Extractions and wisdom teeth
When a tooth has to come out and when we can keep it, how an extraction goes, wisdom teeth included, and what recovery looks like.
We only take a tooth out when it can't be saved, or when keeping it does more harm than good. Before any extraction we explain why, on the X-ray, and what your options are afterwards.
Wisdom teeth are a case of their own. Many come through normally and can stay. Others grow at an angle, stay partly covered by gum or push on the teeth next to them, and then it's better to take them out, ideally before they cause problems.
Suitable if
- Broken-down teeth that can no longer be rebuilt.
- Infections that root canal treatment can't resolve.
- Wisdom teeth that keep getting inflamed or affect the neighbouring teeth.
- Very loose teeth from advanced gum disease.
- Making space before braces, when needed.
Not suitable if
- Teeth that can be saved with root canal treatment and rebuilding.
- Healthy wisdom teeth that have come through properly and that you can clean well.
Your alternatives
For a diseased tooth, extraction is usually the last option, not the first:
- Root canal treatment can save a tooth with an infected nerve.
- A crown can protect a badly broken-down tooth, if the root is healthy.
- Gum treatment can stabilise teeth that are moving, if the disease isn't too advanced.
For a wisdom tooth that isn't causing trouble, sometimes the best option is to keep an eye on it at check-ups. When a tooth does have to come out, we discuss from the start how to replace it: an implant, a bridge or a denture.
How it goes
Consultation and plan
We examine the tooth and take an X-ray. For wisdom teeth, especially lower ones, a CBCT scan shows in three dimensions how close the roots are to the nerve that gives feeling to the lip.
Preparation
We go through the medicines you take, especially blood thinners, and, if needed, talk to your own doctor. If there is an active infection, we sometimes treat it first.
The treatment itself
Extraction is done under local anaesthetic. A simple tooth usually comes out in a few minutes. An impacted wisdom tooth needs a small procedure: we open the gum and sometimes divide the tooth into pieces, to remove it with as little pressure on the bone as possible.
Check-ups and maintenance
If stitches were placed, we remove them at a check-up, usually after about a week. Then we discuss replacing the tooth, where that applies.
How long it takes overall
- Consultation and X-ray
- one visit
- Simple extraction
- a few minutes
- Impacted wisdom tooth
- a longer visit
- Gum healing
- 1–2 weeks
- Bone healing
- a few months
What the cost depends on
The cost depends on how straightforward the extraction is: a tooth with a straight root that's easy to grip, or a wisdom tooth impacted in the bone that needs a procedure. It also matters whether a CBCT scan or stitches are needed.
You get the estimate after the consultation. If the tooth is to be replaced, the plan includes the replacement too. Details in the guide to treatment cost.
Costs
How the cost of a treatment is set →What you will feel
With local anaesthetic you feel pressure, not pain: the tooth moves and gradually loosens from the bone. We tell you what comes next and stop when you raise your hand.
Once the anaesthetic wears off there is some discomfort, more after a wisdom tooth, which eases with the recommended painkiller. Swelling peaks on the second or third day. If you are afraid of extractions, tell us at the start: it's one of the most common reasons patients put treatment off.
Risks and limits
The most common complication is a dry socket: the clot in the socket comes away and pain returns, stronger, after the second or third day. It is easily treated at the practice, and following the first-day instructions makes it less likely.
With lower wisdom teeth, the roots can be close to the nerve of the lip, and rarely there is temporary numbness. That's why we plan on the X-ray and tell you beforehand if the risk is higher in your case.
After treatment
The first day matters most: keep the gauze pressed, don't rinse, spit, smoke or drink through a straw. Everything, hour by hour and day by day, including when to call us, is in Recovery after a tooth extraction.
Common questions
- How long does an extraction take?
- A simple tooth usually comes out in a few minutes. An impacted wisdom tooth needs a longer visit.
- Does wisdom tooth removal hurt?
- Not during the extraction: we work under local anaesthetic and you only feel pressure. Afterwards there is some discomfort for a few days, which eases with the recommended painkiller.
- How often do I come back for check-ups?
- Usually once, after about a week, to check healing and remove stitches, then at your usual check-ups.
- Do all wisdom teeth need to come out?
- No. Ones that have come through normally and can be cleaned well can stay. We remove those that keep getting inflamed, grow at an angle or affect the teeth next to them.
- What do I do about the gap?
- For wisdom teeth, usually nothing. For other teeth we discuss replacing them: an implant, a bridge or a denture.
- How much time off will I need?
- After a simple extraction you're usually back to normal the next day. After an impacted wisdom tooth, plan a quieter day or two.