Wisdom teeth — the third molars at the very back of the mouth — often arrive later than other permanent teeth and can create unexpected problems as the jaw finishes developing. While some people never experience trouble, others face impaction, infection, or pressure on neighboring teeth that make removal the safest choice. This page explains how we evaluate third molars, what the procedure looks like, and how patients can expect to heal afterward.
Fuller Smiles provides comprehensive care for wisdom tooth concerns, combining careful diagnostics with modern techniques to keep recovery comfortable and predictable. Whether you are a young adult considering preventative removal or an older patient dealing with new symptoms, our team aims to present clear options and support you through every step.
Third molars are the final set of permanent teeth to develop, which means they erupt into an already established dental arch. In many mouths there simply isn’t enough room for these large teeth to come in properly. When the tooth’s path is blocked by bone, adjacent teeth, or thick gum tissue, it may become impacted — trapped beneath the gums or bone — and unable to assume a normal position.
The orientation of a wisdom tooth matters: it can be angled toward or away from the adjacent tooth, lie horizontally, or remain vertically aligned but stuck. Each pattern of impaction carries different risks and may influence the recommended approach to removal. In addition, the depth of impaction and proximity to vital structures such as nerves or the sinus cavities help determine the safest surgical plan.
Even when a wisdom tooth is only partially erupted, the opening at the gumline can be difficult to keep clean. Food and bacteria may collect beneath the soft tissue, creating an environment prone to inflammation and infection. Over time, these local issues can affect the long-term health of nearby teeth and gums.
Not all wisdom teeth require removal, but certain symptoms usually prompt a recommendation. Pain and recurrent swelling behind the last molar are the most obvious signs; persistent discomfort often indicates infection or pressure on neighboring teeth. Patients may also notice bad taste, difficulty opening the mouth widely, or recurring gum infections in the area of the third molar.
Dental imaging sometimes reveals problems before symptoms appear. A developing cyst, progressive tooth decay on the wisdom tooth or its neighbor, or evidence that the tooth is shifting adjacent teeth are all reasons to consider timely removal. For patients undergoing orthodontic treatment, a wisdom tooth that threatens to undo alignment may be removed as a preventative measure.
Other concerns include gum disease affecting the back teeth and repeated pericoronitis — inflammation of the tissue around a partially erupted tooth. During your consultation, we’ll weigh current symptoms, radiographic findings, and your overall oral health to recommend the safest, most effective option.
A careful evaluation is the foundation of a smooth extraction. We begin with a review of your medical and dental history, asking about bleeding disorders, medications, prior reactions to anesthesia, and any conditions that may affect healing. A clinical exam checks the position of the third molars, the condition of surrounding teeth and gums, and any signs of infection or pathology.
Imaging plays a crucial role. Panoramic x-rays give a broad view of the jaw, while cone beam computed tomography (CBCT) provides a 3D look at root structure and the relationship between teeth and nearby anatomical features such as the inferior alveolar nerve or maxillary sinuses. These images help us predict surgical complexity and minimize risks.
Following this assessment, we discuss the treatment options, potential complications specific to your anatomy, and the recommended anesthesia approach. Patients are encouraged to ask questions so they fully understand the reasons for extraction and what to expect before, during, and after the procedure.
Wisdom tooth extraction is typically an outpatient procedure performed under local anesthesia with options for additional sedation when appropriate. Our team prioritizes patient comfort; for those with anxiety or for more complex cases, we offer nitrous oxide or IV sedation administered by trained professionals to ensure a calm, pain-free experience.
The surgical technique depends on the tooth’s position and surrounding bone. For fully erupted teeth, a simple extraction may suffice. Impacted teeth often require a small incision in the gum and, if necessary, removal of some bone to access the tooth. In many cases the tooth is sectioned into smaller pieces to allow gentle removal with minimal trauma to bone and soft tissue.
Throughout the procedure we take care to protect adjacent teeth and delicate structures. When indicated, stitches are placed to support healing; most sutures used are either absorbable or are removed at a short follow-up visit. Our clinicians employ modern, evidence-based methods to reduce bleeding and swelling and to promote predictable healing.
Safety is paramount: we review antibiotics and pain-control needs based on individual medical history and the complexity of the extraction. Instructions for the first 24–72 hours are provided so patients know how to manage immediate postoperative care at home.
After extraction, the first few days focus on controlling bleeding, managing swelling, and preventing infection. Bite-down pressure with gauze helps a clot form at the extraction site, which is important for healing. Cold packs applied intermittently can reduce swelling during the first 48 hours, and resting with your head elevated supports comfort. Avoid vigorous rinsing or spitting for the first 24 hours to protect the clot.
Dietary adjustments are temporary but important: choose soft, nourishing foods and avoid anything that requires heavy chewing or could disturb the healing site. Gentle oral hygiene around the surgical area is encouraged after the first day; saltwater rinses or a clinician-recommended mouth rinse can keep the area clean without disrupting recovery. Smoking and using straws should be avoided, as suction can dislodge healing tissue and prolong recovery.
Some degree of soreness and swelling is normal, and your clinician will outline pain-management options tailored to your needs. If you experience increasing pain, prolonged bleeding, high fever, or signs of numbness that persist beyond the expected timeframe, contact us promptly so we can evaluate and, if necessary, adjust your care plan.
Most patients return to light activity within a few days and resume normal routines over one to two weeks, depending on the complexity of the extraction and the individual’s healing response. We schedule follow-up as needed to confirm that healing is progressing well and to address any lingering concerns.
Wrap-up
Wisdom teeth extractions are common and, when handled with careful planning and experienced care, predictable in outcome. If you have discomfort, recurring infections, or imaging shows a problem with your third molars, early evaluation helps protect your long-term oral health. Our team in Culver City is prepared to explain your options and guide you through a safe, comfortable treatment process. Contact us for more information about wisdom tooth evaluation and treatment.
Wisdom teeth are the third molars that typically erupt in late adolescence or early adulthood and are the last permanent teeth to appear. Because they come in after the dental arch is largely formed, they frequently encounter limited space or unfavorable angles that prevent normal eruption. When a wisdom tooth cannot fully emerge, it can create pockets where food and bacteria collect, leading to inflammation or infection.
Impaction occurs when a tooth is blocked by bone, gum tissue, or an adjacent tooth and may be angled horizontally, tilted, or only partially erupted. Each pattern of impaction poses different risks for adjacent teeth, gum health, and nearby anatomical structures. Early evaluation helps determine whether monitoring or planned removal is the safest choice to protect long-term oral health.
Evaluation often begins in the late teenage years when third molars are developing and their trajectory can be assessed on radiographs. Many clinicians recommend assessing wisdom teeth between ages 16 and 22 because potential problems such as impaction, decay, or pressure on neighboring teeth are easier to predict during jaw maturation. That said, older adults can develop new symptoms and may require assessment at any age.
The decision to remove a wisdom tooth depends on symptoms, radiographic findings, and overall oral health rather than chronological age alone. For patients undergoing orthodontic treatment or those with recurrent infections or decay around the third molar, earlier intervention may be advised. Your dental team will weigh the benefits and risks of removal versus monitoring in light of your specific situation.
A thorough assessment includes a review of your medical and dental history, a clinical examination of the back of the mouth, and diagnostic imaging to visualize tooth position and root anatomy. Panoramic x-rays provide an overview of jaw relationships, while cone beam computed tomography (CBCT) can reveal three-dimensional detail about root proximity to nerves or sinuses. These images help clinicians predict surgical complexity and tailor a safe treatment plan.
During the consultation, your provider will discuss findings, potential complications related to your anatomy, and recommended anesthesia options. Factors such as existing infections, the depth of impaction, and patient health conditions play an important role in planning. Clear communication allows patients to understand why extraction is recommended and what to expect before, during, and after the procedure.
Wisdom tooth extraction is commonly performed under local anesthesia to numb the area, and many offices offer additional sedation options to improve comfort and reduce anxiety. Nitrous oxide provides mild relaxation and is easily reversible, while oral sedation or intravenous (IV) sedation can offer deeper levels of sedation for more anxious patients or complex procedures. The choice depends on the case complexity, patient health history, and personal comfort preferences.
All sedation and anesthesia choices are made with safety in mind; trained clinicians monitor vital signs and tailor medication doses accordingly. Your dental team will ask about medical conditions, medications, and past anesthesia experiences to select the safest approach. Preoperative instructions and post-sedation care are provided so recovery is predictable and well managed.
The procedure varies with tooth position: a fully erupted wisdom tooth may be removed with a simple extraction, while an impacted tooth often requires a small incision in the gum and, if necessary, removal of a bit of bone to access the tooth. In many surgical extractions the tooth is sectioned into smaller pieces so it can be removed with minimal force and reduced trauma to surrounding bone and tissues. The goal is efficient removal while protecting nearby teeth and anatomical structures.
Stitches are sometimes placed to support soft tissue healing; many sutures are absorbable and dissolve on their own, while others are removed at a short follow-up visit. Clinicians provide specific postoperative instructions to control bleeding, swelling, and discomfort and may recommend antibiotics or pain management based on the procedure’s complexity. With modern techniques and careful planning, most extractions proceed smoothly and predictably.
Immediately after surgery you should expect some bleeding, which is managed by gently biting on gauze to encourage clot formation at the extraction site. Mild to moderate swelling and soreness are normal and often peak within 48 to 72 hours; applying cold packs intermittently and resting with your head elevated can improve comfort during this period. Your clinician will review pain-control options and any medications you should take to reduce inflammation and prevent infection when indicated.
It is important to avoid vigorous rinsing, spitting, or using straws for the first 24 hours to protect the blood clot and promote healing. Eat soft, nourishing foods and maintain gentle oral hygiene around the surgical area as directed by your provider. If you experience excessive bleeding, severe pain not controlled by recommended measures, fever, or prolonged numbness, contact your dental team for prompt evaluation.
While most extractions heal without issue, possible complications include dry socket, infection, prolonged bleeding, nerve irritation, and, in rare cases, communication with the sinus cavity for upper teeth. A dry socket occurs when the clot is dislodged and can cause increased pain a few days after surgery; clinicians treat it with medicated dressings, improved pain control, and close follow-up. Infections are usually managed with oral hygiene measures and, when appropriate, antibiotics selected based on medical history and clinical signs.
Nerve disturbances that cause altered sensation are uncommon but are assessed on a case-by-case basis and monitored over time, with referral to a specialist if needed. Communication with the sinus for upper molars may require additional management to promote closure and healing. Your dental team will explain the signs to watch for and the steps they will take to manage complications promptly and effectively.
Caring for your mouth after extraction involves balancing hygiene with protection of the surgical site: avoid disrupting the clot by not rinsing vigorously or using straws for the first 24 hours. After the initial period, gentle saltwater rinses several times a day help keep the area clean and reduce bacterial buildup; your clinician may also recommend a specific antimicrobial rinse if appropriate. Maintain a soft-food diet and avoid hard, crunchy, or spicy foods until healing allows a return to normal chewing.
Avoid smoking and tobacco use during recovery, as they increase the risk of complications and delay healing. Follow medication instructions carefully, attend any scheduled follow-up appointments, and contact your dental provider if you notice signs of infection, unexpected bleeding, or persistent numbness. Adhering to postoperative directions supports predictable healing and a faster return to normal activity.
Wisdom teeth can sometimes influence orthodontic outcomes because erupting third molars may exert pressure on adjacent teeth and, in certain cases, contribute to crowding or shifting. However, the relationship between wisdom teeth and orthodontic relapse is complex and varies between individuals, so decisions about removal are made based on clinical evidence rather than assumptions. When a wisdom tooth is diseased, causing decay or recurrent infections, removal is often recommended to protect neighboring teeth and gum tissue.
For patients undergoing orthodontic treatment, clinicians coordinate timing to minimize interference with planned tooth movement and to preserve alignment. Radiographic monitoring helps determine whether third molars are likely to cause future problems. The best approach is individualized care that considers orthodontic goals, radiographic findings, and the patient’s overall oral health.
An oral surgeon is often recommended for particularly complex impactions, teeth with roots close to major nerves or the sinus, patients with complicated medical histories, or cases that may require advanced surgical techniques. General dentists commonly manage straightforward extractions, but referral to a specialist ensures optimal management when risks are higher or specialized operating-room resources are preferable. Your dental provider will discuss the complexity of your case and whether a referral is in your best interest.
If you prefer specialist care or if imaging reveals close proximity to the inferior alveolar nerve or maxillary sinus, an oral and maxillofacial surgeon can offer advanced assessment and surgical planning. The practice coordinates care and referrals when necessary and can arrange evaluation with a surgeon experienced in complex third-molar cases in the Culver City area. This team-based approach helps ensure safe, effective treatment tailored to each patient’s needs.
