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Patients often have some misplaced conception about dentistry and getting their wisdom teeth extracted in particular. We outline the procedure of surgical wisdom tooth extraction in this article and the aftercare steps to minimize infection afterward.

Getting a tooth extracted can be scary enough for some patients but when they come to know that their wisdom teeth will require oral surgery, they really start to freak out. Thankfully, wisdom tooth extraction surgery is relatively minor and is carried out routinely around the world [1]. Here is what you can expect from the procedure as well as some tips to be comfortable and avoid infection after wisdom tooth removal.

Why is surgery needed to remove a wisdom tooth?

The reason for needing surgery to remove a wisdom tooth is because dentists often do not have direct access it. The wisdom teeth erupt as the last ones in the mouth and end up not having the necessary space to find their place in the mouth. The wisdom teeth can remain partially or completely buried in the bone making it necessary to perform a small incision to be able to visualize the tooth and begin the process of removing it [2].

The clinical reasons for extracting a wisdom tooth could be pain, difficulty in opening the mouth, decay, food lodgment, or just as a preventative procedure so that no such problems arise in the future [3].

What to expect from a surgical wisdom tooth extraction?

The surgery involved in removing a wisdom tooth is minor but it does carry some risks. The lower wisdom tooth is placed in close proximity to the nerve that supplies the entire lower jaw and a few important blood vessels are also in the vicinity [4].

This is why the dentist will ask for x-rays and maybe even a CT scan of the jaw to determine the distance of the tooth from these important structures [5]. A few blood tests to determine blood sugar levels, bleeding time, clotting etc may also be carried out if deemed necessary after the medical history has been recorded [6].

On the day of the surgery, patients will be asked to come after a light meal and with any pre-medication that the doctor prescribed. An antibiotic, a painkiller, or anti-anxiety drugs are among the common drugs used before the procedure.

The entire procedure is carried out under local anesthesia which will be given in the area/areas where the extraction has to be performed. A lot of the times, dentists will extract all four wisdom teeth in one sitting itself [7].

Once the local anesthesia has taken effect, the dentist will make a small incision and begin the process of removing the wisdom tooth. Some amount of drilling to remove the bone as well as to cut the tooth in pieces and then remove it may be carried out [8].

All of this is the dentist's job and patients don’t really have to worry about the specifics. They will feel some mild vibrations and maybe some pressure as the tooth is being extracted. At no point should there be any pain. If, in fact, the procedure does cause you some pain then it is important to let the dentist know so that additional anesthesia may be administered [9].

The time required to remove the tooth can vary according to its clinical difficulty. 25-45 minutes is an average ballpark time span which this procedure can take.

After the extraction is over, the dentist will place a few stitches to close the wound.

What to expect after a surgical wisdom tooth extraction?

The normal amount of healing after a non-surgical extraction takes place around 7 days. In case of a surgical extraction, this time can be around 7-14 days depending upon the aggressiveness of the surgical procedure [10].

Patients must maintain good oral hygiene so that no wisdom tooth removal infection occurs. In fact, poor oral hygiene is the chief reason for infection after wisdom tooth removal.

Avoid eating anything that is too hot, too hard, too spicy, or too acidic. The idea is to minimize the work being done by the chewing muscles as well as not to irritate the extraction socket. The doctor will also advise the patient to not spit for 24-48 hours after the procedure is over. This is very important and can determine the comfort of the patient to a large degree.

We want the extraction socket to begin healing as soon as possible and for that to happen a blood clot must form inside it. Sometimes, patients keep on spitting the blood after the extraction and cause the clot to dislodge. Such a condition leads to the development of a dry socket which is very painful to the patient and delays healing considerably [11].


A wisdom tooth extraction is minor oral surgery but can cause a lot of discomfort if not performed properly or if the patient does not follow the correct precautions. The procedure is not, however, something to fear or avoid because delaying it can often worsen the infection and make the eventual extraction more difficult.

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