Wisdom Tooth Extraction Guide: When to Remove, Recovery and National Health Insurance in Korea

Wisdom teeth (third molars) are the last molars to erupt, usually in the late teens to early 20s. A tooth that comes in straight and is used for chewing does not have to be removed, but removal is considered when it lies sideways or is partly covered by gum and keeps getting inflamed, and around age 20 is the easiest time. In Korea, wisdom tooth extraction is covered by National Health Insurance, with fees that differ by impaction level, and recovery gradually improves once the 48 hours when swelling is worst have passed.

Published 2026-11-08 · Updated 2026-11-08 · DentalStatics editorial team

Key facts

Eruption age	Usually late teens to early 20s (source: Korea Disease Control and Prevention Agency (KDCA, 질병관리청) National Health Information Portal)
Best time for extraction	Around age 20 (source: KDCA National Health Information Portal)
People without wisdom teeth	About 30% in most civilized populations (source: KDCA National Health Information Portal)
When pain is worst after extraction	3 to 5 hours after extraction, mostly on the day of surgery (source: KDCA National Health Information Portal)
When swelling is worst after extraction	48 hours (2 days) after extraction (source: KDCA National Health Information Portal)
Abnormal sensation after extraction	About 0.6 to 5% (source: KDCA National Health Information Portal)
Insurance extraction items	Divided by tooth condition, such as molar, complex impacted tooth and fully impacted tooth (source: Health Insurance Review and Assessment Service (HIRA, 건강보험심사평가원))
Outpatient copayment rate at dental clinics	30% of the total covered medical cost (source: National Health Insurance Service (NHIS, 국민건강보험공단))

Do wisdom teeth always have to be removed?

No. The KDCA explains that a wisdom tooth that grows in straight like other molars and can chew does not have to be removed. However, because it sits at the very back of the mouth where a toothbrush hardly reaches and food easily gets trapped, many are removed preventively to avoid cavities and bad breath.

Conversely, a tooth buried deep in the bone with a high risk of nerve damage may be left alone and monitored. Whether to extract is decided with a dentist who has reviewed the X-rays. Typical cases in which the KDCA recommends extraction are as follows.

The tooth grows in sideways and damages or decays the molar in front of it
The tooth is only partly covered by gum and inflammation between tooth and gum keeps recurring
Surrounding inflammation has been severe enough to swell the face and neck
A cyst (dentigerous cyst) has formed around an impacted wisdom tooth
Removal is needed for the stability of orthodontic treatment or for treatment of the molar in front

When is the best time to remove wisdom teeth?

The KDCA explains that the best time is around age 20, when wisdom teeth come into the mouth. At this age extraction is relatively easy and the wound heals well. With age, the surrounding bone of an impacted tooth hardens and the chance of systemic disease rises, making extraction harder.

If it already hurts a lot, inflammation has likely formed around the tooth, so the inflammation is calmed first and the tooth is removed afterward. If pus has collected, an incision to drain it is done first. If you plan a pregnancy or expect a period when regular dental visits will be difficult, it is wise to have the condition of your wisdom teeth checked in advance.

What tests are done before extraction?

The dentist examines by looking, asking and touching to check the gum around the wisdom tooth and any systemic disease. Then a panoramic X-ray and a periapical X-ray show the tooth position, root shape and distance to the inferior alveolar canal (mandibular canal).

If the roots are very close to the mandibular canal or sharply curved, a dental CT may be added. When a lower wisdom tooth touches the nerve canal, the lower lip and chin may feel temporarily numb after extraction, so it is wise to discuss with the dentist whether to take a CT.

How is wisdom tooth extraction performed?

A wisdom tooth that has come in straight is removed under local anesthesia like any other molar. A lower impacted wisdom tooth buried in gum or bone is mostly removed in this order: gum incision, removal of some jawbone, sectioning of the crown, tooth removal and stitching.

Mesioangular impaction, tilted forward, is the most common, followed by horizontal and vertical impaction. Difficulty and time vary not only with the tilt but also with the number and curvature of roots, fusion with bone and distance to the nerve canal.

If the roots of an upper wisdom tooth are close to the maxillary sinus, an opening into the sinus can form after extraction. The KDCA explains that a small opening usually closes on its own, while a large one needs a closing procedure and antibiotics, and sneezing and nose blowing should be avoided for about 3 to 4 weeks.

How does recovery after extraction go?

Pain is usually worst 3 to 5 hours after extraction and gradually fades after 1 to 2 days. Swelling peaks around 48 hours and then subsides. The aftercare instructions given by the KDCA are as follows.

For the first 1 to 2 days, brush while avoiding the surgical site, and afterward gently clean around the extraction area too. If pain is severe even with medication, return to the dentist even before the appointment date. If the socket hurts badly again and smells around days 3 to 5, it may be dry socket.

Bite firmly on gauze to stop bleeding, and swallow rather than spit out blood and saliva
Do not use a straw for 3 days, and do not touch the extraction site with your tongue or fingers
Apply a cold pack to the cheek for 1 to 2 days and sleep with your head slightly raised
For about a week, avoid chewing on the extraction side and eat soft food
For 1 to 2 days, avoid saunas, hot baths and strenuous exercise, and refrain from smoking and drinking
Take prescribed medicine (usually 3 to 5 days' worth) as directed

Does health insurance cover wisdom tooth extraction?

In Korea, wisdom tooth extraction is covered by National Health Insurance. Insurance extraction items are divided by tooth condition. HIRA review cases include extraction of an ordinary molar, a complex impacted tooth removed in sections, and a fully impacted tooth with at least two thirds of the crown buried in bone, removed with both bone removal and sectioning. The deeper the impaction, the higher the fee.

The patient pays according to the outpatient copayment rate, which differs by facility: 30% at dental clinics, 40% at dental hospitals in dong areas and 50% at general hospitals in dong areas. Dental CT and prescriptions are charged separately depending on care, so ask about the expected cost before extraction. For pregnant women, lower outpatient rates of 10% at dental clinics and 20% at dental hospitals apply.

How do you choose a dentist for wisdom tooth extraction?

In high-risk cases, such as a deeply buried lower wisdom tooth close to the nerve canal or a patient with systemic disease, referral to the oral and maxillofacial surgery department of a dental hospital or general hospital may occur. Copayment rates differ by type of facility, so weigh the referral and the cost together.

After comparing publicly available information in DentalStatics' regional dental lists, asking at the consultation about the impaction level, whether a CT is needed, and the schedule for the day of extraction and follow-up visits makes it easier to compare dentists.

Detailed guides

Frequently asked questions

Can a wisdom tooth be removed right away when it hurts?

Extraction during severe inflammation heals poorly and may spread the infection, so the KDCA explains that the inflammation is calmed first and the tooth is removed afterward. Seeing a dentist is safer than taking painkillers on your own and enduring it. Self-medication may bring brief relief, but the inflammation can worsen into an emergency.

Which is harder, an upper or a lower wisdom tooth?

Lower wisdom teeth are often impacted and their roots are often close to the mandibular canal, so the risk of nerve damage must be weighed. Upper wisdom teeth are close to the maxillary sinus, so an opening into the sinus can occur as a complication after extraction. Either way, the actual difficulty is judged from the tilt and root shape seen on X-rays.

What problems can occur if a wisdom tooth is left alone?

A forward-tilted wisdom tooth traps food behind the molar in front and causes cavities, and in severe cases that molar may need root canal treatment or extraction. A cyst around an impacted wisdom tooth can also weaken the jawbone. The KDCA explains that when a cyst grows, even a small impact can break the jawbone, so prompt treatment is needed.

When should I go back to the dentist right away after extraction?

See a dentist immediately if your face swells a lot and your mouth does not open well, if swallowing is difficult, or if you have chills or fever along with pain deep in the throat. If pain and swelling increase rather than ease even 3 days after extraction, infection is suspected.

Should I remove wisdom teeth in advance if I am planning a pregnancy?

The KDCA advises that if you are planning a pregnancy, it is desirable to have your wisdom teeth checked and discussed at a dental clinic. During pregnancy, wisdom tooth treatment is done after consulting your obstetrician. If you have a wisdom tooth that has repeatedly become inflamed, dealing with it before pregnancy can reduce the burden of treatment during pregnancy.

When can I drink alcohol and smoke after extraction?

KDCA extraction guidance says to avoid drinking and smoking for about 7 to 10 days after extraction, because they slow early recovery and can cause complications such as infection. Inhaling on a cigarette can also interfere with blood clotting, so it is safer to reconsider after the wound is checked at a follow-up visit.

References

Korean version →