Wisdom Teeth: When to Extract, When Pain Starts, Aftercare, and Health Insurance

What are wisdom teeth?

Wisdom teeth (third molars) are the back teeth that usually come in at the very back of the dental arch in the late teens to twenties [1]. When there is not enough space in the jawbone, they often come in at an angle or stay impacted in the gum or bone, and in that case they are hard to reach with a toothbrush and prone to problems [1].

When DentStat analyzed 17,460 patient comments (4,987 of them questions) on wisdom teeth in YouTube dental content, the most common questions concerned pain and anesthesia (1,444), impaction and nerve proximity (974), and extracting several at once and sedation (628) [4]. This guide organizes facts confirmed by public sources in that order.

Do wisdom teeth always have to be removed?

If a wisdom tooth has erupted straight and can be kept clean by brushing, it is sometimes kept [1]. On the other hand, impacted or partially erupted wisdom teeth can cause cavities in the neighboring molar, inflammation of the surrounding gums, or cysts even without symptoms, so extraction is considered [1]. Whether to extract is judged from the type of impaction seen on X-rays and the condition of the neighboring teeth, so discuss it with a dentist [1].

The comment analysis found 216 questions about whether to extract, such as “It doesn’t hurt, so do I need to have it out?”, showing demand for explanations about symptom-free wisdom teeth [4].

When does pain start, and how long does it last?

Extraction is done under local anesthesia, so pain during the procedure is fairly low [1]. Pain usually begins once the anesthesia wears off and gradually eases over several days, and swelling is also worst at first and then decreases [1]. Pain is often controlled with prescribed painkillers, and it is safest to follow the extracting clinic’s instructions on when to take them [1].

Pain and anesthesia was the most common question theme in the comment analysis (1,444), with repeated questions about pain “after the anesthesia wears off” [4].

How should I care for the site after extraction?

Right after extraction, you bite on gauze to stop the bleeding, and keeping the blood clot that forms at the site in place is the key to recovery [1]. If the clot comes loose and the bone is exposed, a complication called dry socket can occur, and actions that create suction in the mouth, such as smoking and using straws, are cited as risk factors [1]. If pain gets worse and a bad smell appears several days after extraction, dry socket is suspected, so you should visit the dentist [1].

The comment analysis counted 275 questions on aftercare, with many about when you can eat and what to avoid [4].

Can several be removed at once?

Whether several can be extracted at once is decided by a dentist after assessing extraction difficulty and the patient’s overall health [1]. The comment analysis found many cases of people being advised to have extractions split into left and right sides, with the ability to eat on the other side mentioned as the reason [4]. Questions about extracting several at once and sedation were the third theme at 628 [4].

When are patients referred to a university hospital?

The roots of lower wisdom teeth can be close to the nerve canal running through the lower jaw, so when impaction is deep or close to the nerve, the position is assessed with imaging such as CT [1]. Cases near the nerve or fully impacted are sometimes referred to dental hospitals or university hospitals with Oral & Maxillofacial Surgery, and this is a standard procedure to reduce the risk of nerve damage [1]. Altered sensation after extraction is known to be temporary in many cases, but if it persists, it needs care [1].

In the comment analysis, impaction and nerve proximity was the second theme at 974, and questions about the situation “my local dentist told me to go to a university hospital” came up often [4].

What about cost and health insurance?

Wisdom tooth extraction is covered by Korea’s National Health Insurance [2]. Extraction fees differ by difficulty, such as simple versus impacted extraction, so even for the same wisdom tooth, your out-of-pocket cost differs with the type of impaction [2]. On the other hand, sedation (conscious sedation) and some hemostatic materials are sometimes billed as non-covered (not paid by National Health Insurance), so checking the explanation of covered and non-covered items before treatment helps you understand the cost structure [2].

In the comment analysis, questions checking non-covered items such as sedation stood out more than questions about the covered extraction fee itself [4]. Non-covered prices vary by clinic, so this guide does not cover them.

Information on dental clinics nationwide (number of board-certified oral and maxillofacial surgeons, locations, and more) is available on DentStat’s regional pages, based on public data from the Health Insurance Review & Assessment Service (HIRA) [3].