Wisdom teeth removal

Not everyone needs their wisdom teeth out. Wisdom teeth that have come through straight, sit in a healthy position and can be kept clean are often simply left alone and checked at your normal visits. If a dentist has never looked at yours, that check, not removal, is the sensible first step.

Removal earns its place when a wisdom tooth is causing trouble or clearly heading for it: repeated pain or infection in the gum over the tooth, decay in the wisdom tooth or the tooth in front of it, a tooth coming through at an angle and trapping food, or a tooth stuck partly under the gum where it can't be cleaned. In those cases, taking it out early is usually easier than waiting for the painful week that forces the decision.

When monitoring is fine

A wisdom tooth that is fully through, upright, biting against its partner and reachable with your toothbrush is just a molar with a dramatic name. We keep an eye on it with X-rays at check-ups and leave it in peace.

Monitoring is also often right for a tooth that is completely buried, not pressing on anything and causing no symptoms. Surgery has its own costs and risks, and we don't recommend it to solve a problem you don't have. What changes the calculation: recurring infections, decay we can see starting, pressure against the neighbouring tooth, or pain that keeps returning. If we recommend removal, we'll show you the reason on your X-ray, not just tell you.

What removal is like

Most wisdom teeth are removed in the chair, awake, with local anaesthetic: the same numbing as for a filling, just more thorough. You'll feel pressure and pushing, which is normal and expected, but not sharp pain; if anything sharp gets through, tell us and we stop and top up the anaesthetic. Straightforward removals take minutes once you're numb. A tooth that's partly under the gum takes longer and may need a small cut in the gum and a stitch or two.

Some wisdom teeth are genuinely difficult: deeply buried, lying sideways, or close to the nerve that runs through the lower jaw. Difficult or deeply impacted teeth are assessed with a CBCT scan (a 3D X-ray) before any decision is made, not halfway through. We do most removals here and refer complex cases to a maxillofacial surgeon. We'll tell you at the check-up which applies to you.

If you're anxious about the procedure, ask us about sedation. For anxious patients we offer oral sedation (a calming tablet taken before treatment) for adults and older children, where it's safe. For children and some adults, we also hold scheduled sedation lists where a medical doctor trained in sedation gives and monitors the sedation while the dentist works. The dentist will discuss whether it suits you, how to prepare, and you'll need someone to drive you home.

Recovery, honestly

Expect a few uncomfortable days, not a ruined fortnight. Swelling and jaw stiffness peak around the second or third day and then ease. Ordinary painkillers, cold compresses on the cheek, soft food and rest cover most of it. We'll give you written instructions to take home, including when to start salt-water rinses.

Two rules matter more than the rest: don't smoke, and don't disturb the blood clot in the socket: no vigorous rinsing or drinking through straws in the first days. The clot is the healing; lose it and you get dry socket, which announces itself as pain that eases for a day or two and then comes back worse, sometimes with a bad taste. Dry socket isn't dangerous, but it's miserable and we can settle it quickly. Phone us rather than pushing through.

Call us straight away if you have bleeding that won't stop with firm pressure on a gauze pad, swelling that keeps growing after day three, or fever.

Extractions in general

The same honesty applies to any tooth, not just wisdom teeth. Sometimes a tooth genuinely can't be saved: decay too deep, a crack below the gum, bone loss that has loosened it beyond repair. And sometimes a tooth that feels doomed can still be rescued with a root canal or a crown.

Before we take any tooth out, we tell you which of those it is and what saving it would involve and cost, so pulling it is a decision you make with the facts, not the default because it hurt on a Friday. If the tooth does need to go, we'll also talk about what happens to the gap. Some gaps matter and some don't, and dentures, bridges and implants each have their case.

What it costs

A simple extraction and a surgical removal of an impacted tooth are priced differently, because they're different procedures. You'll get the assessment first (examination and X-ray), then a clear quote before anything is removed. Most medical aids cover extractions; cover for surgical removals varies by plan, and we'll help you check yours before you book the procedure.

Frequently asked questions

How do I know if my wisdom teeth are coming through?

Usually in your late teens or twenties: a dull ache or pressure at the back of the jaw, tender gum behind your last molar, sometimes a flap of gum you can feel with your tongue. Discomfort while a tooth comes through normally passes; pain that keeps returning is worth an X-ray.

Do all four have to come out at once?

No. We remove what needs removing. Some people have one problem tooth and three healthy ones; doing all four "while we're there" is only right if all four actually need it.

Can I drive myself home afterwards?

After a removal under local anaesthetic, yes. You're awake and alert; your mouth is just numb. If you have sedation, you'll need someone to drive you home, and the dentist will discuss this with you beforehand.

How long before I can eat normally?

Soft food on the day, chewing away from the socket for the first few days, and back to normal as comfort allows. Most people are eating ordinarily within a week.

What if I just leave a painful wisdom tooth?

Infections around a partly-through tooth tend to come back, and each round is harder to treat. Decay between a tilted wisdom tooth and its neighbour can end up costing two teeth instead of one. Leaving it is a decision too. Make it with an X-ray, not in the dark.