At Dr Haim Aseriel's dental clinic in Jerusalem, wisdom tooth extraction, including complex cases, is done with as much care for the surrounding tissues as possible. The aim is a safe, precise procedure that keeps discomfort to a minimum.
Every wisdom teeth removal is planned in advance from an X-ray, and in complex cases with a 3D scan on the clinic's Planmeca ProMax 3D CBCT, to anticipate possible difficulties. Complex cases are treated at the clinic together with an oral and maxillofacial surgeon, Dr Yves Weinberg, head of the Oral and Maxillofacial Surgery Department at Barzilai Medical Center. You receive full aftercare instructions and follow-up visits to check that healing goes as planned.
What are wisdom teeth, and why are they removed?
Wisdom teeth are the third set of molars, at the back of the jaw. Also called third molars, they usually come in between the ages of 17 and 21, when most other permanent teeth are already in place (ADA). Often there is not enough room in the jaw for them to erupt properly, which leads to an impacted wisdom tooth, fully or partly trapped in the jawbone or the gum.
Common reasons for tooth extraction of a wisdom tooth include:
- preventing damage to neighboring teeth when the wisdom tooth pushes against them
- preventing repeated infections, when a partly erupted wisdom tooth leaves a pocket between tooth and gum where bacteria build up
- preventing cysts or benign tumors around impacted wisdom teeth, which can destroy bone and nearby teeth
- preventing tooth decay in wisdom teeth that are hard to clean and treat because of their position
Sometimes, preventive removal of a wisdom tooth is suggested when future problems are likely, particularly in younger patients: with age, the bone becomes denser and the extraction can be more difficult. In a cohort study from the American Association of Oral and Maxillofacial Surgeons (AAOMS) that included more than 4,000 patients, age over 25 was associated with a higher complication rate (Chuang et al., 2007). Every decision is still made after a clinical examination, appropriate imaging and a discussion with you.
Wisdom tooth extraction: how the procedure works
01
Precise diagnosis
X-rays, or CBCT 3D imaging at the clinic when the case requires it, show the exact position of the tooth, its angle and its relationship to important structures such as the inferior alveolar nerve in the lower jaw and the maxillary sinus in the upper jaw.
02
Anesthesia and access to the tooth
The area is numbed with local anesthesia; depending on the complexity of the case, light oral sedation can be added, as discussed with you beforehand. For an impacted tooth, a small incision exposes the tooth, and some bone may be removed or the tooth divided into sections, to limit trauma to the surrounding tissues.
03
Cleaning and closing the site
Once the tooth is out, the socket is cleaned thoroughly, stitches are placed if needed, and a sterile gauze pad is placed to stop the bleeding. In complex extractions, PRF (platelet-rich fibrin, prepared from your own blood in the clinic's centrifuge) is used according to the indication, to support healing.
| Feature | Upper wisdom tooth | Lower wisdom tooth |
|---|---|---|
| Bone density | The upper jawbone is usually less dense | Denser bone |
| Nearby nerve or sinus | Close to the maxillary sinus | Close to the inferior alveolar nerve, which gives feeling to the lower lip and chin |
| Complexity | Usually a simpler extraction | Often impacted, in which case a surgical extraction is needed |
How long does wisdom teeth removal take? It varies: removing a fully erupted wisdom tooth can take just a few minutes, while a deeply impacted tooth that has to be divided takes considerably longer. Although wisdom teeth removal is a routine procedure, each case is planned individually.
When should a wisdom tooth be removed? Signs to look for
The need for wisdom tooth extraction is based on clinical signs, imaging findings and preventive considerations. The main clinical signs are wisdom tooth pain, swelling and redness of the gum around it. Other signs the dentist looks for:
- Pericoronitis: inflammation of the gum around a partly erupted wisdom tooth.
- Decay: in the wisdom tooth or the neighboring molar, hard to treat because of its position.
- Gum and bone loss: gum recession and bone loss around the second molar, or other gum problems in the area.
- Tooth movement: gradual shifting of the teeth further forward.
X-ray findings also matter: confirming that the tooth is impacted, detecting a cyst or benign tumor, and seeing how close the roots are to the mandibular nerve or the maxillary sinus.
Not every wisdom tooth needs to come out. A wisdom tooth that has fully erupted, sits in a normal position, is healthy and causes no clinical or X-ray problems can be kept, with periodic check-ups. The decision always weighs the risks and benefits for you as an individual.
Wisdom teeth removal cost: what affects the price?
The cost of wisdom teeth removal depends on how complex the case is and on the type of extraction needed. Removing a fully erupted wisdom tooth is a standard procedure; the cost changes when the tooth is impacted or hard to reach. The main factors are the degree of impaction and position of the tooth, the imaging needed, the type of anesthesia and the length of the procedure.
A panoramic dental X-ray is often needed before the procedure, to assess the position of the tooth and its distance from the nerves. Although the wisdom tooth is a molar, removing it is often different from a molar tooth extraction because of its position at the back of the mouth and the possibility that it is impacted. You receive a detailed written quote after the consultation, and itemized receipts you can submit to your insurer (coverage depends on your policy).
Examination, treatment plan and price quote
detailed and personalized
During the consultation, Dr Haim Aseriel examines your teeth, explains all the options and gives you a transparent price quote, with no obligation. The clinic is at 12 HaTnufa Street, Jerusalem.
Wisdom teeth removal recovery: how long does it take?
Recovery after wisdom teeth removal is gradual: swelling, pain and discomfort are expected in the first days and usually ease within the first few days. The extraction site usually heals within one to two weeks, and the bone continues to rebuild for longer, depending on the complexity of the case and personal factors (MedlinePlus).
Healing speed depends on your age, general health and how closely you follow the aftercare instructions; recovery from a surgical extraction can take longer than from a simple one (see bleeding after tooth extraction). Most patients return to normal daily activities within a few days; strenuous exercise or sport is resumed when your dentist says so.
Pain that gets worse after wisdom teeth removal, instead of better, needs to be checked. It can be a sign of infection or of a dry socket (see the risks below).
A fever, swelling that spreads toward the eye or the neck, or difficulty swallowing or breathing require immediate care in a hospital emergency room.
Possible risks and complications of wisdom tooth removal
- Dry socket: the blood clot comes loose too early, causing increasing pain, usually one to three days after the extraction. It affects a small minority of routine extractions (up to about 7%), is more common after surgical removal of an impacted wisdom tooth, and is treated at the clinic (Daly et al., Cochrane, 2022).
- Inferior alveolar nerve injury: rare, with lower wisdom teeth; it causes numbness or tingling of the lower lip and chin, usually temporary, while permanent injury is very rare (Sarikov & Juodzbalys, 2014).
- Opening into the sinus: with an upper wisdom tooth close to the maxillary sinus, a connection between the socket and the sinus can occur and is treated as needed.
- Age: in an AAOMS cohort study of more than 4,000 patients, age over 25 was associated with a higher complication rate (Chuang et al., 2007).
Aftercare after wisdom teeth removal: bleeding, rinsing, eating and smoking
After wisdom teeth removal, your dentist gives you detailed instructions. The essentials:
- Bleeding: bite on the gauze with steady pressure. Light bleeding and pink-stained saliva in the first hours are normal; if the bleeding is heavy, does not stop with steady pressure on gauze, or significant bleeding starts again several hours later, contact the clinic. Details: bleeding after a tooth extraction.
- Protect the clot: do not rinse forcefully, spit or drink through a straw in the first days (no straw for at least 24 hours). According to MedlinePlus, gentle rinsing and spitting can start again about three days after the extraction; salt water only if your dentist recommends it. A cold pack on the cheek, 10 to 20 minutes at a time, and ask your dentist or pharmacist which pain reliever to take.
- Eating: soft, not-too-hot food, chewing on the other side, without hard foods or small grains that can get stuck in the socket. Details: what to eat after a tooth extraction.
- Smoking and alcohol: smoking roughly triples the risk of dry socket (Kuśnierek et al., 2022), so do not smoke for at least the first few days, as your dentist advises, and avoid alcohol. Details: smoking after a tooth extraction.
Wisdom teeth removal in Jerusalem: book a consultation
Surgical removal of a wisdom tooth calls for skill and experience. At the clinic, each case is assessed individually, from diagnosis to recovery; complex cases are treated at the clinic together with the oral and maxillofacial surgeon, under local anesthesia, with light oral sedation when needed. The clinic does not offer IV sedation or general anesthesia (see dental treatment under general anesthesia).
If you have pain around your wisdom teeth, swelling, difficulty opening your mouth, recurring headaches or repeated infections, book a consultation. Dr Haim Aseriel, a US-trained dentist (DDS, NYU College of Dentistry), examines your case, explains the options in English and gives you a written treatment plan and quote. The clinic is at 12 HaTnufa Street in Talpiot, south Jerusalem.
Wisdom teeth removal: frequently asked questions
Wisdom teeth are the third set of molars, at the very back of the jaw. They are also called third molars and usually come in between the ages of 17 and 21, when most of the other permanent teeth are already in place.
Not every wisdom tooth needs to be removed. The decision is based on an examination and an X-ray, not on age alone. A wisdom tooth that has fully erupted, sits in a normal position, is healthy, works normally and causes no clinical or X-ray problems can stay in the mouth, with periodic check-ups.
After wisdom teeth removal, pain and swelling usually ease within the first few days. The extraction site usually heals within one to two weeks, and the bone continues to rebuild for longer. Recovery varies from patient to patient and depends on how complex the extraction was; return to strenuous exercise is decided with your dentist.
How long wisdom teeth removal takes depends on the case: removing a fully erupted wisdom tooth can take just a few minutes, while a deeply impacted tooth that must be divided into sections can take considerably longer. The planned duration is explained at the consultation, after the X-ray.
After wisdom teeth removal, choose soft, not-too-hot foods in the first days and chew on the other side; avoid spicy or hard foods and small grains (like rice) that can get stuck in the socket. A detailed list is on our page "What to eat after a tooth extraction".
Sources
- American Dental Association (MouthHealthy), Wisdom Teeth – View source
- MedlinePlus (U.S. National Library of Medicine), Tooth extraction, 2024 – View source
- Chuang SK et al., Journal of Oral and Maxillofacial Surgery, 2007 – View source
- Daly BJ et al., Cochrane Database of Systematic Reviews, 2022 – View source
- Kuśnierek W et al., Dentistry Journal, 2022 – View source
- Carrasco-Labra A et al., Journal of the American Dental Association, 2024 – View source
- Sarikov R, Juodzbalys G, Journal of Oral & Maxillofacial Research, 2014 – View source
