Impacted Tooth Removal: Procedure, Recovery, and What to Expect

Impacted Wisdom Teeth

Wisdom teeth (third molars) are the most commonly impacted teeth. They are the last teeth to develop, usually between ages 17 and 25, and there is often not enough room in the jaw to accommodate them. Impacted wisdom teeth can grow sideways, at an angle toward the second molar, or remain completely buried in the bone.

Symptoms of impacted wisdom teeth include pain or swelling at the back of the jaw, difficulty opening the mouth, bad taste or odor from the area, and swollen or bleeding gums around the partially erupted tooth. Some impacted wisdom teeth cause no symptoms and are discovered on routine dental X-rays.

Impacted Canines

Upper canines (eyeteeth) are the second most commonly impacted teeth. Unlike wisdom teeth, canines play an important role in your bite and are not routinely extracted. When a canine is impacted, the treatment goal is usually to guide it into the correct position using a combination of surgical exposure and orthodontic traction.

An oral surgeon uncovers the impacted canine by removing the gum and bone covering it, then bonds a small bracket to the tooth. An orthodontist attaches a chain or elastic to the bracket and gradually pulls the tooth into alignment over several months. This combined approach preserves the natural tooth and avoids the need for an implant or bridge.

Impaction Depth Classifications

The depth and angle of impaction determine how complex the extraction will be and affect both cost and recovery time.

• Soft tissue impaction: The tooth has erupted through the bone but is still covered by gum tissue. This is the simplest type to remove.
• Partial bony impaction: The tooth has partially erupted through the bone but a portion remains enclosed in the jawbone. This requires some bone removal during extraction.
• Full bony impaction: The tooth is completely encased in the jawbone. This requires the most surgical time and the longest recovery.
• Angular impaction: The tooth is tilted horizontally, mesially (toward the front), or distally (toward the back) rather than growing straight up.

Before the Procedure

Your oral surgeon will take X-rays or a CBCT (3D cone-beam CT) scan to see the exact position of the impacted tooth, its relationship to nearby nerves and sinuses, and the amount of bone covering it. This imaging guides the surgical plan.

You will receive instructions about eating and drinking before surgery, especially if IV sedation or general anesthesia is planned. Arrange for someone to drive you home, as you will not be able to drive after sedation.

Anesthesia Options

Your oral surgeon will recommend an anesthesia option based on the complexity of the case and your comfort level.

• Local anesthesia: Numbs the surgical area only. You remain fully awake. Suitable for simple soft tissue impactions in patients comfortable with dental procedures.
• IV sedation (conscious sedation): Medication delivered through an IV makes you drowsy and relaxed. You may not remember the procedure. This is the most common choice for wisdom tooth removal.
• General anesthesia: You are completely unconscious. Used for complex cases, multiple impactions, or patients with significant dental anxiety. Typically administered in an oral surgery office equipped with full monitoring.

The Surgical Procedure

Once anesthesia takes effect, the oral surgeon makes an incision in the gum tissue to expose the tooth and bone. If bone covers the tooth, the surgeon removes the necessary amount using a surgical handpiece. In many cases, the tooth is sectioned (cut into smaller pieces) to make removal easier and minimize the amount of bone that needs to be taken out.

After the tooth is removed, the surgeon cleans the socket to remove any debris or infection. The incision is closed with dissolvable stitches that typically fall out on their own within 7 to 10 days. Gauze is placed over the extraction site to help a blood clot form.

Days 1 to 2: Immediate Recovery

Swelling, bruising, and discomfort peak during the first 48 hours. Apply ice packs to the outside of your face for 20 minutes on and 20 minutes off during the first day. Take prescribed pain medication as directed. Eat soft foods like yogurt, applesauce, and smoothies. Avoid using a straw, as the sucking motion can dislodge the blood clot and cause a painful condition called dry socket.

Days 3 to 5: Gradual Improvement

Swelling begins to decrease. You can transition to softer solid foods like scrambled eggs, pasta, and mashed potatoes. Continue gentle saltwater rinses (starting 24 hours after surgery) to keep the area clean. Avoid vigorous rinsing or spitting.

Weeks 1 to 2: Continued Healing

Most patients feel significantly better by the end of the first week. Stitches dissolve or are removed at a follow-up appointment. Soft tissue healing is largely complete by 2 weeks. Avoid hard, crunchy, or sharp foods near the surgical site until your surgeon clears you.

Full bony impactions may take longer to heal. Some soreness and stiffness in the jaw is normal for up to 2 weeks after surgery for these more complex cases.

When to Call Your Oral Surgeon

• Severe pain that worsens after day 3 (possible dry socket)
• Fever above 101 degrees Fahrenheit
• Excessive bleeding that does not slow with pressure
• Numbness or tingling in the lip, chin, or tongue that persists beyond the first day (possible nerve involvement)
• Pus or foul-tasting drainage from the surgical site
• Difficulty swallowing or breathing

Cost by Impaction Type

Removing all four wisdom teeth in one visit typically costs $800 to $2,400 total depending on the impaction types involved. A single impacted canine exposure and bonding for orthodontic treatment usually costs $500 to $900.

• Soft tissue impaction: $225 to $400 per tooth
• Partial bony impaction: $275 to $450 per tooth
• Full bony impaction: $325 to $600 per tooth

Anesthesia Costs

Local anesthesia is included in the extraction fee. IV sedation adds $250 to $600 to the total cost. General anesthesia adds $300 to $800. The additional cost covers the medication, monitoring equipment, and trained anesthesia staff.

Insurance Coverage

Most dental insurance plans cover impacted tooth removal as a surgical procedure, typically at 50% to 80% after your deductible. Wisdom tooth removal is generally covered when the teeth are impacted or causing problems. Some medical insurance plans also cover impacted tooth removal, especially when it is medically necessary due to infection, cysts, or damage to adjacent teeth.

If your dental plan has an annual maximum (commonly $1,000 to $2,000), removing all four wisdom teeth may exceed that limit. Ask your oral surgeon's office to submit a predetermination to both your dental and medical insurance to maximize your coverage.