10 min read • By Dr. Kevin Baharvand, DMD, MS • Updated August 2026
The short answer
The appointment itself takes about an hour and your teenager will remember almost none of it. IV sedation means medication delivered through a small line in the arm, titrated by the provider throughout, so they drift somewhere between very relaxed and asleep. They need an empty stomach beforehand, a driver afterward, and someone with them for the rest of the day. The recovery, not the surgery, is where the planning actually matters.
This is one of the few procedures where the parent is often more anxious than the patient, usually because the words IV sedation sound considerably more serious than the experience is.
What follows is the whole sequence, from the consultation to the week afterward, including the parts people are not told and then worry about at 11pm.
Our oral surgeon, Dr. David Roberts, has been doing this for more than thirty five years, and having him on site means this happens in the same building as the rest of your family dental care.
On this page
Why they come out, and why the mid teens
Not every wisdom tooth needs removing. That is worth saying first, because the assumption is often that it is automatic.
They come out when there is not enough room for them to erupt properly, when they are impacted against the tooth in front, when they are partially erupted and creating a flap of gum that repeatedly gets infected, or when they cannot be kept clean and are decaying.
The reason the mid to late teens is the usual window is the roots. At that stage the roots are only partly formed, which makes the extraction significantly easier and the healing faster. Wait until twenty five and the roots are fully developed, often curved around a nerve, and the same procedure becomes more involved with a longer recovery.
That is not a reason to remove healthy, fully erupted, cleanable wisdom teeth just because of age. It is a reason not to postpone when they clearly need to come out. Ask to see them on the panoramic x-ray, because the position is usually obvious once you are looking at it.
What IV sedation actually is
A small line goes into a vein in the arm or hand, and medication is delivered through it and adjusted continuously during the procedure. That adjustability is the whole advantage over a pill.
Most patients are somewhere between deeply relaxed and lightly asleep. They may respond to instructions and will usually remember nothing about it afterward. It is not general anaesthesia, which is a different depth entirely and typically happens in a hospital.
Local anaesthetic is still given, so the surgical site is numb regardless. The sedation handles awareness and anxiety, the local handles sensation.
Recovery from sedation is quick in the office and slow at home. They will be walking out within half an hour and genuinely groggy for the rest of the day. No school, no sport, no decisions.
If sedation is not needed, nitrous oxide or local anaesthetic alone is a legitimate option for straightforward extractions, and we compared them in the piece on laughing gas.
Before the day
The instructions are simple and non negotiable.
| When | What to do | Why it matters |
|---|---|---|
| At the consultation | Panoramic x-ray, review the position of each tooth, full medical history | Positions determine difficulty. History determines the sedation plan |
| Disclose everything | All medications, supplements, and any cannabis or nicotine use | Cannabis affects anaesthetic requirements. This is a safety question, not a moral one |
| The night before | Nothing to eat or drink after the stated cutoff, usually midnight | An empty stomach is the single most important safety instruction |
| Morning of | No breakfast. Regular medications only if specifically approved | Same reason |
| Clothing | Short sleeves or loose sleeves, flat shoes | The IV goes in the arm |
| Arrange the day | A driver, and an adult with them for the rest of the day | They cannot drive, and should not be alone while groggy |
| Fill prescriptions | Before the appointment, not after | Nobody wants to be at a pharmacy while the numbness wears off |
The empty stomach rule is the one instruction that gets the appointment cancelled on the day. If they had breakfast, say so. Do not let a teenager quietly decide it was only a granola bar.
The day itself, hour by hour
You arrive, paperwork is confirmed, and the IV is placed. That is a small needle and it is over quickly.
The sedation begins and within a minute or two they are somewhere pleasant and stop caring about proceedings. Local anaesthetic is given once they are comfortable.
The extraction itself typically takes thirty to sixty minutes for all four, depending on how impacted they are. Gauze goes in, and they are moved to recover.
Fifteen to thirty minutes of recovery in the office with monitoring, then you take them home. Expect them to be talkative and not making sense, and to have no memory of the drive.
You will get written post operative instructions. Read them in the office rather than in the car, because the person they apply to will not be retaining anything for several hours.
The recovery, which is the part that actually matters
Days one and two are the peak of swelling and discomfort, and this is normal. Swelling peaks around forty eight to seventy two hours and then improves.
Cold compresses on the outside of the face for the first day, twenty minutes on and twenty off. Head elevated when sleeping, including the first night, which makes a substantial difference to morning swelling.
Pain medication on a schedule rather than waiting for pain to arrive. Staying ahead of it works far better than chasing it.
Soft, cool food. Yoghurt, smoothies, apple sauce, lukewarm soup, scrambled eggs. Nothing crunchy, nothing with seeds, nothing hot for the first day.
No straws. This is the instruction most likely to be ignored and the one with the clearest consequence. Suction can dislodge the clot forming in the socket and cause a dry socket, which is a genuinely painful complication appearing around day three to five and requiring a return visit. No straws, no spitting forcefully, and no smoking or vaping, for the same reason.
Gentle salt water rinses starting the day after, not the same day. Keep brushing the other teeth normally.
What is normal and what warrants a call
Normal: swelling peaking on day two or three, bruising along the jaw, difficulty opening wide for several days, mild oozing on the first day, a sore throat, and a low grade temperature the first evening.
Call the office: pain that worsens sharply around day three to five rather than improving, which is the classic dry socket pattern. Bleeding that does not slow with firm pressure on gauze. Swelling that increases after day three. Difficulty swallowing or breathing. A fever that climbs. Numbness of the lip or chin persisting well beyond the day of surgery.
That last one is worth knowing about. The lower wisdom teeth sit close to a nerve, and temporary altered sensation happens occasionally. It nearly always resolves, but it should be reported and tracked rather than waited out silently.
Most teenagers are back at school within two to three days and back to sport in about a week, though full bone healing underneath continues for months.
Making it easier
Book it for a Thursday or Friday if you can, so the worst two days land on a weekend.
Have the soft food in the house beforehand. Nobody wants to shop on day one.
Set alarms for the pain medication schedule for the first forty eight hours, including overnight if instructed. This is the difference between a comfortable recovery and a miserable one.
And take the swelling photos on day two, because it is genuinely funny later and it will not look like that for long.
Common questions
How long does wisdom teeth removal take?
Typically thirty to sixty minutes for all four, depending on how impacted they are, plus fifteen to thirty minutes of recovery in the office afterwards.
Will my teen remember the procedure?
Almost certainly not. IV sedation reliably produces amnesia for the procedure even though the patient may respond to instructions during it.
Why can they not eat before?
An empty stomach is the central safety requirement for sedation. If they ate, the appointment gets rescheduled, so it is important to be honest about it on the day.
What is dry socket and how do we avoid it?
It is the loss of the blood clot from the socket, causing sharp pain around day three to five. Avoid straws, forceful spitting, smoking, and vaping for the first several days.
How long is the recovery?
Most teenagers return to school in two to three days and to sport in about a week. Swelling peaks around 48 to 72 hours and improves after that.
Do all wisdom teeth have to come out?
No. They come out when there is not enough room, when they are impacted, when they repeatedly get infected, or when they cannot be kept clean. Fully erupted, cleanable wisdom teeth can often stay.
Start with the consultation and the x-ray
You will see exactly where each tooth sits, hear whether all four need to come out or fewer, and get the full cost in writing before anything is scheduled. Dr. Roberts handles the surgery here in our office.
You may also be interested in these
- Does laughing gas knock you out?
- Why is your face swelling up?
- How long does numbness last after a filling?
About Tribute Family Dentistry
200+ five-star Google reviews • Family owned and independent • D Magazine Best Dentist 2026 • Living Magazine Readers' Choice 2026 • Se habla espanol
Tribute is a family owned, independent practice on FM 423 in Frisco. I own it with my wife, Dr. Julia Kang, DMD, MS. We both trained at Boston University and we are both members of the Omicron Kappa Upsilon national honor society. I am a Diplomate of the American Board of Orthodontics. Day to day, most patients and their kids see Dr. Christina Pham, DMD, our general and family dentist, and oral surgery is handled by Dr. David Roberts, DDS, who has been doing it for more than 35 years. D Magazine named me a Best Dentist for 2026, and Living Magazine readers voted us Best Family Dentist in Frisco and Plano the same year.
We handle the whole family in one place: cleanings and preventive care, fillings, crowns, bridges, implants, root canals, extractions and wisdom teeth, whitening, night guards, and emergency visits. We are open Monday through Friday, 8:00 AM to 5:00 PM, we speak Spanish, we work with most major insurance plans, and we run an in house savings plan for families without dental benefits.
If you need braces or clear aligners, that is the other side of what we do. Elate Orthodontics, our sister practice, treats kids, teens, and adults out of three offices in Frisco and The Colony.
Tribute Family Dentistry
5605 FM 423, Suite 600-B, Frisco, TX 75036
Book an appointment: (469) 598-1021
About the author: Dr. Kevin Baharvand, DMD, MS is a Diplomate of the American Board of Orthodontics and a national speaker on clear aligner treatment. His clinical work was selected for the cover of the American Journal of Orthodontics and Dentofacial Orthopedics. He and his wife, Dr. Julia Kang, own Tribute Family Dentistry and Elate Orthodontics in Frisco, Texas.
