Extractions and wisdom teeth
Removing a tooth that cannot be saved, and surgically removing wisdom teeth that are trapped against bone or the tooth in front.
Taking a tooth out is the last option, not the quick one. Where a tooth can be restored with a filling, a root canal or a crown, that is almost always the better long term answer, because nothing replaces a natural root as well as the root itself.
Some teeth genuinely cannot be kept. A root fractured below the gum, decay that has destroyed the tooth to the bone level, or advanced gum disease that has removed the support are all reasons to remove rather than repair.
Wisdom teeth are a separate problem. They arrive last, often with nowhere to go, and end up wedged against the tooth in front or buried in bone. Removing those is surgery rather than a simple extraction, which is why an oral and maxillofacial surgeon does them here.
- Time in the chair
- Twenty minutes for a simple tooth, up to an hour for a difficult impaction
- Anaesthesia
- Local
- Sutures
- Usually for surgical removals, dissolving where possible
- Swelling
- Peaks around day two, then eases
At a glance
When it is needed
Signs we look for
Repeated pain behind the last molar
A partly erupted wisdom tooth traps food and bacteria under a flap of gum. The swelling and pain settle with treatment and then return, usually at the worst possible time.
A tooth broken to the gum line
When there is not enough tooth left above the bone to hold a crown, restoring it is not realistic and removal is the honest answer.
Severe looseness
A tooth that moves when you push it has lost the bone that held it. Once that support is gone it does not come back.
Crowding before orthodontics
Some orthodontic cases need space created. Those extractions are planned in advance as part of the treatment, not decided on the day.
Step by step
What actually happens
- 01
Imaging
An x-ray, and for wisdom teeth a wider view, shows the root shape and how close the roots sit to the nerve in the lower jaw. That determines the approach.
- 02
Anaesthesia
Local anaesthesia, given time to take full effect before starting. You should feel firm pressure but no sharpness.
- 03
Removal
A straightforward tooth is loosened and lifted out. An impacted tooth may need the gum lifted, a small amount of bone removed, and the tooth divided into sections so it comes out through a smaller opening.
- 04
Closing the site
Surgical sites are stitched. Dissolving sutures are used where possible so you do not need a separate visit to remove them.
- 05
Review
A check after a week confirms the socket is healing cleanly, and is the point at which replacing the tooth is discussed if it is one that shows.
Afterwards
Looking after it at home
Questions
tooth extraction & impaction, answered
If your question is not here, call the clinic and a dentist will talk it through before you book anything.
Not during, because of the local anaesthetic. Afterwards there is soreness for a few days that ordinary painkillers manage, and more swelling after a surgical wisdom tooth removal than after a simple extraction.
No. A wisdom tooth that has come through in a good position, bites properly and can be cleaned should be left alone. The ones that cause trouble are those trapped part way through or angled into the tooth in front.
After a simple extraction, usually yes. After a surgical wisdom tooth, plan on taking the following day off, and expect swelling to be at its most noticeable on the second day.
It is when the blood clot is lost from the socket, leaving bone exposed. It shows up as a deep ache three to five days after the extraction. It is not dangerous and a dressing settles it quickly, but it does need to be seen.
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