Wisdom Tooth Extraction: When It's Needed and What to Expect

By the time a patient comes in asking about their wisdom teeth, they’ve usually been in pain for a few days and someone has told them “they have to come out”. Often that’s true. Sometimes it isn’t. Here’s what I tell patients in Roorkee when they sit down to discuss their wisdom teeth.

What are wisdom teeth and why are they a problem?

Wisdom teeth (third molars) are the last teeth to come in, usually between ages 17 and 25. They’re an evolutionary leftover — our ancestors needed the extra grinding surface for tougher diets, but modern jaws have become smaller while the wisdom teeth haven’t.

The result, for about 70% of people in our region, is that there isn’t enough room for wisdom teeth to emerge correctly. They come in sideways, remain partially buried under gum, push against the tooth in front, or get stuck completely in the jawbone. These are called impacted wisdom teeth, and they cause most of the trouble we treat.

You might not need them removed

This is the part many patients don’t hear enough. Not every wisdom tooth needs to come out. If a wisdom tooth has erupted fully and is straight, you can clean around it, and it isn’t causing decay or gum problems in the tooth next to it — it can stay. We’ve seen plenty of 60-year-olds with all four wisdom teeth in perfect health.

What we look for on your X-ray (OPG) and examination:

Is there space for it to erupt straight?
Is it angled into the second molar (causing damage to a tooth you actually need)?
Is the gum flap over it repeatedly getting infected (pericoronitis)?
Is there a cyst forming around the crown of an unerupted tooth?
Can you reach it to brush and floss properly?

If the answer is “no room, angled, infected, unreachable” — it needs to come out. If the answer is “erupted, clean, no problems” — we leave it alone and monitor it yearly.

Signs your wisdom tooth is in trouble

Come in for an evaluation if you’re experiencing:

Pain at the back of the jaw, often worsening over days
A swollen, red gum flap over the wisdom tooth area
Bad taste or smell that won’t clear with brushing
Difficulty opening your mouth fully
Pain radiating to the ear or jaw joint on the same side
Food constantly trapping behind the second molar

These are usually signs of pericoronitis — infection around a partially-erupted wisdom tooth — which is the most common wisdom tooth problem we treat.

What the extraction actually involves

Wisdom tooth extraction is a broad category. The experience depends heavily on the tooth’s position:

Simple extraction — a fully erupted wisdom tooth with a straight root. This takes 15-20 minutes under local anaesthesia. It feels similar to any other tooth extraction.

Surgical extraction — a partially or fully impacted tooth. We use local anaesthesia, make a small incision in the gum, sometimes remove a tiny amount of bone around the tooth, often section the tooth into 2-3 pieces to remove it gently without forcing the jaw. This usually takes 30-60 minutes. The incision is closed with dissolving sutures.

For patients who are very anxious, or for complex cases involving all four wisdom teeth at once, we offer IV sedation in partnership with an anaesthesiologist.

Despite how it sounds, surgical wisdom tooth extraction is almost always comfortable. Good anaesthesia technique and not rushing are the difference between a difficult experience and a forgettable one.

What recovery looks like

Day 0 (extraction day):

Bite on gauze for 30-40 minutes
Start applying cold compress (15 min on, 15 min off) for the first 24 hours
Take prescribed painkillers before the anaesthesia wears off
Soft, cool foods only — curd, kheer, smoothies, dal-chawal cooled to room temperature
No rinsing, no spitting, no drinking through a straw

Days 1-3:

Expect mild-to-moderate swelling that peaks on day 2 or 3
Some mild discomfort; most patients are off strong painkillers by day 3
Saltwater rinses start the day after extraction (gentle swishing, not vigorous)
Continue soft diet

Days 4-7:

Swelling resolves
Normal diet returns, avoiding the extraction site
Back to work/college typically by day 3-4 for single extractions

Weeks 2-3:

Soft tissue fully healed
Bone continues to heal beneath for 6-8 weeks

Most patients tell me afterwards that they were expecting worse than what actually happened. The horror stories you hear are often from the pre-antibiotic, pre-CBCT era.

Complications (the honest list)

Dry socket (alveolar osteitis) — the blood clot at the extraction site dislodges, exposing bone. It causes severe pain 3-5 days after extraction. It’s uncommon (3-5% of cases) but more common in smokers and with lower wisdom tooth extractions. It’s treated easily at the clinic with a medicated dressing.

Infection — uncommon if antibiotics are prescribed appropriately and oral hygiene is maintained. If you get a fever, increasing swelling after day 3, or pus discharge — come in.

Nerve sensitivity — the lower wisdom teeth sit close to a nerve (inferior alveolar nerve). In about 1% of lower extractions, patients experience temporary numbness of the lip or chin on that side. Permanent numbness is very rare (under 0.5%) and is why we always review a CBCT before a deep impaction extraction.

Jaw stiffness (trismus) — temporary inability to fully open the mouth. Resolves within 1-2 weeks with gentle exercises.

Costs in Roorkee (2026)

At our Roorkee clinic, typical wisdom tooth extraction costs are:

Simple (erupted wisdom tooth): ₹1,500 – ₹3,000
Surgical impaction (soft tissue): ₹4,000 – ₹6,000
Surgical impaction (bony / complex): ₹6,000 – ₹10,000
CBCT scan (for deep lower impactions close to the nerve): ₹2,500 – ₹3,500
IV sedation add-on (for all four at once, or high anxiety cases): additional ₹6,000 – ₹10,000

Do all four at once, or one at a time? Either works. Many patients prefer doing all four under sedation in one sitting to get the whole process over with. Others prefer to do one side at a time so they can eat comfortably on the other side during recovery.

When to come in

If a wisdom tooth is actively hurting, swelling or discharging — this is an urgent issue, not something to wait on. Pericoronitis can progress into a more serious deep-tissue infection if untreated.

If your wisdom teeth aren’t bothering you yet and you just want an evaluation — that’s ideal. The best time to assess wisdom teeth is between ages 17 and 22, before the roots are fully formed. Extractions at this age are simpler, heal faster, and complications are rarer.

Book a wisdom tooth evaluation at Dantam Dental Solutions, Roorkee, or call us at +91 97591 17777 for urgent wisdom tooth pain.