Can I have all four wisdom teeth removed at once?

In theory it’s possible, but it’s generally not recommended. Removing all four at the same time makes it hard to chew on either side during recovery, so eating and daily life become very inconvenient. If complications occur, both sides can be affected simultaneously, increasing the risk. Typically, it’s recommended to do it in **two visits**, treating the upper and lower on the same side first (upper/lower left → upper/lower right). After extracting one side, allow a 1–2 week recovery before extracting the other side. However, if you will be under sedation (especially when all four are similarly impacted), removing them all at once may be more efficient for the patient. Discuss with your dentist considering your schedule, recovery environment, and overall health.

How long should I rest after wisdom tooth extraction? When can I go back to work or school?

For a simple extraction, you can usually return to work/school the same day or the next day. For an impacted extraction, we recommend **rest on the day of extraction + the following day**. Swelling typically peaks on day 2, and pain medication can reduce concentration. Most people can return to normal activities from day 3, but if your job is sensitive to speech, eating, or appearance, allowing about a week is more comfortable. Avoid strenuous exercise/weight training for 1 week, and saunas/swimming for at least 2 weeks. If you schedule the extraction on Friday or Saturday, you can use the weekend to recover, which we recommend.

Is it true you lose weight after wisdom tooth extraction?

Partly true, but it’s temporary. For 1–2 weeks after extraction, you’ll tend to eat only soft foods and may eat less than usual because you’re mindful of the extraction site, so a temporary weight loss of around 2–5 kg is common. After you recover and return to a normal diet, most people regain their original weight. Getting a wisdom tooth extraction for weight loss is not recommended. Extraction should be based on medical need.

After a wisdom tooth extraction, how many days should I take antibiotics and painkillers?

As a rule, take them exactly as prescribed until finished. **Antibiotics** are usually prescribed for 3–5 days. Even if you feel better, finish the full course to prevent antibiotic resistance. For **pain relievers**, taking them on a regular schedule for the first 2–3 days controls pain better than waiting for pain to start. From day 4, take them only as needed. If you experience gastrointestinal upset, rash, or breathing difficulties, stop immediately and contact the dental office. If you are pregnant, breastfeeding, or taking other medications, inform us in advance.

I’ve heard a wisdom tooth can be autotransplanted. In what cases is it possible?

It’s a procedure that moves a healthy wisdom tooth to another extraction site in the same person. For example, if a molar is so decayed it can’t be saved and must be extracted, and your wisdom tooth on the same or opposite side is healthy, the molar can be removed and the wisdom tooth transplanted into that site on the same day. **Eligibility criteria** are strict: - The wisdom tooth root is at an appropriate stage of development (typically age 17–25) - The wisdom tooth itself is healthy (no cavity, crack, or gum disease) - Adequate jawbone at the recipient site (the molar extraction socket) - Similar size between the wisdom tooth and the molar When the criteria are met, it can cost less than a dental implant (about 1,000,000–2,000,000 KRW [approx. $730–$1,460]) and has the advantage of using your own tooth. However, it’s not suitable for every case, and a detailed evaluation is required during diagnosis.

The Complete Guide to Wisdom Tooth Extraction

Q: My molar next to the extraction feels sensitive. Is that normal?

It’s common and temporary. If an impacted wisdom tooth had been pressing on the adjacent second molar, the root area of that molar can be exposed to external stimuli after extraction, causing sensitivity for about 1–4 weeks. Using a desensitizing toothpaste (containing potassium nitrate and sodium fluoride) for about 2–4 weeks helps in most cases. If sensitivity lasts more than 4 weeks or you have pain when chewing, there may be a cavity or gum disease in the adjacent molar, and a follow-up exam is needed.

01What is a wisdom tooth?

A wisdom tooth is the third molar at the very back of the mouth, and it usually erupts between ages 17 and 25.

The medical term for a wisdom tooth is third molar (M3). The number varies—from having all four, to only one to three, to none at all. About 25% of Koreans are reported to be congenitally missing at least one wisdom tooth.

Anthropologically, wisdom teeth are a 'vestigial tooth' becoming smaller through evolution. Modern human jawbones are smaller than those of our ancestors while tooth size is similar, so there is often not enough room for wisdom teeth to come in normally. As a result, impaction is common, with wisdom teeth remaining buried within the gum or jawbone.

Four types of wisdom tooth impaction

Classification	Angulation	Extraction difficulty
Vertical impaction (Vertical)	Tooth is upright, but only part is above the gum	★~★★ (Relatively easy)
Mesioangular impaction (Mesioangular)	Tilted forward (most common, about 40~45%)	★★~★★★ (Moderate)
Horizontal impaction (Horizontal)	Tooth lies completely sideways	★★★★ (Difficult)
Distoangular impaction (Distoangular)	Tilted backward	★★★~★★★★ (Difficult)

02Do Wisdom Teeth always need to be removed?

You don’t need to remove every Wisdom Tooth. There are clear criteria for extraction vs. preservation.

When extraction is recommended

Pressure on the neighboring tooth from an impacted Wisdom Tooth: can resorb the adjacent 2nd molar’s root or cause cavities
Recurrent pericoronitis around a Wisdom Tooth: Food gets trapped around a partially erupted Wisdom Tooth; gums swell, and pain/bad breath keep recurring
Cavity in a Wisdom Tooth: Hard to brush due to its position, so cavities form easily and may recur even after treatment
Cysts/Tumors: When a lesion such as a dentigerous cyst forms around an impacted Wisdom Tooth
Creating space before Orthodontic treatment: If a Wisdom Tooth could affect alignment after Orthodontic treatment
Interference with Denture/Dental Implant prosthetic planning: When its position could compromise prosthesis stability

When preservation can be considered

A Wisdom Tooth that has fully and normally erupted and can be cleaned well: If upper and lower teeth meet normally and there are no cavities or gum disease, it can be kept
Asymptomatic impacted Wisdom Tooth in an older patient: After your 30s~40s, the jawbone becomes denser, making extraction much harder and recovery slower; if asymptomatic, watchful waiting is an option
Candidate for autogenous tooth transplant (as an alternative to a Dental Implant): A Wisdom Tooth that could be transplanted to a missing molar area via "autogenous tooth transplant"

The pitfall of "You don’t need extraction if there are no symptoms"

Even without symptoms, an impacted Wisdom Tooth can affect the 1st molar after your 30s, and after your 40s the difficulty and complication risk of extraction rise significantly. In general, extracting in your early to mid-20s offers the best outcomes for recovery and lower complication riskIf you have an impacted Wisdom Tooth, a panoramic X-ray every 1~2 years is recommended to monitor for changes.

03Wisdom Tooth Extraction Cost (2026)

Wisdom Tooth extractions are covered by Korean NHIS. However, costs vary widely depending on the degree of impaction.

Extraction Type	Patient co-pay (2026, clinic 30%)	Notes
Simple extraction (fully erupted)	Approx. 5,000~10,000 KRW (approx. $3.65~$7.30)	Including X-ray, approx. 20,000~30,000 KRW or less (approx. $14.60~$21.90)
Extraction with gum incision (partially impacted)	Approx. 15,000~25,000 KRW (approx. $10.95~$18.25)	Including X-ray and anesthesia, around 50,000 KRW (approx. $36.50)
Fully impacted extraction (gum incision + bone removal)	Approx. 30,000~50,000 KRW (approx. $21.90~$36.50)	Including X-ray and anesthesia, approx. 80,000~120,000 KRW (approx. $58.40~$87.60)
Tooth sectioning (horizontal impaction)	Approx. 50,000~80,000 KRW (approx. $36.50~$58.40)	High difficulty; if CBCT is added, total around 150,000 KRW (approx. $109.50)
Sedation (option for all impacted extractions)	Additional approx. 100,000~300,000 KRW (approx. $73.00~$219.00)	Non-covered (out-of-pocket)
CBCT 3D imaging (if needed)	Additional approx. 50,000~100,000 KRW (approx. $36.50~$73.00)	Non-covered (recommended when close to the inferior alveolar nerve canal)

For impacted Wisdom Tooth extractions, CBCT is a worthwhile safety investment

Mandibular (lower jaw) Wisdom Teeth inferior alveolar nerve canal (inferior alveolar nerve)is often right beneath or in contact with the roots of these Wisdom Teeth. A standard panoramic X-ray is 2D, so it’s difficult to determine the exact distance and relationship to the nerve canal. CBCT (3D imaging) can assess this precisely and greatly reduce the risk of nerve injury. For an additional 50,000~100,000 KRW (approx. $36.50~$73.00), it is a very worthwhile exam to help prevent permanent nerve damage.

04Wisdom Tooth Extraction Process

The process differs substantially between simple and impacted extractions. The following focuses on impacted cases.

Step 1: Diagnosis (panoramic X-ray + CBCT if needed)

We check the Wisdom Tooth’s position, angle, and its relationship to adjacent teeth and the inferior alveolar nerve canal. CBCT is usually recommended for impacted Wisdom Teeth.

Step 2: Local anesthesia (5 min)

About 0.5~1ml of local anesthetic (lidocaine + epinephrine) is injected at the extraction site. You may feel a brief sting with the injection, but during the procedure anesthesia is effective and pain is minimal. Numbness typically lasts 2~4 hours after the procedure.

Step 3: Gum incision (5 min)

Impacted Wisdom Teeth are covered by gum tissue, so a small incision is made to gain access. The incision is L-shaped or straight along the top and side of the tooth, about 1~2cm long.

Step 4: Bone removal (5~15 min)

A small handpiece (dental drill) is used to remove some of the bone covering the tooth. You will hear vibration/noise, but with anesthesia there is no pain.

Step 5: Tooth sectioning and extraction (10~25 min)

If the impaction is severe, it is safer to section the Wisdom Tooth into 2~3 pieces and remove them one by one rather than taking it out whole. This is the standard technique to minimize damage to the bone and neighboring teeth. You may feel pressure and vibration during extraction.

Step 6: Extraction socket rinse + suturing (5~10 minutes)

We flush the extraction socket with saline and suture the gums. Typically 2~5 stitches; absorbable sutures dissolve naturally in 1~2 weeks, non-absorbable sutures are removed after 7~10 days.

Step 7: Gauze pressure + aftercare instructions (10 minutes)

Bite on gauze over the extraction site and apply pressure for about 30~60 minutes to control bleeding. You will receive prescriptions (pain reliever · antibiotic · mouth rinse) and aftercare guidance before heading home.

Total time for an impacted tooth extraction: Average 30~60 minutes (up to 90 minutes depending on difficulty)

05Pain and swelling — a candid recovery timeline

We’ve laid out, candidly, what most patients want to know: "How much will it hurt, how much will it swell, and when will I recover?"

Day of extraction (Day 0)

Before the anesthesia wears off (2~4 hours after the procedure): lips, cheeks, and tongue feel numb; no pain
After the anesthesia wears off: A dull ache begins; manageable with pain medication
Bleeding: Slight pink-tinged saliva on the gauze is normal; minor bleeding up to 24 hours is normal
Swelling: Little to none yet (swelling usually starts the next day)

Days 1~3 after extraction (peak swelling)

Pain: Pain peaks at 24~48 hours after extraction; controllable with pain relievers
Swelling: Worst on days 2~3; you may look puffed up like a chipmunk
Bruising: Occurs in 30~40% of patients; resolves on its own within 5~7 days
TMJ (Jaw Joint) soreness: Caused by keeping your mouth open for a long time; temporary
Care: Cold compresses (day of procedure~2 days), warm compresses (after 3 days), take pain medication on schedule

Days 4~7 after extraction (recovery phase)

Pain: Gradually decreases; mostly gone by days 5~7
Swelling: Gradually subsides; near normal by day 7
Eating: Soft foods are fine; regular diet is okay as long as you avoid the extraction area
Suture removal: Non-absorbable sutures are removed around 7~10 days

2 weeks~3 months after extraction (full recovery)

Gums: The outer gums are almost healed after 2 weeks
Extraction socket: It takes about 2~3 months for the space in the jawbone to fill in naturally.
Caution: Avoid strenuous exercise, alcohol, and smoking for 1~2 weeks

Compresses — cold vs warm, when?

Day of extraction ~ the next day (within 48 hours): Cold compresses are effective. They constrict blood vessels to reduce swelling and bleeding. Wrap an ice pack in a towel and apply for 20 minutes, then rest for 20 minutes, repeating.

Starting on day 3: Switch to warm compresses. They promote blood flow to help resolve bruising and swelling. Use a warm towel or a lukewarm water bottle with the same pattern.

06Complications and aftereffects

Tooth extraction is a safe procedure, but complications can rarely occur. Knowing about them in advance helps you respond quickly.

1. Dry socket (alveolar osteitis) — incidence 3~5%

This is a complication where the blood clot formed after extraction dislodges too early, exposing the jawbone. Severe pain often begins suddenly on days 2~4 after extraction and does not respond well to over-the-counter pain relievers. Bad breath may accompany it.

Risk factors: Smoking, using a straw right after extraction, vigorous brushing, alcohol use, female sex (estrogen effect), impacted tooth extraction

What to do: Visit the dentist promptly → socket irrigation + medicated gauze placement (usually improves within a few days)

2. Nerve injury — incidence about 0.5~5%

During lower Wisdom Tooth extraction, the inferior alveolar nerve or the lingual (tongue) nerve can be injured temporarily or, rarely, permanently.

Temporary injury (most cases): Numbness of the lip, chin, or tongue; spontaneous recovery within 1 week~6 months
Permanent injury (rare, 0.5% or less): Numbness persists for 6 months or more

Prevention: Identify the nerve canal location with CBCT before extraction; have the procedure done by an experienced oral and maxillofacial surgeon

3. Infection — incidence about 1~3%

This occurs when bacteria enter the socket or suture site, causing a purulent infection. If pain improves then worsens again around days 5~7, and is accompanied by fever, swelling, or pus, suspect infection.

What to do: Return to the dentist; adjust or add antibiotics; perform incision and drainage if needed

4. Injury to adjacent teeth — very rare, but possible

During extraction, a filling in the neighboring molar may come off, or the tooth may loosen. We check the condition of adjacent teeth with X-ray before the procedure.

5. Sinus perforation — possible with upper Wisdom Tooth extractions

If the roots of an upper Wisdom Tooth are close to the maxillary sinus (paranasal sinus), a perforation connecting the sinus and the mouth can occur during extraction. Most small perforations heal naturally within 2~3 weeks, but larger ones may require additional suturing.

07Post-extraction care — 7-day recovery checklist

Your recovery speed and complication prevention depend greatly on care during the first 7 days after extraction.

Day of extraction

Compress with gauze for 30~60 minutes, then remove. If bleeding continues, apply pressure for 30 more minutes.
Avoid eating for 2 hours (prevents biting your lip before the numbness wears off).
No rinsing with cold water, vigorous rinsing, or using a straw (to prevent dislodging the clot).
Cold compresses (apply 20 minutes, rest 20 minutes, repeat).
Take your prescribed medications on schedule (pain medication, antibiotics, mouth rinse)
Absolutely no alcohol, smoking, strenuous exercise, or sauna

Days 1~3 after extraction

Soft, lukewarm foods (rice porridge, soy milk, thin rice gruel, mashed tofu, steamed egg, etc.)
Chew on the side opposite the extraction site
You may brush, but be gentle around the extraction site; do not rinse directly over the site
Use the prescribed chlorhexidine mouth rinse (just hold it in your mouth, then gently spit)
Plenty of fluids + rest

Days 4~7 after extraction

Once the swelling subsides, switch to warm compresses
Gradually return to a regular diet (avoid hard nuts, gum, and hard foods for at least 1 week)
Schedule suture removal (7~10 days)
Avoid smoking and alcohol for at least 1 week (dry socket risk ↑)

If you have any of these symptoms, visit the dentist immediately

Pain that gets worse on day 4~5 (possible dry socket)
High fever over 38°C (possible infection)
Persistent bleeding (24 hours or more)
Numbness of the lip or tongue lasting 1 week or more (possible nerve injury)
Mouth barely opens (trismus)

08Frequently Asked Questions

We have compiled the questions patients most often ask about Wisdom Teeth.

Q.Can I have all 4 Wisdom Teeth removed at once?

In theory it’s possible, but we generally don’t recommend it.

Having all 4 removed at the same time makes it hard to chew on both sides during recovery, so eating and daily life become very inconvenient. If complications occur, both sides can be affected at once, which increases risk.

We usually recommend splitting it into 2 visits, treating the upper and lower on the same side (upper/lower left → upper/lower right). After removing one side, allow 1~2 weeks to recover before extracting the other side.

However, if you receive sedation dentistry (especially when the 4 teeth are similarly impacted), removing them all at once may be more efficient for the patient. Consult your dentist after considering your schedule, recovery environment, and overall health.

Q.How long should I rest after a Wisdom Tooth extraction? When can I return to work or school?

For a simple extraction, you can usually return to work/school the same day or the next day.

For an impacted extraction, we recommend resting on the extraction day + the next day. Swelling typically peaks on day 2 after extraction, and while taking pain medication your concentration may be reduced.

From day 3 after an impacted extraction, most people can resume normal activities, but if your work is sensitive to speech, eating, or appearance, allowing about 1 week is more comfortable. Avoid strenuous exercise/gym for 1 week, and sauna/swimming for at least 2 weeks.

If you have the extraction on Friday or Saturday, you can use the weekend to recover, so we recommend it.

Q.Is it true you lose weight after a Wisdom Tooth extraction?

Partly true, but only temporarily.

For 1~2 weeks after extraction you’ll tend to eat only soft foods and may eat less because you’re careful with the area, so a temporary weight loss of about 2~5kg is common. After recovery, once you return to a normal diet, most people go back to their usual weight.

We do not recommend having a Wisdom Tooth extraction for dieting purposes. Extraction should be decided based on medical need.

Q.The molar next to the Wisdom Tooth feels sensitive after extraction. Is that normal?

This is common and temporary.

If an impacted Wisdom Tooth had been pressing on the adjacent molar (second molar), after extraction the root area of that molar can be exposed to external stimuli, leading to sensitivity for about 1~4 weeks.

Using a desensitizing toothpaste (containing potassium nitrate and sodium fluoride) for about 2~4 weeks usually resolves it. If sensitivity persists for more than 4 weeks, or if you have pain when chewing, there may be a cavity or gum disease in the adjacent molar and you should return for evaluation.

Q.After a Wisdom Tooth extraction, for how many days should I take antibiotics and pain medication?

As a rule, take your medications exactly as prescribed until you finish them.

**Antibiotics** are usually prescribed for 3–5 days. Even if you feel better, finish the entire course to help prevent antibiotic resistance.

**Pain relievers** are most effective for pain control if you take them on schedule for the first 2–3 days (better than waiting until pain starts). From day 4, take them only as needed for pain.

If you develop side effects such as stomach upset, rash, or shortness of breath, stop taking the medication and contact the dental clinic right away. If you are pregnant, breastfeeding, or taking other medications, please let us know in advance.

Q.I heard you can autotransplant a Wisdom Tooth. When is it possible?

This is a procedure that moves a healthy Wisdom Tooth to another extraction site in the same person.

For example, if a molar is too damaged by a Cavity to save and must be extracted, and the same person’s Wisdom Tooth on the same or opposite side is healthy, we can extract the molar and transplant the Wisdom Tooth into that site on the same day.

**Eligibility criteria** are strict: - The Wisdom Tooth is at an appropriate stage of root development (usually age 17–25) - The Wisdom Tooth itself is healthy (no Cavity, cracks, or gum disease) - Adequate bone at the recipient site (the molar extraction socket) - Similar size between the Wisdom Tooth and the molar

If the conditions are met, it can cost less than a Dental Implant (about 1,000,000–2,000,000 KRW; approx. $730–$1,460) and has the advantage of using your own tooth. However, it isn’t suitable for every case and requires a detailed evaluation during diagnosis.

Have more questions about Wisdom Teeth?

A specialist at Seoul BD Dental will consult with you directly. Your first consultation is free.

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A column on this topic by the director

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