Wisdom Tooth Removal
Short answer: Wisdom teeth are removed when they cause repeated infection, decay that cannot be restored, damage to the tooth in front, or a cyst. A wisdom tooth that has come through cleanly and can be kept clean is usually best left alone. We image with cone beam 3D first, so the position of the nerve is known rather than estimated.
When it genuinely needs to come out
- Repeated infection around the gum flap — one episode may pass, recurring episodes are a strong indication
- Decay that cannot be restored; wisdom teeth are hard to reach and harder to fill well
- Damage to the tooth in front — an angled wisdom tooth pressing into the second molar can destroy a tooth well worth keeping. One of the strongest reasons
- A cyst or other pathology
- It cannot be cleaned, and the gum around it is persistently inflamed
Equally worth saying: removing symptom-free, fully erupted wisdom teeth "just in case" is not routinely recommended, and the old idea that they cause front-teeth crowding is not supported by evidence. More on when they can stay.
Knowing where the nerve is before we start
The main risk with a lower wisdom tooth is the nerve that supplies sensation to the lip and tongue, which can run very close to the roots. Damage to it causes numbness — usually temporary, occasionally not.
A flat x-ray shows the tooth and the nerve overlapping without showing how far apart they actually are. Cone beam 3D imaging, which we have on site, shows the relationship in three dimensions. That is the difference between knowing the risk in your case and estimating it.
You should be told what that imaging showed. If nobody has mentioned the nerve, ask.
The appointment, and afterwards
Done under local anaesthetic, with sedation available — oral, nitrous oxide, or IV with an anaesthetist. Anxiety about this particular procedure is extremely common and worth mentioning when you book.
Expect swelling and soreness for several days, easing steadily. You will be given aftercare instructions, and what matters most is protecting the clot that forms in the socket — so no smoking, no rinsing vigorously and no straws for the first day or two.
If you are having several removed, doing them together under sedation is sometimes sensible. It is also sometimes convenience rather than necessity, and it is reasonable to ask which.
Common questions
Do all wisdom teeth need to be removed?
No. A wisdom tooth that has erupted cleanly, bites properly and can be kept clean is generally best kept. Removal is indicated for recurring infection, unrestorable decay, damage to the tooth in front, or cysts.
What are the risks of wisdom tooth removal?
Swelling and discomfort for several days, and for lower wisdom teeth a risk of temporary — rarely permanent — numbness of the lip or tongue, because the nerve can run close to the roots. Cone beam 3D imaging shows how close it is in your case.
Can I be sedated for wisdom tooth removal?
Yes. Oral sedation, nitrous oxide, or IV sedation with an anaesthetist are all available. Mention it when booking so the appointment is planned around it.
How long does recovery take?
Swelling and soreness typically peak in the first couple of days and ease over roughly a week. Protecting the clot in the socket matters most: no smoking, vigorous rinsing or straws early on.