Not every wisdom tooth needs to be removed. Some can stay healthy and useful; others cause problems or carry a meaningful risk of future damage. The decision should follow an examination and a discussion of the benefits and risks of removal or monitoring. Having no pain is helpful, but it does not by itself tell you whether a wisdom tooth is healthy. [1] [2]
What makes wisdom teeth different?
Wisdom teeth are the third molars at the very back of the mouth. They usually appear in the late teens or early adulthood. A tooth is called impacted when it cannot come through normally, such as when it is blocked by another tooth or remains beneath the gum.
A partly erupted or poorly positioned wisdom tooth can be difficult to keep clean. Food and bacteria may collect around it, and the nearby tooth and gums may also be affected. These are reasons to have the area checked, even when you cannot see much of the tooth yourself. [1]
When might removal be recommended?
A dentist may recommend removal because of infection, gum disease, decay that cannot reasonably be restored, damage to a nearby tooth, or a cyst or other abnormal change. Pain can be a reason to investigate, but the source of the pain needs to be identified before choosing treatment. [1] [2]
Contact a dentist if you notice recurring soreness behind your last molar, swollen gums, an unpleasant taste, or difficulty opening your mouth. Those symptoms need assessment; they are not a reliable do-it-yourself test for deciding which tooth should come out. [3]
Get emergency medical care for trouble breathing or swallowing, swelling around an eye, or a large amount of swelling inside the mouth. Do not wait for a routine dental appointment with those symptoms. [5]
When can a wisdom tooth be monitored?
A healthy wisdom tooth that has grown into a useful position and can be kept clean may be able to stay. Keeping it involves ongoing professional checks and cleaning, with imaging when appropriate. Monitoring means planned follow-up, not ignoring the tooth until it hurts. [6]
Ask what the follow-up plan includes and what changes should prompt an earlier visit. The plan may change if a new problem develops. Discuss the balance between the risks of keeping the tooth and the risks of surgery for your own situation. [4]
What happens at an evaluation?
Your dentist reviews your symptoms and medical history, examines the teeth and gums, and uses appropriate imaging to understand the tooth's roots and nearby structures. This helps distinguish problems with a wisdom tooth from other causes of discomfort and guides a discussion of treatment. [2]
Some extractions can be managed by a general dentist. Others need an oral surgeon because of their complexity or the patient's medical needs. A consultation does not necessarily mean removal that day. [4]
Useful questions to bring include:
- What problem do you see, and which tooth is causing it?
- What are the likely benefits and risks of removing or keeping it?
- Would treatment be provided here or through a referral?
- What costs, time away from work, and transportation should I plan for?
What happens during removal?
Local anesthetic is commonly used to numb the area. Depending on the tooth, removal may involve an opening in the gum, dividing the tooth into smaller pieces, or stitches. Discuss any anxiety ahead of time so the treating clinician can explain suitable anesthesia or sedation choices. [3]
How long does healing take?
Feeling better and finishing healing are different milestones. Many people feel substantially better within a week, but soreness, bruising, or jaw stiffness can last about two weeks. A difficult extraction may take longer. The gum and bone keep healing after you feel ready to return to your usual routine. [3] [9] [10]
| Time after surgery | What to expect |
|---|---|
| First 2–3 days | Pain and swelling are often most noticeable. Swelling may increase for about 72 hours before starting to settle. [8] |
| About 1–2 weeks | Comfort and jaw movement generally improve. Some people resume light daily activities sooner; others need several days off work. Follow your clinician's instructions about exercise and driving after sedation. [3] |
| Several weeks | The gum opening gradually closes. Closure can take a few weeks, so keep following your cleaning instructions even when pain has eased. [8] |
| Following months | Bone reshaping is slower than gum healing. It can continue for months; feeling comfortable does not mean the bone has finished remodeling. [9] |
These are typical stages, not deadlines. Follow your own aftercare instructions for eating, cleaning, activity, and medicines. Severe pain, increasing swelling, or a fever needs advice rather than simply more time. [3]
For meal ideas and practical home care, read our guide to dry socket, foods to eat after an extraction, and aftercare.
How common are numbness and permanent nerve problems?
Paresthesia means an unusual feeling, such as tingling or pins and needles. A nerve injury can also cause reduced feeling, numbness, or occasionally painful sensations. This risk mainly concerns lower wisdom teeth, which can lie near two sensory nerves. [7]
- Inferior alveolar nerve: supplies feeling to the lower lip, chin, and lower teeth.
- Lingual nerve: supplies feeling to the tongue and is involved in taste. [10]
There is no single percentage that fits every extraction. For context, the Royal College of Surgeons of England's patient guide gives these general estimates: [7]
| What is being counted? | Estimate in that guide |
|---|---|
| Nerve injury, usually temporary | Up to 2% of patients — about 2 in 100. This includes nerve injuries overall; it is not a temporary-only rate. |
| Permanent nerve injury | About 0.5% of patients — 1 in 200. |
Higher-risk lower teeth are a different situation. When a lower wisdom tooth lies close to the lip-and-chin nerve, that same guide quotes approximately 20% temporary injury and 2% permanent injury for those higher-risk patients. Those figures do not apply to every lower wisdom tooth. [7]
These are counseling estimates from one published source, not your personal odds or this clinic's measured complication rate. Other sources report different rates. Ask your surgeon how your imaging and planned procedure affect the risk to each nerve. If the roots are very close to the nerve, a specialist may discuss a coronectomy: removing the crown while leaving selected roots in place. It is not suitable for every tooth and may need later treatment. [4]
If numbness happens, how long can it last?
Numbness from local anesthetic usually lasts several hours. Ask how long the medicine used for your procedure should last. Numbness beyond that expected period is different from routine soreness and should be reported to the treating dentist or surgeon. [8] [10]
Temporary nerve symptoms can improve over weeks or months. Recovery can sometimes take as long as 18 months, and some people do not regain normal feeling completely. Symptoms that persist early on do not by themselves establish that an injury is permanent. Your clinician needs to assess the affected area and follow changes over time. [3] [4]
Do not wait months to report it. Contact your treating clinician promptly for unexpected numbness, persistent tingling, burning, or altered tongue sensation after the anesthetic should have worn off. Ask about assessment, follow-up, and whether specialist referral is appropriate. While an area is numb, be careful not to bite it or burn it with hot food or drinks. [10] [8]
What other complications should you watch for?
- Dry socket: the protective blood clot breaks down or is lost. Pain may become more intense several days after removal, sometimes with a bad taste or odor. Contact the dental team for an examination and treatment. [3] [9]
- Infection: fever, feeling unwell, pus, or increasing pain and swelling need prompt dental advice. [9]
- Bleeding: some blood-stained saliva can occur. Contact your treating clinician if bleeding continues despite following the pressure instructions you were given. [8]
- Nearby structures: a neighboring filling or crown can be damaged. Upper wisdom-tooth removal can sometimes create an opening to the sinus. Your surgeon should explain risks specific to your tooth. [10]
Use emergency medical care for trouble breathing or swallowing, swelling around an eye, or severe swelling inside the mouth. [5]
Common questions about wisdom teeth
Do all four wisdom teeth have to come out?
Not automatically. Ask the dentist to explain the recommendation for each tooth. A treatment plan should reflect the findings and the reasons for keeping or removing it. [2]
Is there one best age for removal?
Age is one consideration, along with tooth position, disease, root development, and surgical risk. It is more useful to arrange an assessment than to assume everyone should have surgery at a particular birthday. [2]
When should I call after an extraction?
Contact your treating dentist or surgeon for bleeding that will not stop, severe or worsening pain or swelling, fever, an unpleasant taste with pain, or unexpected numbness after the anesthetic should have worn off. Use emergency medical care for the breathing, swallowing, or severe swelling symptoms described above. [3] [5] [10]
Planning a visit in Yankton
Read about tooth extractions at Yankton Dental Clinic, then contact the office for an evaluation. If you are anxious, mention it when arranging your visit and ask about sedation options. The dentist can discuss what is appropriate for your procedure and whether a referral is needed.
Sources
- ADA MouthHealthy — Wisdom Teeth
- AAOMS — Management of Third Molar Teeth
- NHS — Wisdom tooth removal
- British Association of Oral and Maxillofacial Surgeons — Removal of Impacted Wisdom Teeth
- NHS — Dental abscess
- AAOMS MyOMS — Wisdom Teeth Management
- Royal College of Surgeons of England — Get Well Soon: Removal of Wisdom Teeth (nerve-risk estimates, page 5)
- University College London Hospitals — Dental extractions: post-operative instructions
- Royal Cornwall Hospitals — Following your wisdom tooth extraction
- Hull University Teaching Hospitals — Removal of Wisdom Teeth (Third Molars)
This guide provides general information and does not replace an examination or advice based on your health history.
Talk with a dentist in Yankton.
Learn about tooth extractions and arrange an evaluation to discuss monitoring, treatment options, or a referral when needed.