When to Extract Wisdom Teeth: When to Pull and When to Wait

If a wisdom tooth needs to come out, the best time is around age 20, when it erupts into the mouth. In Korea, the Korea Disease Control and Prevention Agency (KDCA, 질병관리청) explains that extraction is relatively easy and wounds heal well at this age, but that for impacted wisdom teeth, the surrounding bone hardens and the chance of systemic disease rises with age, making extraction harder. However, when there is a lot of pain from inflammation, the tooth is not pulled right away; the inflammation is calmed first and then a date is set.

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

Key facts

When wisdom teeth erupt	Usually late teens to early twenties (source: KDCA National Health Information Portal)
Recommended extraction time	Around age 20, when the wisdom tooth erupts into the mouth (source: KDCA National Health Information Portal)
With increasing age	Surrounding bone hardens and systemic disease becomes more likely, making impacted tooth extraction harder (source: KDCA National Health Information Portal)
When inflammation is severe	Extract after calming inflammation first; if there is pus, incision and drainage come first (source: KDCA National Health Information Portal)
When it helps to check in advance	Planning a pregnancy, being unable to get long-term dental care, or before starting medication or radiation therapy that affects surgery (source: KDCA National Health Information Portal)

Why is around age 20 said to be best?

Wisdom teeth are the last teeth to form inside the jawbone and usually erupt between the late teens and early twenties. At this age the bone around the wisdom tooth is relatively soft and the body recovers well, so extraction goes smoothly and the wound heals easily.

The KDCA explains that the older you are, the harder it is to extract an impacted wisdom tooth. The surrounding bone hardens, and with age the chance of systemic diseases such as high blood pressure and diabetes also rises. The official guidance is that if a dentist recommends extraction, it is best to have it done as soon as possible.

What happens if you wait until a problem develops?

If you put it off because it does not hurt, the neighboring molar and gum bone can be damaged in the meantime. The KDCA explains that leaving a tooth until problems arise increases loss of surrounding teeth and bone and damage to the gums.

If a tooth tilted forward causes decay behind the front molar, root canal treatment or a prosthesis for that molar may be needed before or after the wisdom tooth is pulled. When damage is severe, the front molar may even have to be extracted, so the later the extraction, the wider the treatment can become.

Gums near the wisdom tooth that repeatedly swell and calm down are also a signal to bring the timing forward. The more often inflammation recurs, the worse the surrounding gum and bone become, and extraction and recovery can be harder later on.

Why is the tooth not pulled right away when it hurts?

If a wisdom tooth hurts a lot, inflammation has likely already developed around it. The KDCA explains that pulling a tooth during severe inflammation heals poorly and can spread the inflammation to surrounding areas, so severe inflammation is calmed first and the tooth is extracted afterward.

If pus has collected around the wisdom tooth, incision and drainage come before extraction. Taking painkillers or anti-inflammatories on your own may help briefly but can make things worse and become an emergency, so when pain starts it is safer to see a dentist first.

In which situations is it better to pull the tooth in advance?

The KDCA advises that if any of the following are planned, it is advisable to have a dentist check for wisdom teeth and give advice in advance. This is because if wisdom tooth inflammation arises during those periods, treatment options narrow.

When you are planning a pregnancy
When you will find it hard to get dental care for a long time, such as military service, study abroad or a long business trip
Before starting drug therapy that could affect dental surgery
Before starting radiation therapy that could affect dental surgery

Is it better not to pull wisdom teeth when you are older?

It is not decided by age alone. If a tooth is buried deep in the bone, has no symptoms and carries a high risk of nerve damage, it is sometimes left in place and watched regularly. Conversely, if inflammation recurs or a cyst forms, extraction is considered regardless of age.

If you have a systemic disease, or for women when there are bodily changes such as menstruation or pregnancy, the timing is decided in discussion with your dentist. Telling the dentist about your medicines and chronic conditions in advance lets them set the date accordingly.

Common myths and facts

Myth: A wisdom tooth can just be pulled when it hurts.

When it hurts, inflammation has often already developed, so it is hard to pull right away, and the neighboring molar and bone can be damaged while you wait. If you are diagnosed as needing extraction, it is best to have it done as soon as possible.

Myth: Every wisdom tooth must be pulled as it comes in.

The KDCA explains that if a tooth erupts straight and can function in chewing, it does not necessarily have to be pulled.

Myth: Wisdom teeth cannot be pulled at all once you are older.

It only becomes harder with age, not impossible. It is decided together with your dentist after looking at your general condition and the degree of impaction.

Frequently asked questions

Can wisdom teeth be pulled in the teens?

Yes, if the dentist judges that extraction is needed. The KDCA considers around age 20, when the wisdom tooth erupts, the best time, and the exact timing is set by looking at root development and position on an X-ray.

Can all four wisdom teeth be pulled at once?

The dentist decides whether to pull them at once or in stages, considering the degree of impaction, your general condition and recovery time. Pulling both sides together makes chewing on either side difficult, so discuss your schedule and meal plan. The KDCA advises not chewing on the surgical site for about a week after extraction.

Can I have a tooth pulled before an exam or trip?

Pain is worst for 1 to 2 days and swelling around 48 hours after extraction, so it is better to avoid the time right before an important event. The KDCA advises avoiding strenuous exercise and work and resting well for 1 to 2 days after extraction.

My wisdom tooth is not visible yet. Could it still need to be pulled?

An impacted wisdom tooth buried in gum or bone is not visible in the mouth but shows on an X-ray. Depending on its tilt and the surrounding condition, preventive extraction may be recommended. Having the wisdom tooth position checked once at a regular checkup in the late teens makes it easier to plan the timing of extraction.

What should I do if I missed the best time to extract?

Even now, have the dentist check the wisdom tooth and the front molar on an X-ray. If there is no problem, it is watched regularly, and if there is inflammation or decay, the order of treatment is decided then.

References

Korean version →