom teeth?

Wisdom tooth removal is one of the most commonly performed dental surgeries.


Because in many cases, inadequate space in the mouth prevents wisdom teeth from properly erupting and becoming fully functional.

If this happens, one or more wisdom teeth can become impacted (stuck under the gumline) in a position that could contribute to infection, cysts, damage to other teeth, and even tumors.

Even partially emerged wisdom teeth pose a threat as it’s easier for food particles to become trapped around the tooth and gums which leads to plaque build up and can cause tooth decay, gum disease, or abscesses.

And while not all wisdom teeth grow in crookedly (as is commonly believed), those that do can cause damage to nearby teeth and even jaw and nerve damage.

It’s important to note that for these reasons, your dentist may recommend a wisdom tooth removal even if you’re not experiencing any pain.

However, there are many lucky young adults who have no problems with their wisdom teeth – they have enough space in their mouths for them, all the teeth emerge through the gumline and are straight enough to not damage or misalign other teeth.

If this is the case, there’s no need for removal!

It’s important to note here that no two mouths are alike; even in the same family, one sibling may need all four teeth extracted while another may have no issues keeping theirs.

Which is why, once again, we recommend consulting your family dentist about the best options for you.

This is an image of a woman getting her teeth cleaned to prevent any cavities in her mouth.

How are wisdom teeth removed?

The exact steps of your wisdom teeth removal procedure will depend on how developed the teeth are, whether they’ve broken through the gum line, and how much (if any) damage has been caused to the rest of your mouth.

While your dentist or oral surgeon will describe your specific situation to you, here’s the general process for wisdom tooth removal (and other tooth extractions):

  • Prior to surgery, you’ll receive a local anesthetic to numb your mouth; if you’re having multiple teeth removed, you may receive a sedation or a general anesthetic which will make you unconscious during the procedure.
  • During the procedure, your dentist will make an incision in any gums above impacted wisdom teeth and remove any bone covering them before removing the teeth themselves.
  • After the surgery, you may receive stitches to help the area heal and cotton gauze will be inserted to prevent bleeding.

Wisdom teeth that have broken through the gumline are easily extracted, so your dentist may choose to wait until this has happened to perform surgery.

One of the most difficult wisdom tooth removal procedures occurs when one or more teeth are embedded in the jawbone, as this requires breaking the teeth and removing them in parts.

We generally recommend seeing an oral surgeon for wisdom teeth removal, as these specialists tend to have more experience in handling anything unexpected that might come up during your surgery.

That being said, because wisdom tooth removal is so common, many family dentists routinely perform this procedure and may be a good option for you.

Just be sure to talk to them about their experience, and ask if they have a dental drill specifically for oral surgery – the same drill they use for fillings and crowns shouldn’t be used for wisdom teeth surgery as it can cause an air embolism, a serious complication.

Preparing for wisdom teeth surgery

Wisdom tooth removal is an outpatient procedure – meaning you’ll get to go home the same day.

Depending on the anesthesia used, you may be able to drive home, though it’s best to plan on having someone else do so for you.

Your anestesia will also determine whether you can take prescription or non-prescription medications, and whether or not you should fast (as in not eating).

Before leaving your house, be sure you’ve brushes, flossed, and tongue-scraped as you won’t be able to for a few days after surgery.

Also be sure to setup a home “recovery center” with water, elevated pillows, a place to sleep, tv, music and anything else to help you stay comfortable.

And stock up on pre-made food (there are plenty of wisdom tooth recipes out there) as you’ll likely have trouble or be unable to cook for a few days (from the pain and medications).

Staying comfortable during wisdom tooth removal

Here are a few tips for staying comfortable during your wisdom tooth surgery:

  • Bring a blanket to alleviate anxiety.
  • Ask your surgeon if you can take valium the night before and the morning of.
  • Avoid hyperventilating.
  • Bring a friend who’s had the procedure to hold your hand.
  • Wear comfortable, loose clothing with layers.
  • Bring earbuds to isolate outside noises and listen to music or podcast.
  • Distract yourself with a favorite phone app or game.

What to expect after the procedure

If you receive sedation or general anesthesia you’ll be taken to a recovery room after the procedure for a few hours to allow you to naturally return to consciousness; with local anesthesia you’ll only need a few minutes in the dental chair.

After observation to ensure your breathing is normal and bleeding has stopped, you’ll be allowed to go home.

This is an image of Dr. Wyne and a dental hygienist having a friendly conversation with a patient

How long does it take for wisdom teeth to heal?

Wisdom tooth recovery time varies from person to person, with healing taking typically between a couple days to a week or two. In very rare cases, recovery may last longer than that but that is usually due to improper care after surgery.

A few factors that affect your recovery include:

  • The type of anesthesia you choose – local anesthesia or nitrous take a lot less time to recover from than sedation or general anesthesia.
  • Your nutrition during recovery – eating mostly soft, sugary foods like jello and ice cream will hinder the healing process.
  • Whether you get one or more dry sockets (more on preventing those below).

During your recovery, it’s important to follow the directions provided by your dentist or oral surgeon to avoid aggravating your gums or ruining your stitches with harsh foods, drinks, or suction.

If your dentist used non-dissolving stitches, they’ll be removed about a week after the surgery.

Whether this needs to be done or not, your dentist will also schedule a checkup to check on the healing process and let you know how you’re progressing.

While most of your recovery will be complete after a few weeks at most, here are a few things you might experience for up to a year as a result of wisdom teeth surgery:

  • Thinning of your face due to the lack of wisdom teeth supporting your cheeks and muscles.
  • Cold sensitivity on your second molars (the ones right in front of wisdom teeth).
  • Little folds in your gum line as your jaw bone remodels itself as part of the recovery process.
  • A small occasional bone ache (likely caused by bone remodeling).

Wisdom teeth removal recovery tips

The fastest, safest way to recovery from wisdom tooth extraction is to strictly follow your dentist or oral surgeon’s instructions.

These vary, but will generally include some or all of the following:

  • Keep your head elevated and ice your jaw for the first 3 days to reduce inflammation.
  • Don’t swish, blow, spit, smoke, rinse or drink from a straw to prevent dry socket.
  • No brushing to avoid opening your stitches.
  • Drink lots of water to stay hydrated.
  • Avoid solid, hot, and cold foods for the first 24 hours to avoid irritation.
  • Rest as much as possible and avoid activity to prevent disturbing your gums.

If you notice any of the following symptoms during your wisdom tooth recovery, call your dentist’s emergency line as they may indicate a serious complication:

  • Any tingling or loss of sensation
  • Fever
  • Pus in or around your extraction sites
  • Unbearable pain that isn’t helped by your pain medication
  • Difficulty swallowing or breathing
  • Excessive bleeding from your gums
  • Blood or pus in a nasal discharge
  • Swelling that gets worse two or three days after surgery

How to prevent dry socket after wisdom teeth extraction

One of the most common teeth extraction complications people experience from wisdom tooth surgery is dry socket.

This occur when the blood clot(s) that covers the socket hole(s) left by the extracted tooth gets knocked loose or dissolves too quickly, which leaves the bone and nerve exposed to irritants like air, food, and fluids.

This not only results in pain and discomfort, but also increases healing time as the blood clot not only prevents excessive bleeding but also stimulates bone recovery.

Dry sockets will typically occur within the first week of surgery and can last from 7-10 days, but are a rare occurrence (they only happen in about 5% of all tooth extractions).

woman smiling after she has healed from a tooth extraction

How do you know if you have dry socket?

The best way to tell is timing.

Post-extraction pain typically peaks within a day of wisdom tooth removal, while dry socket pain peaks between 3 and 5 days later, with pain radiating up and down your face particularly when consuming cold drinks and breathing cold air.

Other dry socket symptoms include earaches, bad breath, and an unpleasant taste in your mouth.

Dry socket can be prevented by avoiding the following for the first few days or week after surgery:

  • Drinking from a straw and drinking hot, acidic, or carbonated beverages
  • Smoking
  • Swishing
  • Exercise or blunt force trauma to the mouth
  • Coughing and sneezing
  • Consuming foods that easily get stuck in your teeth, like nuts and seeds

If you do get dry socket after wisdom tooth extraction surgery, you can manage your symptoms at home – in most cases, it’ll heal on its own.

However we recommend seeing your dentist or oral surgeon to stay on the safe side.

They can also pack your sockets with a dressing that contains soothing ointments to relieve pain and promote faster healing.

Need Wisdom Teeth Removed? has an amazing team of dentist and hygienist for all of your dental care needs. Many doctors refer out Wisdom Teeth and  Tooth Extractions but we do them in-house. This way you already know our staff, are comfortable with our practice, and we’ll take amazing care of you before, during, and after your procedure.

If you need your wisdom teeth removed or are looking for a dentist in Rockville Maryland, feel free to call us and our lovely treatment coordinators will help you schedule an appointment at your convenience.


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