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Wisdom teeth removal

Wisdom teeth removal involves taking out wisdom teeth at the back of your mouth that are causing problems.

You will meet the dentist or oral surgeon carrying out your procedure to discuss your care. It may differ from what is described here as it will be designed to meet your individual needs.

Wisdom teeth usually come through your gums between the ages of 18 and 24 although it can be earlier or later. They are the last of the large grinding teeth at the back of your mouth (molars). Some people never develop wisdom teeth but you could have up to four – one in each corner of your mouth.

For most people, wisdom teeth don't cause any problems and don't need to be removed. But if there isn't enough space for them to grow at the back of your mouth, they become what is known as impacted wisdom teeth and can cause pain, swelling and/or infection.

It’s important to see your dentist regularly if you have impacted wisdom teeth and to ensure good dental hygiene. If your wisdom teeth keep causing problems, they may need to be removed. These problems may include:

  • tooth decay
  • repeated gum infections or abscesses (collections of pus) around your tooth or in other teeth
  • cysts (fluid-filled sacs) around your developing wisdom teeth

Having your impacted wisdom teeth surgically removed (extracted) can help to stop these problems. Your dentist may be able to remove your wisdom teeth, or he or she may refer you to an oral surgeon.

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How a wisdom tooth is removed
Wisdom teeth can cause problems if there isn't enough space for them to grow at the back of your mouth
An image showing the position of the teeth

Details

  • Preparation Preparing for wisdom teeth removal

    Your dentist or oral surgeon will explain how to prepare for your procedure. For example, if you smoke, you may be asked to stop as smoking increases your risk of getting a wound infection, which can slow your recovery.

    The operation is usually done as a day case under local anaesthesia. This completely blocks pain from your gums and you will stay awake during the procedure. You may be offered a sedative to help you relax during the operation. If you go to a hospital and your wisdom teeth are particularly challenging to remove, you may have a general anaesthetic. This means you will be asleep during the procedure. Your dentist or oral surgeon will let you know which type of anaesthesia is most suitable for you.

    If you're having a general anaesthetic, you will be asked to follow fasting instructions. This means not eating or drinking, typically for about six hours beforehand. However, it's important to follow your dentist or oral surgeon's advice.

    Your dentist or oral surgeon will discuss with you what will happen before, during and after your procedure, and any pain you might have. This is your opportunity to understand what will happen, and you can help yourself by preparing questions to ask about the risks, benefits and any alternatives to the procedure. This will help you to be informed, so you can give your consent for the procedure to go ahead, which you may be asked to do by signing a consent form.

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  • Alternatives What are the alternatives to wisdom teeth removal?

    Not all wisdom teeth need to be removed. Mouthwashes and careful cleaning can often help prevent problems and treat symptoms caused by impacted wisdom teeth. Antibiotics can treat an infection.

  • The procedure What happens during wisdom teeth removal?

    The procedure for removing your wisdom teeth depends on whether it's an upper or lower tooth and how deeply impacted your teeth are. Many wisdom teeth, especially the upper ones, can be extracted like any other molar. Once the anaesthetic has taken effect, your dentist or oral surgeon will widen the socket (the area your tooth sits in) using dental tools. He or she will then loosen the tooth and remove it completely.

    If your tooth is more difficult to remove, your dentist or oral surgeon will cut through your gums and may remove some of the bone around your tooth to reach it. He or she will remove your wisdom teeth and then close your wounds with stitches, usually dissolvable ones, if you need them. Most wisdom teeth only take a few minutes to remove, but the more difficult teeth can take around 20 minutes.

  • Wisdom teeth treatment

    Our Bupa Dental Centres offer a range of routine, specialist and cosmetic treatments including wisdom teeth removal. Find out more.

  • Aftercare What to expect afterwards

    If you had a general anaesthetic or sedative, you will need to rest until the effects have passed. You will need to arrange for someone to drive you home. You should try to have a friend or relative stay with you for the first 24 hours.

    After a local anaesthetic, it may be several hours before the feeling comes back into your jaw. Take special care not to chew on the area or have any food or drinks that are too hot, as these could burn the area.

    You will be able to go home when you feel ready.

    Your dentist or oral surgeon will give you some advice about looking after your teeth and gums before you go home. You may be given painkillers, antibiotics and mouthwash to take home. You may also be given a date for a follow-up appointment.

    Most people have dissolvable stitches, which will disappear on their own and be brushed away within a few days.

  • Recovery Recovering from wisdom teeth removal

    If you need them, you can take over-the-counter painkillers such as paracetamol or ibuprofen. Follow the instructions in the patient information leaflet that comes with your medicine and ask your pharmacist for advice. Don't take aspirin because this can make bleeding worse.

    Don't vigorously rinse out your mouth during the first 24 hours after having a wisdom tooth removed because this can disturb blood clots that help the healing process. After meals, you can rinse gently with warm water.

    You should brush your teeth as usual as best you can, but keep your toothbrush away from the healing wound for the first couple of days. At first, you may feel small fragments of bone with your tongue. These are the edges of the tooth socket and will soon disappear as your gum heals.

    Eating and drinking

    For the first few days you should eat soft foods only. Gradually return to your usual diet, chewing with unaffected teeth to begin with.

    Bleeding

    If your gum bleeds, fold a clean handkerchief or piece of gauze, place it on your bleeding gum and bite on it for around five minutes. Don't rinse your mouth out and stay sitting up rather than lying down until bleeding has stopped.

    Most people don't experience any problems after having their wisdom teeth removed. However, contact your dentist or your GP immediately if you have:

    • bleeding that doesn't stop after applying pressure or that lasts for more than an hour or two
    • difficulty in breathing or swallowing because of a severe infection
    • severe pain that isn't getting better, or is getting worse
    • a high temperature
    • swelling that doesn't begin to improve after around two days
  • Risks What are the risks?

    As with every procedure, there are some risks associated with wisdom teeth removal. We have not included the chance of these happening as they are specific to you and differ for every person. Ask your dentist or oral surgeon to explain how these risks apply to you.

    Side-effects

    Side-effects are the unwanted but mostly temporary effects you may get after having the procedure.

    You may have some facial swelling, bruising, pain or jaw stiffness for up to two weeks. These symptoms are usually at their worst for the first two or three days and then gradually improve.

    Complications

    Complications are when problems occur during or after the operation. The possible complications of any operation include an unexpected reaction to the anaesthetic or excessive bleeding.

    Specific complications to having your wisdom teeth extracted are uncommon but may include:

    • infection
    • accidental damage to other teeth and your jaw during your operation
    • severe pain caused by dry socket – this is when the blood clot breaks away from the wound exposing the bone and nerves, causing pain and delaying healing
    • numbness in your lower lip or tongue, or changes to taste – this can be caused by nerve damage and there is a small chance that this could be permanent

    The exact risks are specific to you and will differ for every person, so we have not included statistics here. Ask your dentist or oral surgeon to explain how these risks apply to you.

  • FAQs FAQs

    How long will I need to be off work?

    Answer

    Most people need around two or three days off work to recover, but it depends on what your job is, the type of anaesthetic you have and how smooth your recovery is.

    Explanation

    Wisdom teeth removal is a minor procedure and most people don’t need to take a long time off work. If your job is desk-based, you may need a day or two off including the day of the procedure, to get over the worst of the pain and recover from the sedative or general anaesthetic, if you have one.

    If you have a job that involves more physical activity, you may need three or four days off. You can usually drive 24 hours after a sedative and 48 hours after a general anaesthetic, as long as you are confident you could do an emergency stop if you had to. If you’re in any doubt about driving, contact your motor insurer so that you’re aware of their recommendations, and always follow your surgeon’s advice.

    After three days, you may still need some mild painkillers but should be able to do your everyday activities. By the end of the first week, you can usually return to sports, but should not do any contact sports for a few more days. Your dentist or oral surgeon will be able to give you advice that’s right for you.

    You don’t need permission from your GP, dentist or oral surgeon to go back to work – you can go when you feel ready.

    My dentist told me to use a mouthwash after eating. Why is this?

    Answer

    Brushing your teeth after having your wisdom teeth removed can be difficult or uncomfortable. Your dentist or oral surgeon will give you advice on using mouthwashes and how to keep your wounds clean.

    Explanation

    If you can, try to brush your teeth as usual, however, you may find that it's too sore to clean the teeth near your wounds. If this is the case, you can use mouthwashes.

    Mouthwashes help to remove food debris and can help with wound healing.

    You can rinse your mouth out with warm water. Don't use very hot or cold water as this can make your wounds bleed.

    Alternatively your dentist might recommend an antiseptic mouthwash called chlorhexidine, which you can buy over the counter. Chlorhexidine can also be used to help prevent or treat dry socket – a condition caused by the breakdown or loss of the blood clot that forms in your tooth socket after you have had a tooth removed.

    My wisdom teeth are causing me a lot of pain and I'm pregnant. Is it safe to have them taken them out?

    Answer

    Yes. Wisdom teeth removal is safe if you're pregnant. Your dentist or oral surgeon will discuss your options with you.

    Explanation

    If you're pregnant, or think you might be, let your dentist or oral surgeon know. Essential dental treatment is safe for pregnant women, but some parts of the treatment may be changed to suit you.

    Although the X-ray images you need before your teeth are removed are probably safe because the X-ray beam doesn't go near your developing baby, most dentists prefer not to do X-rays while you're pregnant unless they are essential.

    If you do need to have your wisdom teeth removed, your dentist or oral surgeon will probably recommend local anaesthesia, which can be used safely in pregnancy. A local anaesthetic completely blocks feeling from the area and you will stay awake during the procedure. It may be possible for you to have general anaesthesia if you need to – for example, if your teeth will be difficult to extract. A general anaesthetic means you will be asleep during the procedure. However, a general anaesthetic can affect your baby.

    If you need to take painkillers after your wisdom teeth have been taken out, you can take paracetamol. Don't take ibuprofen or aspirin as these aren't recommended during pregnancy. If you need them, certain antibiotics are safe for pregnant women. Always read the patient information leaflet that comes with your medicine and if you have any questions, ask your pharmacist for advice.

    Pregnancy hormones make your gums much more likely to bleed. It's important that you keep your teeth and gums healthy - make sure you clean your teeth twice a day and use dental floss and mouthwash if you need to. NHS dental care is free during pregnancy and for one year after, so you should make an appointment to see your dentist.

    What is dry socket?

    Answer

    Dry socket (alveolar osteitis) is a condition caused by the breakdown or loss of the blood clot that forms in your tooth socket after you have had a tooth removed. The blood clot protects your socket and helps your wound to heal.

    Explanation

    Dry socket can cause severe pain that develops about three to five days after the initial pain has improved. It can lead to infection, halitosis (bad breath) and delayed healing.

    If you think you have dry socket, you should visit your dentist immediately.

    Your dentist will rinse out your empty socket and may then pack the socket with a dressing soaked in painkillers and antiseptics. You may also be prescribed a course of antibiotics to prevent the socket from becoming infected. Always ask your dentist for advice and read the patient information leaflet that comes with your medicine.

    It will usually heal within about 10 to 14 days.

  • Resources Resources

    Further information

    Sources

    • Cowan P. Treatment of third molar teeth – surgery. J Ir Dent Assoc 2006. 52(1):7. www.dentist.ie
    • Guidance on the extraction of wisdom teeth. Technology Appraisal 1. Appendix C. Wisdom teeth removal – patient notes. National Institute for Health and Clinical Excellence (NICE), 2012. www.nice.org.uk
    • Hedstrom L, Sjogren P. Effect estimates and methodological quality of randomized controlled trials about prevention of alveolar osteitis following tooth extraction: a systematic review. Database of Abstracts of Reviews of Evidence (DARE), 2007. www.crd.york.ac.uk
    • Kolokythas A, Olech E, Miloro M. Alveolar osteitis: a comprehensive review of concepts and controversies. Int J Dent 2010. doi:10.1155/2010/249073
    • Management of unerupted and impacted third molar teeth. Scottish Intercollegiate Guidelines Network (SIGN), 2000. www.sign.ac.uk
    • Pregnancy. Royal College of Anaesthetists. www.rcoa.ac.uk, accessed 11 July 2012
    • Removal of impacted wisdom teeth. British Association of Oral and Maxillofacial Surgeons. www.baoms.org.uk, accessed 11 July 2012
    • Top ten dental questions. British Dental Health Foundation. www.dentalhealth.org, accessed 13 July 2012
    • Treatments: tooth extraction. British Dental Association. www.bdasmile.org, accessed 13 July 2012
    • The pregnancy book. Department of Health. www.dh.gov.uk, published October 2009
    • Wisdom teeth extraction. Royal College of Surgeons of England. www.rcseng.ac.uk accessed 11 July 2012
  • Related information Related information

  • Author information Author information

    Produced by Rebecca Canvin, Bupa Health Information Team, January 2013.

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