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Wisdom teeth removal

Your wisdom teeth are the four teeth located right at the back of your mouth. You may need your wisdom teeth removed if they’re causing problems. It’s a common procedure: every year in the UK over 75,000 people have their wisdom teeth removed.

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

Your wisdom teeth may not be able to come through normally if they don’t have enough space or you have other teeth in the way. Wisdom teeth that don’t come through normally are known as impacted. For many people, wisdom teeth don't cause any problems, even if they are impacted, and don't need to be removed. 

It’s important to clean your teeth thoroughly if you have impacted wisdom teeth and to see your dentist regularly, as you normally would.

Impacted wisdom teeth can sometimes cause problems such as pain, swelling or infection. If you’re having problems such as these with your wisdom teeth, make an appointment to see your dentist. Having impacted wisdom teeth surgically removed (extracted) can help to stop these problems. Your dentist will examine you and discuss with you whether this would be best in your case. Your dentist may be able to remove your wisdom teeth, or they may need to refer you to an oral surgeon for hospital treatment.

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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 wisdom tooth removal. For example, if you smoke, you may be asked to stop because smoking increases your risk of getting a wound infection, which can slow your recovery. 

    The procedure is usually done as a day case under local anaesthesia. This completely blocks pain from your gums but means you will stay awake while your wisdom teeth are being removed. You may be offered sedation, a medicine to help you relax. If you go to a hospital and your wisdom teeth are particularly difficult to remove, you may be offered general anaesthesia. This means you will be asleep during the procedure. Your dentist or oral surgeon will discuss with you which type of anaesthesia is most suitable for you. 

    If you’re having a general anaesthetic, you’ll probably be asked not to eat or drink anything for around six hours before your procedure. This is because a general anaesthetic can make you sick. Follow your dentist’s or surgeon’s advice, and if you have any questions, just ask.

    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 ask questions so that you understand what will be happening. You don’t have to go ahead with the procedure if you decide you don’t want it. You’ll be asked to sign a consent form if you are happy to go ahead.

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  • Alternatives What are the alternatives to wisdom teeth removal?

    Not all wisdom teeth need to be removed. If your wisdom teeth aren’t causing you any problems, there’s probably no reason for them to be taken out. 

    Carefully cleaning your teeth may help some of the symptoms of impacted wisdom teeth – such as soreness and swelling around your gums. Your dentist or oral surgeon may offer you antibiotics if your teeth become infected. 

    If your wisdom teeth keep causing problems though, it’s unlikely that these will go away without having the teeth removed.

  • The procedure What happens during wisdom teeth removal?

    The procedure for removing your wisdom teeth may vary, depending on how difficult your teeth are to remove. Upper wisdom teeth are usually less complicated to remove than lower ones. We’ve given a general overview here of what you can expect. But the exact details about the procedure may be different depending on your own circumstances. You can discuss this more with your dentist or oral surgeon.

    You may be able to have your wisdom teeth removed in your dental surgery, with local anaesthesia. This means you’ll be awake but you won’t be able to feel any pain. If your dentist thinks your teeth will be complicated to remove though, they will probably recommend you have the procedure in hospital. In the hospital, you may have local anaesthesia, possibly with sedation (a medicine to help you relax). Or you may be offered general anaesthesia. This means you’ll be asleep during the procedure.

    Once the anaesthetic has taken effect, your dentist or oral surgeon will grasp your tooth with dental tools. He or she will then loosen the tooth by rocking it back and forth and twisting slightly. It can then be removed completely. 

    If your tooth is more difficult to remove, your dentist or oral surgeon may make a cut in your gum close to the tooth. They may need to remove a small piece of bone to help get the tooth out. After removing your tooth your dentist or oral surgeon will close your wound with stitches, usually dissolvable ones, if you need them. Most wisdom teeth only take a few minutes to remove, but 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

    What happens after you have your wisdom teeth removed will depend on the type of anaesthesia you have. If you have general anaesthesia or sedation, you will need to arrange for someone to drive you home. You should ask a friend or relative stay with you for the first 24 to 48 hours and take it easy during this time.

    After local anaesthesia, it may be three to four 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 your mouth.

    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, especially if your tooth was difficult to remove.

    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

    After you’ve had your wisdom teeth removed you will probably feel some pain for a day or two. Your mouth may be sore for up to a week or longer if the removal was very difficult. If you need them, you can take over-the-counter painkillers such as paracetamol or ibuprofen. Your dentist or oral surgeon may suggest you take both of these medicines because they can work well together to reduce pain. Follow the instructions in the patient information leaflet that comes with your medicine and ask your pharmacist if you need any advice. Don't take aspirin because this can make bleeding worse.

    Rinse out your mouth only very gently during the first 24 hours after having a wisdom tooth removed. Vigorous rinsing can disturb blood clots that help the healing process. After meals, rinse gently to remove bits of food from the area where your tooth was removed.

    You should brush your teeth as usual as best you can after your wisdom teeth have been removed. But keep your toothbrush away from the healing wound for the first couple of days.

    Eating and drinking

    For the first few days, stick to soft foods only. You can gradually return to your usual diet, but to begin with, try not to chew on the areas of your mouth that are healing. It’s best if you avoid alcohol or very hot or cold drinks for the first 24 hours.

    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 to 10 minutes. Don't rinse your mouth out, and stay sitting up. Contact your dentist if the bleeding hasn’t stopped after an hour or two.

    When to seek help

    Most people don't experience any problems after having their wisdom teeth removed. But you should contact your dentist immediately if you have any of the following.

    • Bleeding that doesn't stop after applying pressure, or that lasts for more than an hour or two. 
    • Severe pain that isn't getting better, or is getting worse. 
    • A high temperature, which might mean you have an infection. 
    • Swelling that doesn't begin to improve after around three or four days.
  • Risks What are the risks?

    All medical procedures come with some risk. But how these risks apply to you will be different to how they apply to others. Be sure to ask your dentist or oral surgeon for more information if you have any concerns.

    Side-effects

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

    You may have some swelling around your face, bruising, pain or jaw stiffness. This should improve day by day but may last for up to two weeks. You may also have bad breath, and the teeth next to the empty wisdom tooth socket may feel a little sensitive. 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 may include the following. 

    • Infection of the tissues around the area where you wisdom tooth was removed. 
    • Accidental damage to other teeth nearby, perhaps dislodging a filling or a crown. 
    • Severe pain caused by a condition known as dry socket. This is when the blood clot breaks away from the wound exposing the bone and nerves. It can be painful and means it might take longer to heal. See FAQs for more information. 
    • Numbness in your lower lip or tongue caused by nerve damage. This is normally temporary, but there is a small chance it could be permanent. 

    The exact risks are specific to you and will differ for every person, so we haven’t 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 after having wisdom teeth removed?

    Answer

    Most people need around two or three days off work to recover after having wisdom teeth removed. The time you need depends on what your job is, the type of anaesthetic you had and how quickly you recover.

    Explanation

    Most people don’t need to take a long time off work after having their wisdom teeth removed. It’s good for you to get back to your normal routine as soon as possible. 

    If your job is desk-based, you may need a day or two off including the day of the procedure. Some people take longer, especially if they have had more than one tooth removed. Taking a few days off gives you time to recover from the sedation or general anaesthetic, if you had these. If you have a job that involves more physical activity, you may need three or four days off. It might be a good idea to ask your employer if you can do lighter duties for your first few days back. 

    You can usually drive 24 hours after a sedative and 48 hours after a general anaesthetic. Make sure you’re 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. You should wait a little longer to do contact sports such as rugby or martial arts. 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 while I’m recovering from having my wisdom teeth out. Why is this? 

    Answer 

    Using a mouthwash helps to keep the place where your tooth was removed clear of bits of food. Your dentist or oral surgeon will give you advice on brushing, using mouthwashes and how to keep your mouth clean after having wisdom teeth removed. 

    Explanation 

    It’s important to keep your mouth clean while you’re recovering from having wisdom teeth removed. If you can, try to brush your teeth as usual although you should avoid brushing the site where your tooth was removed for three to four days. 

    Your dentist or oral surgeon will probably recommend that you also use mouthwashes regularly to help keep your mouth clean. Mouthwashes help to remove food debris and can help with wound healing. Your dentist or oral surgeon may suggest you rinse your mouth out with a salt-water mouthwash. Use about half a teaspoon of salt in a glass of warm water. Or they might recommend an antiseptic mouthwash. 

    If you use a mouthwash too soon after your operation, or do it too vigorously, you may dislodge the blood clot in your wound. This may stop it healing properly. Your dentist or oral surgeon will give you advice about when to start using the mouthwash.

    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 can be 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. Routine dental treatment is generally safe for pregnant women. 

    Most dentists prefer not to do X-rays while you're pregnant unless they are essential. If you really do need an X-ray of your mouth, this won’t harm your baby because your abdomen gets only a very tiny dose of radiation. 

    If you need to have your wisdom teeth removed, your dentist or oral surgeon will probably recommend local anaesthesia. This can be used safely in pregnancy. Local anaesthesia completely blocks feeling from the area and you’ll stay awake during the procedure. The medicines used for general anaesthesia can affect your baby, so your dentist or surgeon will only advise this if they think it’s really necessary.

    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.

    What is dry socket?

    Answer

    Dry socket is a condition caused by the breakdown or loss of the blood clot that forms in your tooth socket after your tooth is removed. The blood clot normally protects your socket and helps your wound to heal.

    Explanation

    The medical name for dry socket is alveolar osteitis. It happens in around five in every 100 people who have a wisdom tooth removed. Dry socket can cause severe pain that develops about three to five days after your initial pain has improved. It can lead to infection, bad breath and make it take longer for your gums to heal.

    Mouthwashes containing the antiseptic chlorhexidine can help stop you getting dry socket. That’s why your dentist or oral surgeon may suggest you use an antiseptic mouthwash after having a wisdom tooth removed.

    If you have severe pain and normal painkillers aren’t helping, you should visit your dentist immediately. If you do have dry socket, your dentist will rinse out your empty socket. They will then pack the socket with a dressing soaked in painkillers and antiseptics. You may also be offered 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. 

    Dry socket will usually heal within about 10 days.

  • Resources Resources

    Further information

    Sources

    • Tooth extraction. Medscape. www.emedicine.medscape.com, published 4 April 2013
    • Guidance on the extraction of wisdom teeth. National Institute for Health and Care Excellence (NICE), 2000. www.nice.org.uk
    • Management of unerupted and impacted third molar teeth. Scottish Intercollegiate Guidelines Network (SIGN), 1999. www.sign.ac.uk
    • Get well soon - helping you make a speedy recovery after removal of wisdom teeth. Royal College of Surgeons. www.rcseng.ac.uk, accessed 9 December 2014
    • Wisdom teeth. British Dental Health Foundation. www.dentalhealth.org, accessed 9 December 2014
    • My teeth. British Dental Health Foundation. www.dentalhealth.org, accessed 9 December 2014
    • What to do following an extraction. British Dental Health Foundation. www.dentalhealth.org, accessed 9 December 2014
    • Dental care for mother and baby. British Dental Health Foundation. www.dentalhealth.org, accessed 9 December 2014
    • Removal of wisdom teeth. British Association of Oral Surgeons. www.baos.org.uk, accessed 9 December 2014
    • Having wisdom teeth taken out. British Dental Association. www.bdasmile.org, accessed 9 December 2014
    • Tooth extraction. British Dental Association. www.bdasmile.org, accessed 9 December 2014
    • Cowan P. Treatment of third molar teeth – surgery. J Ir Dent Assoc 2006. 52(1):7. www.dentist.ie
    • Coulthard P, Bailey E, Esposito M, et al. Surgical techniques for the removal of mandibular wisdom teeth. Cochrane Database of Systematic Reviews 2014, Issue 7. doi:10.1002/14651858.CD004345.pub2.
    • Mettes T, Ghaeminia H, Nienhuijs M, et al. Surgical removal versus retention for the management of asymptomatic impacted wisdom teeth. Cochrane Database of Systematic Reviews 2012, Issue 6. doi:10.1002/14651858.CD003879.pub3.
    • Bailey E, Worthington H, van Wijk A, et al. Ibuprofen and/or paracetamol (acetaminophen) for pain relief after surgical removal of lower wisdom teeth. Cochrane Database of Systematic Reviews 2013, Issue 12. doi:10.1002/14651858.CD004624.pub2.
    • Daly B, Sharif M, Newton T, et al. Local interventions for the management of alveolar osteitis (dry socket). Cochrane Database of Systematic Reviews 2012, Issue 12. doi:10.1002/14651858.CD006968.pub2
    • Moore K and Dalley A. Clinically oriented anatomy. 4th ed. Baltimore: Lippincott Williams & Wilkins; 1999
    • Smoking and surgery. ASH, Action on Smoking and Health. www.ash.org.uk, published March 2014
    • Anaesthesia explained – third edition. The Royal College of Anaesthetists, 2008. www.rcoa.ac.uk
    • Nejdlova M, Johnson T. Anaesthesia for non-obstetric procedures during pregnancy. Contin Educ Anaesth Crit Care Pain 2012;12(4): 203-206. doi:10.1093/bjaceaccp/mks022
    • The pregnancy book. Public Health Agency 2014. www.publichealth.hscni.net
    • Can medical imaging exams hurt the baby of a pregnant woman? RadiologyInfo.org. www.radiologyinfo.org, published 19 August 2011
    • Common postoperative complications. PatientPlus. Patient.co.uk/patientplus.asp, published 11 February 2013
    • Joint Formulary Committee. British National Formulary (online) London: BMJ Group and Pharmaceutical Press. www.medicinescomplete.com, accessed 10 December 2014
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