Wisdom Tooth Removal

Does every wisdom tooth need to come out?

No. A wisdom tooth that sits correctly, meets its opposing tooth and can be cleaned is left alone. The decision to remove rests on specific findings: recurrent inflammation of the overlying gum (pericoronitis), decay or root resorption in the adjacent molar, cyst formation, obstruction of planned orthodontic treatment, or a position that makes cleaning impossible.

Assessment

A panoramic radiograph is the first step. If the relationship between the roots and the inferior alveolar nerve looks equivocal, three-dimensional tomography is requested — not as an extra, but because it is the only way to see the risk. Surgery without knowing where the nerve runs raises the chance of temporary or permanent numbness unnecessarily.

How it is done

The procedure is performed under local anaesthesia; where anxiety is high, sedation is discussed as a separate option. The gum is reflected, bone over the tooth is removed if needed, and the tooth is sectioned and taken out in pieces. Sectioning costs less bone and heals faster than forcing the tooth out whole. The site is cleaned and sutured.

For a single tooth the procedure usually takes 20 to 40 minutes.

Afterwards

Protecting the clot in the first 24 hours is essential: do not spit, do not suck, do not drink through a straw. Swelling peaks on the second or third day and then subsides. Cold on day one; warm rinses from day two.

Dry socket is the most common complication and is usually related to early loss of the clot; smoking raises that risk markedly. If pain increases rather than decreases after the third day, call the clinic.

Risks

As with any surgery, bleeding, infection and swelling are possible. Lower wisdom teeth carry a risk of temporary numbness of the lip and chin because of nerve proximity; upper ones can communicate with the sinus. These possibilities are discussed in detail beforehand and appear on the consent form.

This page is general information and does not replace a dental examination. Whether the treatment suits you, and the method and duration, are decided only after an intraoral examination and radiographic assessment.