Wisdom tooth removal - Questions 

We asked Miss Carrie Newlands, consultant oral and maxillofacial surgeon at Royal Surrey Hospital in Guildford, to tell us what questions she would ask if she had to have her wisdom teeth removed.

Why are my wisdom teeth causing me problems and what should I do?

The wisdom teeth are the last teeth to come through so they often get stuck because the jaw runs out of room. If they get stuck then they become difficult to clean, and that can lead to infection around the gum or decaying of the teeth. Those are the two most common reasons why people have to have their wisdom teeth taken out.

It’s a good idea to talk to your dentist to see whether you need to have them removed and, if so, whether you need to be referred to hospital to have that done.

Where should I go to have them removed? Will it be painful?

Some wisdom teeth are quite straightforward and can be taken out by your dentist. Other people need to see a specialist surgeon in hospital, usually an oral and maxillofacial surgeon.

If you’re having your wisdom teeth removed under local anaesthetic then it shouldn’t be painful. A local anaesthetic is an injection into the gum to make the area go numb. However, you'll hear some noise from the drilling and also feel some pressure as the wisdom tooth is taken out.

If you’re having your wisdom tooth taken out under a general anaesthetic, it will need to be done at hospital. That can usually be done on a day-case basis, so you go home on the same day.

Is it a complicated procedure?

If a wisdom tooth isn’t particularly stuck, then it can sometimes be taken out quite simply. But if the gum is sitting partly over the tooth and the tooth is stuck underneath some bone, then we usually need to fold the gum back and may need to drill some bone away.

More difficult wisdom teeth have to be divided with a drill and cut into smaller pieces so they can be removed more easily. The gum is then stitched back with dissolvable stitches.

Are there risks associated with having wisdom teeth removed?

There are some risks. Usually, your mouth is sore for up to a week afterwards and it’s quite common for there to be some swelling, particularly around the cheeks. There also may be some bruising. There will be some stiffness of the jaw, so it will be a bit difficult to open the mouth for a while but that usually goes back to normal within a week or so.

One of the important risks relates to a couple of nerves that run in and near the jaw bone. These supply the feeling, but not the movement, of the lower lip, chin and tongue. Sometimes, these nerves can get bumped or bruised when your wisdom teeth are taken out, which can result in a feeling of numbness and tingling in the lower lip, cheek or tongue. This is quite uncommon and it usually goes back to normal.

In rare cases, the numbness or tingling can be permanent, so it’s important to ask your surgeon what the risks might be in your particular case.

What should I do after the operation?

It’s important to take it easy. You might need to recover for up to a week or so, so take some time off work if necessary. It's important to keep your mouth clean, so use a toothbrush. If dissolving stitches were used inside your mouth, you’ll need to brush carefully around these.

Sometimes you'll need to use an antiseptic mouthwash. A simple warm salt mouthwash would also work well.