Wisdom Teeth, Explained

Must All Wisdom Teeth Go?

No. Wisdom teeth are the last molars, right at the back, and usually come through between the late teens and mid twenties. Many come through normally and are useful. Others only partly erupt, or stay buried, because there isn't room. UK guidance is that wisdom teeth which are healthy and not causing problems don't need to come out, and that includes buried teeth that are sitting quietly. Many people keep theirs for life.

What matters is whether the tooth is causing trouble now, or is likely to. We check wisdom teeth at your examinations, with an X-ray when needed, so a tooth that's decaying or damaging its neighbour is picked up early rather than when it becomes an emergency.

When Should They Come Out?

• Repeated infection of the gum around a partly erupted tooth, called pericoronitis, especially after more than one episode
• Decay in the wisdom tooth that can't be repaired, because it's too far back to fill well
• Decay or damage to the tooth in front, where food packs between the two
• Cysts or other changes seen on an X-ray
• Gum disease around the tooth, with bone loss that threatens the tooth in front
• A tooth that's rubbing the cheek, or an upper wisdom tooth that bites into the gum over a buried lower one

Occasionally a wisdom tooth is removed as part of other treatment, when leaving it would get in the way. Your dentist will explain why in your case, and the alternative of leaving it and keeping an eye on it. The decision is yours, and we'll give you the fee in writing before anything is booked.

Wisdom Tooth Pain

The most common cause of wisdom tooth pain is pericoronitis: the flap of gum over a partly erupted tooth traps food and bacteria, and becomes swollen and sore. You may notice a bad taste, difficulty opening your mouth fully, pain on swallowing, and swelling on that side of the face. It often flares when you're run down.

A first episode usually settles with careful cleaning and warm salt-water rinses, and sometimes a short course of antibiotics if the infection is spreading or you feel unwell. We can clean under the gum flap and, if the upper tooth is biting into it, smooth or remove the upper tooth. If it keeps coming back, removing the lower tooth is the lasting fix. If swelling is affecting your breathing or swallowing, or spreading to your eye or neck, go to A&E or call 999.

Before Removal: X-Ray and 3D Scan

A standard X-ray shows the position of the tooth, the shape of its roots and how close it sits to the nerve that runs through the lower jaw, which supplies feeling to your lip and chin. For most teeth, that's enough to plan removal. Where a lower wisdom tooth sits close to that nerve, a 3D CT scan, £160, shows exactly where the roots and the nerve are in relation to each other. It's taken here on our own Vatech scanner, so there's no referral elsewhere and no waiting.

That matters because the main risk with lower wisdom teeth is numbness of the lip, chin or tongue afterwards, which is usually temporary and rarely lasting. Seeing the anatomy in 3D lets us plan the safest approach and tell you honestly what your risk is. Our CT scan guide explains what a scan involves.

What Happens During Removal?

The area is numbed with local anaesthetic, and IV sedation is available if you're anxious. You'll feel pressure and pushing, but not pain. A tooth that has fully come through may be removed like any other. A buried or partly erupted tooth is a surgical extraction: a small cut is made in the gum, a little bone around the tooth may be removed, and the tooth is often divided into sections so it comes out with less force. The gum is then closed with stitches, which usually dissolve on their own. Most removals take under an hour.

Dr Davinder Kalsi, who has a special interest in oral surgery, carries out surgical extractions. If a tooth is unusually complex, we'll say so at your assessment and talk through the options, which can include referral. Our sedation page explains what IV sedation involves.

How Do I Recover?

Most people are back to normal in three to five days, with the first two days the most uncomfortable.

• Bite on gauze for 20 minutes to stop bleeding, and bite on a fresh piece if it starts again
• Avoid hot drinks, alcohol, smoking and vigorous rinsing for the first day, so the blood clot in the socket isn't disturbed
• Take ordinary painkillers as directed on the packet, starting before the numbness wears off
• Eat soft, cool food for a couple of days, chewing on the other side
• Keep the area clean, with gentle warm salt-water rinses from the next day, and brush your other teeth as normal
• Expect swelling, some bruising and a stiff jaw for a few days. A cold compress on the first day helps
• Call us if pain gets worse after two or three days rather than better. This can be a dry socket, where the clot is lost, and a dressing in the socket eases it

What Does It Cost?

Fees are confirmed in your written plan before anything is done, and dental plan members save 10% on extractions.² If you're in pain now, call us on 0141 248 1183. We keep same-day emergency appointments every weekday for patients and non-patients. See every fee.

Sedation for Wisdom Teeth

Wisdom tooth removal is one of the treatments people most often ask to have under sedation. IV sedation, given by Dr Kalsi alongside the local anaesthetic, makes you deeply relaxed and drowsy while still able to respond, and most people remember little of the appointment. It's £500 per session, plus £250 for each additional 30 minutes, and you'll need an adult to take you home and stay with you for the rest of the day, with no driving for 24 hours. Our IV sedation guide explains how to prepare.

Questions

This guide is general information, not a diagnosis. A dentist needs to examine you to say what is right for your teeth.