Prepare for wisdom teeth extraction and recover smoothly. Covers pre-appointment steps, anesthesia options, what to expect during the procedure, post-operative care, diet during recovery, and warning signs to watch for.
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Estimated time: 1-2 weeks total
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Before the Procedure
Attend your consultation and review the X-rays with your oral surgeon
The initial consultation includes a panoramic X-ray showing the position of all four wisdom teeth relative to nerves and sinuses. Your surgeon will explain whether your teeth are impacted (trapped under the gum or bone), the recommended anesthesia type, and any specific risks based on tooth position. The consultation typically costs 100-200 USD and may be covered by dental insurance. Ask about the total cost of the extraction (typically 225-600 USD per tooth, or 800-2,400 USD for all four).
Choose your anesthesia option and understand what each involves
Options include local anesthesia (numbing injections only, you are awake), IV sedation (you are sedated but breathing on your own, most patients remember nothing), and general anesthesia (fully unconscious, used for complex cases). IV sedation is the most common choice for removing all four teeth and costs 250-500 USD additional. If choosing IV sedation or general anesthesia, you must fast for 8 hours before the procedure.
Arrange a ride home and someone to stay with you for 24 hours
If receiving IV sedation or general anesthesia, you cannot drive for 24 hours. Arrange a responsible adult to drive you home and stay with you. Under sedation, you may be groggy, confused, or emotional for several hours after the procedure. Your companion should be able to pick up your prescriptions, prepare soft foods, and help you follow post-operative instructions while you are still drowsy.
Stock up on soft foods and recovery supplies
Buy before the procedure: applesauce, yogurt, mashed potatoes, soup (broth-based, not chunky), smoothie ingredients (bananas, protein powder, milk), ice cream, Jello, and scrambled eggs. Recovery supplies: gauze pads (your surgeon provides initial gauze), ibuprofen (600-800 mg doses for swelling), ice packs or frozen peas, and extra pillows to keep your head elevated while sleeping.
Day of the Procedure
Follow fasting instructions and wear comfortable clothing
If receiving IV sedation: no food or liquid for 8 hours before surgery. If receiving only local anesthesia: eat a light meal beforehand (you may not want to eat for several hours after). Wear a short-sleeved shirt (for IV access), comfortable pants, and slip-on shoes. Do not wear contacts, jewelry, or nail polish. Arrive 15-30 minutes early to complete paperwork.
Understand what happens during the extraction
The procedure takes 30-60 minutes for all four teeth. With IV sedation, you will feel nothing and likely remember nothing. The surgeon makes an incision in the gum, removes any bone blocking the tooth, extracts the tooth (sometimes in pieces), and places dissolvable stitches. You wake up in a recovery area with gauze in your mouth. The most common sensation upon waking is numbness and slight confusion.
First 24 Hours of Recovery
Bite on gauze pads to control bleeding for the first 30-60 minutes
Keep firm, constant pressure on the gauze for 30-60 minutes without peeking. Replace gauze every 30-45 minutes until bleeding significantly slows. Some oozing and blood-tinged saliva is normal for 24-48 hours. If heavy bleeding continues after 2 hours of consistent gauze pressure, bite on a moistened black tea bag (tannic acid promotes clotting) for 30 minutes. Contact your surgeon if bleeding does not slow.
Apply ice packs to your cheeks in 20-minute intervals
Ice reduces swelling and pain. Apply ice packs (or frozen peas wrapped in a towel) to both cheeks for 20 minutes on, 20 minutes off during the first 24-48 hours. Swelling peaks on days 2-3 and gradually resolves over 5-7 days. After 48 hours, switch from ice to moist heat (warm washcloth) if swelling persists. Sleeping with your head elevated on 2-3 pillows also reduces swelling.
Take pain medication before the numbness wears off
Take your first dose of prescribed pain medication or ibuprofen (600-800 mg) while your mouth is still numb (about 1-2 hours after surgery). Staying ahead of the pain is much easier than catching up once it becomes severe. Alternate between ibuprofen and acetaminophen every 3 hours for the best pain control. Prescription opioids may be given for severe cases but should be used sparingly and only for the first 2-3 days.
Eat only cold, soft foods and drink plenty of fluids
Stick to cold foods on day 1: smoothies (no straw), yogurt, applesauce, ice cream, and cold soup. Drink plenty of water. Do not use straws for 5-7 days because the suction can dislodge the blood clot and cause dry socket (the most common complication). Do not eat hot foods on day 1. Gradually transition to lukewarm soft foods (mashed potatoes, scrambled eggs, oatmeal) on day 2-3.
Recovery Days 2-7
Continue soft foods and add gentle rinsing on day 2
Starting 24 hours after surgery, gently rinse your mouth with warm salt water (1/2 teaspoon salt in 8 ounces of warm water) after meals and before bed. Do not spit forcefully. Let the water fall out of your mouth. Continue soft foods for 5-7 days. Gradually reintroduce firmer foods as comfort allows. Avoid crunchy, hard, or spicy foods until the extraction sites have closed (typically 7-10 days).
Do not smoke, use a straw, or spit for at least 5-7 days
Smoking is the single biggest risk factor for dry socket (exposed bone in the extraction site, extremely painful). Avoid smoking for a minimum of 72 hours, ideally 7+ days. Straws and spitting create suction that can dislodge the blood clot. Dry socket occurs in approximately 5% of extractions (up to 30% in smokers). If you develop severe, throbbing pain on days 3-5 that worsens and radiates to your ear, contact your surgeon immediately.
Resume brushing carefully, avoiding the extraction sites
Brush your other teeth normally starting on day 2, but avoid the extraction sites for 7 days. A baby toothbrush or extra-soft brush can help. If your surgeon provided a syringe for flushing the lower extraction sites (common for impacted lower wisdom teeth), begin using it on day 5-7 as instructed. Gently flush with warm salt water to remove food debris that collects in the healing sockets.
Full Recovery
Attend your follow-up appointment if scheduled
Some surgeons schedule a follow-up at 1-2 weeks to check healing, remove non-dissolvable stitches (if used), and address any concerns. If you develop signs of infection (increasing pain after day 3, fever, pus, persistent bad taste), contact your surgeon before the scheduled follow-up. Most extractions heal uneventfully and do not require follow-up if dissolvable stitches were used.
Return to normal eating and activities within 1-2 weeks
Most people return to school or work within 2-4 days (desk work) or 5-7 days (physical work). Resume exercise gradually after 5-7 days (light activity first, then increase intensity). Full gum healing takes 3-4 weeks. Bone in the extraction site fills in completely over 3-6 months. By 2 weeks, you should be eating normally. Call your surgeon if pain persists beyond 10 days or if you notice any unusual symptoms. This guide is informational only, not medical advice.
Frequently Asked Questions
How long does wisdom teeth recovery take?
Most people feel significantly better by day 3-4. Swelling peaks at days 2-3 and resolves by day 5-7. Most people return to work or school within 2-4 days. Soft food diet is recommended for 5-7 days. Full gum healing takes 3-4 weeks. Complete bone healing in the socket takes 3-6 months. Avoid strenuous exercise for 5-7 days. If you develop dry socket (5% of cases), recovery extends by 7-10 additional days.
How much does wisdom teeth removal cost?
Without insurance: 225-600 USD per tooth for simple extraction, 300-800 USD per tooth for surgical extraction of impacted teeth. All four teeth: 800-3,200 USD. IV sedation adds 250-500 USD. Dental insurance typically covers 50-80% of surgical extractions with annual maximums of 1,000-2,000 USD. Some oral surgeons offer payment plans. The consultation (100-200 USD) may be credited toward the procedure.
What is dry socket and how do I prevent it?
Dry socket (alveolar osteitis) occurs when the blood clot in the extraction site dissolves or dislodges, exposing the underlying bone and nerves. It causes severe, radiating pain on days 3-5 that does not respond well to pain medication. Prevention: do not smoke (biggest risk factor), do not use straws for 7 days, do not spit forcefully, and follow all post-operative care instructions. Treatment involves your surgeon placing a medicated dressing in the socket, which provides immediate pain relief.
Should I remove wisdom teeth if they are not causing problems?
Recommendations vary. The American Dental Association suggests removal if wisdom teeth cause pain, infection, cysts, damage to adjacent teeth, or if they are partially erupted (prone to bacteria buildup). Many dentists recommend preventive removal in the late teens or early 20s when roots are less developed and recovery is faster. Fully erupted, properly aligned, and cleanable wisdom teeth may not need removal. Discuss the risks and benefits specific to your X-ray findings with your dentist or oral surgeon.