Dr H S Elmanharawy
Registered Specialist Oral Surgeon


Wisdom Teeth

What are wisdom teeth?

They are the third molars and the last teeth to erupt in the back of the mouth. This usually occurs in late teens ('the age of wisdom'). Most people have two in the upper jaw (Maxilla) and two in the lower jaw (Mandible).

Why am I having my wisdom tooth/teeth removed?

Surgical removal can be required for several reasons. Often, wisdom teeth are stuck ('impacted') against the adjacent tooth or within the jawbone and are not able to come through fully into the mouth.

A partially erupted wisdom tooth may be difficult to keep clean. This can then cause chronic infection and discomfort in the surrounding gum tissue. Such infections may require treatment with antibiotics.

Tap image then pop up window to play animation

A wisdom tooth can also become decayed or cause decay to adjacent teeth. Your dentist may not be able to treat this decay until the wisdom tooth has been removed.

In Line with NICE guidelines (National Institute of Clinical Excellence), wisdom teeth should only be removed if they are causing problems. We will discuss this with you during your appointment.

How will it be removed?

This depends on the position of your tooth and degree of impaction as well as the way it is impacted. Some can be quite straightforward to remove. More commonly, simple extraction is not possible and surgery is necessary to remove it.

The type of the surgery needed depends on the position of the wisdom tooth. This may influence whether your operation is carried out under local anaesthesia alone.

All options can be discussed with you during a consultation appointment.

How long will the operation take?

This again depends on the position of your tooth, and whether the operation is being carried out with local anaesthesia alone.

An appointment for surgery under local anaesthesia usually lasts 45 minutes.

The longer time allows for the recovery period needed before you can be discharged home.

Will there be any stitches?

Sometimes stitches are needed and they are usually dissolvable. An appointment will be arranged for this, usually one week after surgery.

Will I be in pain afterwards?

You should not feel any pain immediately after the operation, as the area of surgery will be numb from the local anaesthetic. As the numbness wears off, the area might become uncomfortable and then you should take painkillers. We will supply you with these, with information about doses.

Could there be any after-effects?

This depends on the operation. If there are any issues in particular to be aware of, they will be discussed with you beforehand.

There may be swelling and bruising in the area of surgery as well as some discomfort which might limit jaw opening. Bruising is usually at its most obvious two to three days after surgery and varies between patients. It normally resolves itself after 10 to 14 days.

Occasionally, an impacted lower wisdom tooth can be very close to nerves supplying the lower teeth, lip, chin, cheek and tongue. These can get bruised when the tooth is removed, resulting in the sensation of numbness or tingling in these areas.

This change in sensation only affects 2-5% of patients and is usually temporary. It can take up to six months to fully resolve itself. It only very rarely becomes permanent. If this is a factor for you to be aware of, due to the proximity of your wisdom tooth to the nerves, we will discuss it with you during your appointment.

When can I return to work?

This depends on your occupation and how you are after your treatment. It may be possible to return to work the next day.

Some people need to take some time off work. We will give you appropriate advice for your particular circumstances.

After your operation

After your surgery, we will give you an post operative information sheet with instructions to help bring about a quick recovery.

We will discuss this with you before you are discharged home, to ensure that the information is clear and understood.

The main points are as follows.

On the day of the operation
  • Get plenty of rest in the first few hours after your operation.
  • Do not rinse your mouth or drink hot fluids.
  • Relieve discomfort by taking the supplied painkillers as directed and use ice packs to reduce discomfort at the operation site.
From the following day
  • Keep your mouth as clean as possible by gently brushing your teeth as usual.
  • Use salt water mouth rinses (one teaspoon of salt in a cup of warm water) every four hours for seven days. This will help to keep the operation site clean and clear of debris.
  • Avoid smoking. The local action of nicotine in the mouth has been shown to have a detrimental effect on healing after surgery and greatly increases the likelihood of wound infection developing.
  • Continue to take the painkillers and any other supplied medications as directed and use ice packs for the next two to three days.
  • If bleeding is troublesome, you can usually control it by placing dampened gauze over the wound and applying pressure for 15 to 20 minutes (slight oozing can be expected for a short time following surgery).

If you have any other complications or require advice after treatment, please call 01793 855335 and leave a message including a contact telephone number. We will return your call as soon as we can.