Oral & maxillofacial2 min read

Tooth extraction and wisdom teeth

When a tooth needs to come out, what removal involves, and how recovery usually goes.

Stone Surgical ArtsOriginally published February 11, 2026Updated September 9, 2026

Perspective from Stone Surgical Arts

Extraction is one of the most common procedures in oral surgery, and wisdom teeth account for a large share of it. Whether a tooth needs removing is a clinical judgement rather than a rule.

A thought to keep

Not every wisdom tooth needs removing. Ask what specifically is wrong with yours, and what happens if it stays.

Why a tooth might need removing

Common reasons include decay or damage beyond repair, advanced gum disease affecting the supporting bone, infection, or a tooth positioned so that it damages its neighbour. Extraction is sometimes part of orthodontic planning.

Wisdom teeth are removed when they are impacted and causing problems: repeated infection of the overlying gum, decay that cannot be treated, damage to the tooth in front, or an associated cyst.

When removal is not automatic

A wisdom tooth that has come through, is cleanable and is causing no trouble does not necessarily need removing. Being impacted is not on its own a reason if it is causing no symptoms or damage.

Ask what the specific indication is in your case, and what monitoring would involve if you chose to keep the tooth under review.

What the procedure involves

Most extractions are done with local anaesthetic; sedation is available and is discussed beforehand. A straightforward tooth is loosened and lifted out. An impacted tooth may need an incision in the gum and removal of a small amount of bone, and the tooth may be divided to remove it in pieces.

Imaging beforehand shows the position of the roots and their relationship to the nerve in the lower jaw, which is what the risk discussion is based on.

Recovery

Swelling and discomfort peak in the first two to three days and then settle. Follow the instructions on rinsing, eating and activity: the clot in the socket is what healing depends on, and disturbing it early is the usual cause of problems.

Contact the practice if pain increases after a few days rather than easing, if bleeding does not settle, or if you develop a fever. Altered sensation in the lip or tongue should also be reported.

Adapted from the Stone Surgical Arts archive and updated for clarity. This article offers general information; an individual consultation is needed for treatment advice.