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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.

Video: how a wisdom tooth is removed

About wisdom teeth removal

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.

Illustration showing the position of the teeth


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.

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.

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.

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.

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.

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

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.

 

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

For answers to frequently asked questions on this topic, see FAQs.

For sources and links to further information, see Resources.

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  • This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the about our health information page.

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