Wisdom tooth Extraction

Upper wisdom teeth are usually very easy to extract with minimal post-operative complications. It is more common to have complications with lower wisdom teeth removal. An x-ray called an ‘OPG/OPT’ (Orthopantomogram) is taken to assess the position of the wisdom teeth before the procedure is carried out.

Your dentist will discuss with you the various options for removal of wisdom teeth but most can be done routinely at the dental practice if there are no added risks or complication to treatment. The OPG x-ray will be assessed by your dentist in relation to such risks as:

  • A wisdom tooth being impacted (lying horizontally on its side)
  • Sectioning the tooth roots in order to extract it successfully
  • An involvement with the Inferior dental alveolar nerve (IDN)

If the risks are high and the extraction is likely to be a considerably difficult and lengthy procedure, your dentist may suggest a referral to hospital to have the tooth/teeth removed under General Anaesthetic. Sedation can also be offered in the general dental practice if this would make you feel more at ease with going through the procedure and it is safe to remove your wisdom tooth within general practice setting. 

With lower wisdom tooth extraction, sometime a few sutures are needed to aid healing if there is a large cavity left, or it has been a difficult extraction.

Risks associated with lower wisdom teeth extraction are:

  • Permanent numbness to your lip and chin if the Inferior dental alveolar nerve is damaged or severed (on the same side as the extracted tooth)
  • Poor gum healing
  • Pain, swelling (After anaesthetic wears off)
  • Continued Bleeding
  • Difficulty with pain from opening your jaw (Trismus)


The image below is an OPG Radiograph showing both lower 8's involvement with the 'Inferior Dental Alveolar Nerve'


Risks associated with upper wisdom teeth extraction:

  • An opening into the sinus cavity (With Upper wisdom teeth)
  • Bleeding, pain, swelling (after anaesthetic wears off)

Your dentist will ask you to bite down hard on a piece of gauze when the tooth has been removed to stem the bleeding and encourage clotting. If you take anti-coagulant medication (blood thinning medication) you will need to let your dentist know as they may have to monitor you after the extraction and place a special packing that helps to encourage faster clotting.

You can expect to be slightly sore in the area after the extraction, but taking painkillers and ibuprofen usually helps with any discomfort. It is also important to note that you should relax after the extraction as this will help to keep the blood clot there and keep blood pressure down. After the first day you can gently rinse around the area with warm salt water.

You should start to feel better in 3-4 days after the extraction but if you experience serious pain or a nasty taste in your mouth then you should come straight back to your treating dentist. You may have what is called ‘Alveolar osteitis’ or ‘dry socket’.