Wisdom Teeth Removal – Why It’s Needed and What To Expect

“Why am I Getting my Wisdom Teeth Taken Out?”

As wisdom tooth removal carries some risk, they are not removed unless there is a definite need, i.e. the benefits of extraction outweigh any risks.  So if they are not causing any problems now, and no obvious problems are anticipated, impacted third molars will often be left and monitored. This is not always an easy decision!


Clear reasons for wisdom teeth extraction include:

  • When they are causing pain, swelling etc. on a recurring basis and it is apparent that they will not fully erupt into the mouth in the future. i.e. extraction here is a treatment of toothache.
  • If they have become decayed, or are causing decay in the tooth lying in front (see X-ray picture).
  • The dentition in front is at increased risk of gum problems, because of the presence of the wisdom tooth.
  • Severe infection, such as a large abscess.
  • A cyst or other growth occurs in the bone around the area.
"Wisdom Teeth Removal X-ray"

One of the reasons for extraction. This impaction has led to decay in the wisdom tooth and also in the tooth lying in front of it.


If a decision is taken that removal is indicated, due to current or anticipated symptoms and problems, this is better done early. This is because it is generally easier to remove an impacted wisdom tooth in the younger patient as the bone is more flexible, and the area will heal up faster.


“How is Wisdom Tooth Removal Carried Out?”

Your dentist will usually refer you to a specialist (oral surgeon) for the extraction of any wisdom teeth that appear to be deeply impacted. For some, the treatment involves a straightforward extraction under local anesthetic, done in a few minutes. For others, the procedure can take over an hour, with a general anesthetic being needed.

Most wisdom tooth removals fall somewhere between these two extremes. But what will affect the difficulty of your treatment?…

The length and difficulty of the procedure will depend on:

  • The size and shape of the roots.
  • The degree of impaction, i.e. the amount they are buried under the gum.
  • The angle the tooth lies at.
  • Your age and general health.
  • The degree of access the surgeon has to the area, determined largely by how wide you can open your mouth.
  • How close the roots lie to the nerve canal that runs through the jaw bone.


Based on the above factors the surgeon will advise you whether or not any sedation is advisable. The more difficult extractions may be made easier for the patient by the use of sedation. This may be via IV or inhaled (nitrous oxide). The most difficult removals may require a general anesthetic and are carried out in a hospital. If necessary, all four wisdom teeth may be removed at the same visit, especially if general anesthetia is being used.

If sedation is required, you will need to fast from food for six hours beforehand.  You will also need collected after the procedure by an adult.


A quick look at the procedure

First up, here’s a useful video from BUPA


The procedure to remove impacted wisdom teeth will usually include the following:

  • If you require sedation, this is administered first.
  • The area is then well ‘numbed-up’ by use of local anesthetic. The surgeon will ensure the area is totally anesthetized before beginning the treatment. If you are awake during the procedure, you should not feel any pain. But you will be aware of a fair degree of pressure during the extraction.
  • The exact procedure will depend on the level of impaction etc. (see factors above). But generally a small incision is made in order to access the tooth.
Image of dentists performing wisdom teeth surgery

Wisdom tooth extraction varies greatly in it’s difficulty. Some are routine while others involve fairly major oral surgery

  • Some of the surrounding bone will often need to be filed away, as this encases the roots. This allows access for the extraction.
  • The tooth may need to be divided into smaller pieces which are taken out individually.
  • Once all of the impacted molar (and roots of course) is removed, the gum is sutured up.
  • The dentist/oral surgeon will then make sure the wound stops bleeding.
  • The final step, after removal, is when the dentist provides you with details on ensuring good a recovery…


Next:  Advice on wisdom teeth removal recovery.

Further reading: Possible complications including dry socket after removal.

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