Extraction of impacted teeth is one of the most common surgical procedures performed by oral and maxillofacial surgeons. Extensive training, skill, and experience are necessary to perform this procedure with minimal trauma to the surrounding soft and hard tissue. When the clinician is untrained or inexperienced, the incidence of complications rises exponentially. Treatment planning for the removal of asymptomatic teeth is no less problematic. In many situations the course of treatment depends on the clinician’s experience, professional judgment, and knowledge of current evidence-based literature.

Every surgical procedure results in some degree of postoperative bleeding and inflammation, typically manifesting as pain and edema. Through the inflammatory response and the natural progression of the body to heal itself, wound repair and tissue regeneration are activated, and physiologic mediators are concentrated in the wound area, resulting in the induction of nociceptive pathways and a change in vascular permeability. Although the complex physiology of the human body is beyond the scope of this article, the educated clinician should have an understanding of the time line associated with these processes so as to determine whether a patient’s complaint of postoperative bleeding, pain, or swelling represents a normal response to surgical trauma or an aberrant reaction.