Key points in brief
- The plan depends mainly on how difficult the lower wisdom teeth are to remove. Removing all your wisdom teeth at once is possible, but when the lower ones are difficult, the treatment is often split into 2 visits, one side at a time.
- With two difficult lower wisdom teeth, a single visit means swelling on both sides and no side left for comfortable chewing. When all the wisdom teeth are easy to remove, one visit has the advantage.
- Before you book a date, ask your dentist which wisdom tooth is the most difficult. After each visit, plan a few days of soft food and lighter duties.
- The risk of complications depends, among other things, on the position of each wisdom tooth. The number of visits mainly changes whether you go through one healing period on both sides or two, each on one side.
Consult your case with an expert and get your treatment plan
How many wisdom teeth can be removed at once and what that depends on
Anything from one to all four wisdom teeth can be removed at a single visit. The number is settled only once it is clear which teeth are to come out. The first decision is whether your wisdom teeth should be removed or kept.
The position of the lower wisdom teeth tells you the most about how healing will go. A tooth that lies deep in the lower jawbone is removed surgically, which means making a cut in the gum and removing part of the bone. After such a procedure, pain, swelling and difficulty opening the mouth more often last longer than after removing a tooth that lies closer to the surface. The return to work is also more often delayed. How a surgical wisdom tooth extraction goes depends on how deep the tooth lies and how its roots are positioned.
It also matters whether one of the wisdom teeth is already causing trouble. A tooth that hurts or inflames the gum is often removed first, once the acute inflammation has been brought under control.
Strong fear of the procedure is sometimes a reason to have all the wisdom teeth removed at one visit. In people with strong anxiety, however, discomfort after the procedure can be greater. So it is worth mentioning your anxiety at the planning stage: your dentist will take it into account when choosing between one longer visit and two shorter ones.
Upper wisdom teeth that have come through and can be seen in the mouth are usually removed more quickly and easily than lower ones, so the plan less often depends on them. It can be different with an upper wisdom tooth hidden in the bone close to the maxillary sinus, because removing it may leave an opening between the mouth and the sinus.
Your dentist assesses how difficult each tooth is on a panoramic X-ray, an X-ray of all the teeth and both jaws. Apart from the depth of the tooth and the shape of its roots, what counts is how close the roots lie to the inferior alveolar nerve. This nerve runs through a canal in the lower jawbone and gives feeling to the lip and chin. For a wisdom tooth whose roots lie tightly against the canal, the plan may include coronectomy, which means removing only the crown of the tooth. The roots then stay in the bone.
Your general health and the medicines you take also count. Your dentist takes your medicines into account in the plan, especially blood thinners, but do not stop taking them on your own.
At the planning visit, ask your dentist:
- Which of my wisdom teeth is the most difficult to remove, and why?
- Does any of them lie close to the nerve or the sinus?
- Can the upper and lower wisdom teeth on the same side be removed together?
- How many visits are we planning, and for how many days after each will I need to eat carefully?
- With my health conditions and medicines, would one longer visit or two shorter ones be better?
One wisdom tooth, two on one side, both lower ones or all four
Healing time after removing several wisdom teeth at once is known less precisely than after removing one. So your dentist plans mainly on the basis of how healing goes after each wisdom tooth on its own.
| Plan | Healing and eating | Anaesthesia, visits and work |
|---|---|---|
| One wisdom tooth | Swelling and pain on one side. The other side is left for chewing. | One side goes numb. Each further wisdom tooth means a separate visit and a separate break from work. |
| Upper and lower on the same side | As with one wisdom tooth. On the first day, eating can be harder than after the lower one alone. | One visit per side, which usually means 2 visits and 2 breaks from work for all the wisdom teeth. One side of the lip and tongue goes numb. |
| Both lower ones, one on each side | Swelling and reduced mouth opening on both sides at the same time. No side is left for chewing, so soft food is best for a few days. | Both lower teeth at one visit: one healing period and one break from work instead of two. Until the anaesthetic wears off, both sides of the lip and tongue are numb. |
| All four | Similar to both lower ones. | One visit and one break from work, but the longest procedure and the most discomfort at the same time. Both sides of the lip and tongue go numb. |
After surgical removal of one lower wisdom tooth, pain, swelling and difficulty eating last about 4 days on average. Swelling builds up until roughly the second day and then starts to go down. Milder pain lasts more than a week in some people.
Time off work after such a procedure is 1–2 days on average. If your work is physical or involves a lot of talking, the break can be longer than for people who work at a desk, whichever plan you choose. Roughly one person in five finds the procedure and the time after it harder than they expected, so it is worth planning a few spare days.
Each wisdom tooth carries its own risk of complications, such as dry socket or a numb lip. Dry socket is a painful disturbance in the healing of the gap left by the tooth. The risk of complications depends, among other things, on how the tooth lies. Studies do not show that spreading the treatment over two visits lowers the risk of complications at the tooth itself. What the plan mainly changes is how much discomfort falls into a single healing period.
The more wisdom teeth are removed in total, the greater the risk that a complication will appear at one of them - whether they are removed together or separately. Numbness of the lip and chin that lasts for weeks but eventually goes away happens in a few people in 100 after surgical removal of a lower wisdom tooth. Numbness that lasts longer than a year occurs in fewer than 1 in 100. Permanently altered feeling in the tongue is about as rare as permanent numbness of the lip.
When it is better to spread the treatment over two visits
When both lower wisdom teeth are difficult, your dentist often suggests removing the wisdom teeth on one side at each of 2 visits. In many cases this means removing two wisdom teeth at the same time on the same side, the upper and the lower one, and the other two at the second visit.
Surgical removal of one wisdom tooth takes anything from a dozen or so minutes to more than an hour, depending on how difficult it is. With two deep-lying lower wisdom teeth, a single visit is therefore a long one. The longer the removal takes, the stronger the pain afterwards usually is.
Apart from shorter visits, two stages also have the advantage when:
- one of the wisdom teeth lies close to the nerve or the sinus and your dentist wants to give it a whole visit;
- both lower wisdom teeth lie close to the nerve, because if numbness appears after the first side, the plan for the second can be changed;
- you have a medical condition for which your dentist prefers shorter procedures;
- your jaw joint hurts or you find it hard to keep your mouth wide open for a long time;
- you are having wisdom teeth removed for the first time and do not know how you will cope with healing.
If any of these points applies to you, tell your dentist about it when planning. The order is set by your dentist after looking at the X-ray - often the wisdom tooth that is causing trouble or lies in the most difficult position is removed first. The drawback of two stages is two breaks from work and two periods of soft food.
When removing all wisdom teeth at once has the advantage
Removing all wisdom teeth at once has the advantage when the teeth are easy to remove, for example when they have all come through. You then have one healing period, one anaesthetic and one break from work instead of two. For people with few days off, this can matter more than comfortable eating.
If you choose to have your wisdom teeth removed on both sides at once, for the first few days there will be no side you can sleep on without pressure. You will then need to sleep on your back, with your head raised higher than usual.
Plan at least as much time off as you would need after the most difficult of the wisdom teeth you are having removed. The length of sick leave is for the doctor to decide. The rest of the tooth extraction aftercare advice, for example on brushing, smoking and physical effort, is the same as after one tooth.
What local anaesthesia changes in the plan when several wisdom teeth are removed
Wisdom teeth are removed under local anaesthesia. With several wisdom teeth, the anaesthetic mainly changes whether one side goes numb or both. If something hurts during the procedure, your dentist gives more anaesthetic.
After anaesthesia for a lower wisdom tooth, the lip, chin and half of the tongue on that side usually stay numb for a few hours. Anaesthesia for an upper wisdom tooth does not make the tongue numb. That is why adding the upper wisdom tooth to the lower one on the same side changes little in the anaesthesia itself.
When both lower wisdom teeth are removed at once, both sides of the lip and tongue go numb at the same time - usually for the same few hours. It is then harder to speak, swallow and feel whether you are biting your cheek. Some people find this unpleasant, and it is sometimes one of the reasons your dentist suggests two stages.
Your dentist also makes sure that the total dose of anaesthetic is safe for your body weight and health. With several teeth at one visit this matters more than with one, so before the procedure tell your dentist about any heart conditions and about all the medicines you take. Do not eat or drink until feeling has fully returned, because it is easy to bite your lip or not notice that something is too hot. If numbness of your lip, chin or tongue has not gone after a few hours, when the anaesthetic should already have worn off, call the practice straight away.
How to plan the dates of your visits
At the consultation before wisdom tooth removal, your dentist will show you on the X-ray which lower wisdom tooth is the most difficult and will match the number of visits to it. When planning treatment at our practice in Wola, we pay particular attention to whether you will have a side left for eating after the procedure and how many days you can set aside for healing.
Choose a date so that the first 2 days after the procedure fall on days off, because they are usually the hardest. On the day of the procedure, eat a light meal and take your regular medicines, unless your dentist tells you otherwise. If you take a blood thinner, ask beforehand whether to take your morning dose.
Frequently asked questions
How much time usually passes between the first and the second stage?
The second stage is usually planned once the main discomfort on the first side has settled, the wound is healing and your mouth opens normally. After surgical removal of a lower wisdom tooth, the main discomfort lasts a few days on average, and longer in some people. That is why your dentist sets the date of the second stage only at the check-up, when they can see how the first side is healing.
Is a CT scan needed before removing several wisdom teeth?
A CT scan is usually not needed before removing several wisdom teeth. A panoramic X-ray is most often enough for planning. Your dentist considers cone-beam CT, a three-dimensional X-ray, when the roots of a lower wisdom tooth overlap the nerve canal on the X-ray and the result could change the plan. The number of teeth being removed makes no difference here. A CT scan can help plan the procedure, but on its own it usually does not lower the risk of nerve damage.
Does the patient's age change the plan for removing wisdom teeth?
Age changes the plan mainly because in older people the lower wisdom teeth more often lie deep in the lower jawbone. It is not known whether age itself increases the risk of complications, because studies give different results. That is why, when planning, your dentist checks on the X-ray above all how each tooth lies.
Can the plan change during the visit if the first wisdom tooth turns out to be difficult?
Yes, the plan can be changed during the visit. An X-ray shows how difficult a tooth is only approximately, and the full picture becomes clear only during the procedure. If the first wisdom tooth turns out to be more difficult than it seemed and the removal takes a long time, your dentist may suggest moving the second one to a separate visit. When the procedure goes more smoothly than expected, your dentist may also suggest removing another wisdom tooth at the same visit.
Does removing the upper wisdom teeth along with the lower ones make healing longer?
It is not known exactly whether adding the upper wisdom teeth makes healing longer. In one study, people who had their upper wisdom teeth removed along with the lower ones more often ate very little at one of their meals on the first day after the procedure. Your dentist takes this into account when planning how many teeth to remove at one visit and talks with you about eating in the first few days.
How should I eat in the first few days when wisdom teeth have been removed on both sides?
Start eating only after the anaesthetic has worn off, in small portions and without biting with your back teeth. In the first few days, cool or lukewarm, soft and mushy foods work well, for example smooth soups, yoghurt or scrambled eggs. They can usually be eaten with a teaspoon even when your mouth does not open well. Avoid hot drinks and hard or spicy foods.
How long can limited mouth opening last after removal of the lower wisdom teeth?
Most people have limited mouth opening after the procedure. It usually builds up over the first 2 days and goes away after a few days along with the swelling, but in some people it lasts more than a week, more often after a deep-lying tooth. If it gets worse after the third day or you find it hard to swallow, call the practice the same day. If you have difficulty breathing or the swelling spreads down to your neck, call the emergency number 112.
Read more:
- Tooth Extractions in Warsaw Wola
- Dry socket — how to recognise it and why you should not wait
- Pain and swelling after tooth extraction — what is normal and what is a warning sign
- Blood clot after tooth extraction — what a normally healing socket looks like
- Dental radiographs, panoramic imaging, 3D tomography: A guide to dental radiology
Content and liability disclaimer
This article is informational and educational in nature and does not constitute medical advice, a diagnosis or a therapeutic recommendation — it does not replace a consultation with a specialist. If you are experiencing symptoms, have doubts or are facing a decision about treatment, consult a dentist. The methods described and the data cited are general in nature. The results of scientific studies relate to populations, not to an individual patient. The course and outcome of therapy depend on the individual clinical situation and may vary between patients. No information contained in this article constitutes a guarantee of result. The content has been prepared with due care, based on publicly available medical knowledge and the scientific publications indicated in the Sources section. We do not advise taking or refraining from any health-related action solely on the basis of the content of this article, without prior consultation with a doctor.
Sources
Source 1
Links https://doi.org/10.1007/s00784-020-03759-7 │ https://pubmed.ncbi.nlm.nih.gov/33392805/
Description Vranckx M, Lauwens L, Moreno Rabie C, Politis C, Jacobs R. „Radiological risk indicators for persistent postoperative morbidity after third molar removal.” Clinical Oral Investigations. 2021;25(7):4471-4480.
Source 2
Links https://doi.org/10.1016/j.jcms.2023.09.018 │ https://pubmed.ncbi.nlm.nih.gov/37858483/
Description Starch-Jensen T, Gacic B, Konstantinovic VS, Valls Ontañón A, Sapundzhiev A, Pavlov N, et al. „Patient’s perception of recovery following surgical removal of mandibular third molars. A prospective european multi-center study.” Journal of Cranio-Maxillofacial Surgery. 2023;51(10):635-643.
Source 3
Links https://doi.org/10.1016/j.ijom.2025.10.002 │ https://pubmed.ncbi.nlm.nih.gov/41130857/
Description Starch-Jensen T, Giordano R, Alsadi DM, Bruun NH, Arendt-Nielsen L. „Patient perceptions of recovery following surgical removal of an impacted mandibular third molar and application of advanced platelet-rich fibrin: a prospective randomized controlled clinical trial.” International Journal of Oral and Maxillofacial Surgery. 2026;55(3):373-384.
Source 4
Links https://doi.org/10.1186/s12903-022-02154-w │ https://pubmed.ncbi.nlm.nih.gov/35410280/ │ https://pmc.ncbi.nlm.nih.gov/articles/PMC9004130/
Description Taniguchi S, Abe A, Ito Y, Ishihama T, Hayashi H, Momokita M, Naito R, Shibata K. „Factors associated with a reduced food intake after third molar extraction among adults: a cross-sectional study.” BMC Oral Health. 2022;22(1):120.
Source 5
Links https://doi.org/10.1007/s00784-024-05975-x │ https://pubmed.ncbi.nlm.nih.gov/39375233/ │ https://pmc.ncbi.nlm.nih.gov/articles/PMC11458702/
Description Dudde F, Giese M, Schuck O, Krüger C. „Impacted third molar surgery in older patients-Is patient´s age really a risk factor for complications?” Clinical Oral Investigations. 2024;28(11):576.
Source 6
Links https://doi.org/10.1016/j.joms.2024.06.182 │ https://pubmed.ncbi.nlm.nih.gov/39038596/
Description Kim JY, Han MD, Lee H, Ko JH, Park YL, Huh JK. „Are There Differences in the Causes and Complications of Mandibular Third Molar Extraction in Older Patients Compared to Younger Patients?” Journal of Oral and Maxillofacial Surgery. 2024;82(11):1416-1424.
Source 7
Links https://doi.org/10.1016/j.joms.2024.05.003 │ https://pubmed.ncbi.nlm.nih.gov/38821486/
Description Chai Y, Dong Y, Lu Y, Wei W, Chen M, Yang C. „Risk Factors Associated With Inferior Alveolar Nerve Injury After Extraction of Impacted Lower Mandibular Third Molars: A Prospective Cohort Study.” Journal of Oral and Maxillofacial Surgery. 2024;82(9):1100-1108.
Source 8
Links https://doi.org/10.1016/j.oooo.2025.01.717 │ https://pubmed.ncbi.nlm.nih.gov/40254474/
Description Petersen LB, Nielsen H, Schropp L, Matzen LH. „Permanent neurosensory disturbances in the Danish population after removal of a mandibular third molar: incidence, distribution, and morbidity.” Oral Surg Oral Med Oral Pathol Oral Radiol. 2025;140(2):143-148.
Source 9
Links https://doi.org/10.1186/s12903-022-02490-x │ https://pubmed.ncbi.nlm.nih.gov/36329417/ │ https://pmc.ncbi.nlm.nih.gov/articles/PMC9635162/
Description Robbins J, Smalley KR, Ray P, Ali K. „Does the addition of cone-beam CT to panoral imaging reduce inferior dental nerve injuries resulting from third molar surgery? A systematic review.” BMC Oral Health. 2022;22(1):466.
Source 10
Links https://doi.org/10.1016/j.adaj.2025.10.013 │ https://pubmed.ncbi.nlm.nih.gov/41500761/ │ https://pmc.ncbi.nlm.nih.gov/articles/PMC13580382/
Description Benavides E, Krecioch JR, Allareddy T, Buchanan A, Keels MA, Mascarenhas AK, et al. „American Dental Association and American Academy of Oral and Maxillofacial Radiology patient selection for dental radiography and cone-beam computed tomography: Clinical recommendations.” Journal of the American Dental Association. 2026;157(1):20-35.e5.