Wisdom teeth

Wisdom teeth are the last adult teeth to erupt in the mouth and usually appear in older teenagers and young adults. They are in the back of your mouth behind the molars on both sides in the upper and lower jaw. Most people develop four wisdom teeth – two on the top, two on the bottom – but you can have one, two or three wisdom teeth, or none at all.

If your wisdom teeth easily fit into your mouth and there are no problems, they are functional teeth and help you chew food. However, many people have at least one impacted wisdom tooth. This can be trapped under your gums or only partly erupt. Because wisdom teeth occur after your jaw has stopped growing, there may not be enough room for them.

Smiling consultant surgeon with a patient

When do wisdom teeth need to be removed?

Wisdom teeth don’t need to be extracted if they erupt fully, have enough room, can be easily cleaned and don’t cause any pain.

Impacted wisdom teeth which cause pain, damage to other teeth or other dental problems are usually removed. If they don’t have enough room, they can harm nearby teeth, the jaw bone and nerves.

They can also be removed to prevent future problems. Impacted wisdom teeth are hard to clean and can become infected which could lead to pain and cysts.

How are wisdom teeth removed?

You will be given an anaesthetic. Usually the wisdom tooth is not ‘pulled out’ but elevated away from the gum.

The surgeon makes incisions in the gum so they can access the wisdom tooth. The tooth may be cut into small pieces and in some cases, a surgical drill may be used to remove a small amount of bone from around the tooth.

Once the wisdom tooth has been removed, the area is cleaned and stitched back together. In most cases the stitches are dissolvable and will disappear within two weeks. The procedure usually takes less than an hour and you may experience some bleeding, swelling and pain afterwards.

If there is a risk of harming the inferior dental nerve during the procedure, the crown (or upper portion) of the tooth may be removed and the roots left in place. This is called a coronectomy and not generally recommended for younger people as their roots are not yet fully formed.

What kind of anaesthetic will I have?

The type of anaesthetic you have will depend on how difficult the wisdom tooth is to remove.

If the surgery is simple, you will be given a local anaesthetic which is an injection into the gum surrounding the wisdom tooth. The procedure can take place in the clinic room or in the operating theatre.

If you are anxious about the surgery, you can be given intra-venous sedation into your arm as well as the local anaesthetic. The procedure can take place in the clinic room or in the operating theatre and the sedation will be administered by a consultant anaesthetist.

If the position of the wisdom tooth makes the surgery more complicated, you can be given a full general anaesthetic. The procedure will take place in an operating theatre with the support of a consultant anaesthetist.

What are the possible complications of wisdom tooth removal?

As with any surgery there is a risk of complications from wisdom tooth removal.

These include: Swelling – this is a common side effect and can last for up to 14 days. To help with this, wrap an ice pack in a towel and apply it for 24 hours following the procedure.

Restricted mouth opening – this is linked to swelling and will usually disappear once the swelling has gone. You may need to change your diet and eat soft foods during this time. You can use mouthwashes and rinse your mouth with warm salty water to reduce the risk of infection and keep your mouth clean.

Bleeding – once your wound is stitched, bleeding is unlikely to happen. If you start to bleed, use a rolled-up damp handkerchief or swab to apply pressure to the area for at least 10 minutes. If the bleeding continues, contact the hospital as soon as possible.

Nerve injury – occasionally the two nerves which are near the wisdom tooth can be bruised during the procedure. You may feel numbness or pins and needles in the tongue, lower lip, skin over the chin or a combination of these. Your sense of taste can also be affected but this is very rare. In most cases the nerve damage is temporary, but it can take up to 18 months to recover. If it does not fully recover, you may have areas which are permanently numb.

Infection – only 2% of people get an infection in the space left after a wisdom tooth has been removed, called a dry socket. The risk of infection can be minimised by brushing your teeth regularly and using mouthwashes as advised by your consultant. It is also advisable not to smoke.

Weakening of the jaw – in very rare cases wisdom tooth removal can cause a weakening of the jaw and the possibility of jaw fracture. This affects less than 1 in 100 people.

How long will it take to recover from wisdom tooth removal?

You may experience some discomfort and swelling on the inside and outside of your mouth following the procedure, particularly for the first three days. It may take up to two weeks before the soreness disappears completely. Your jaw may also feel stiff for a week or so. If necessary, your consultant will give you painkillers and a course of antibiotics.

There may be some bruising of the skin on your face which can take up to two weeks to go.

You will probably need to take few days off work and avoid strenuous exercise. If you’ve had sedation or general anaesthetic you will not be able to drive for at least 24 hours.

Why choose Harley Street Specialist Hospital?

At Harley Street Specialist Hospital, you can expect:

  • Our team of expert oral and maxillofacial surgeons to offer rapid assessment and the latest treatments in comfortable central London surroundings, as well as video consultations from the comfort of your own home.
  • Holistic care, where you are an equal partner in the creation of your individualised treatment plan.
  • State of the art diagnostic imaging – you don’t need to go elsewhere as we have in house CBCT, X-ray, ultrasound and image intensifiers.
  • Day-case and outpatient investigations and surgical procedures in a modern clinical setting.
  • No waiting lists and your treatment can take place at a convenient time for you.

We welcome patients with private medical insurance or those wishing to pay for their own treatment.

Our oral and maxillofacial surgery consultants

Search our consultants

Search our consultants