Removal of wisdom teeth under local anaesthetic

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What is the problem?

The wisdom tooth (or third molar) is usually the last tooth to erupt into the mouth anytime after about 16 years of age. Frequently there is not enough room to accommodate wisdom teeth and as such they do not come into the mouth normally. When this happens, the wisdom teeth are said to be ‘impacted’. Wisdom teeth are usually either impacted forwards into the tooth in front or backwards into the jaw bone.

Why do I need treatment?

An impacted wisdom tooth can cause a number of problems that mean the tooth is best removed. Most commonly these are:

• Repeated attacks of infection in the gum surrounding the tooth. This leads to pain and swelling
• Food packing which causes decay in either the wisdom tooth or the tooth in front
• Cysts can form around the wisdom tooth if it does not come into the mouth properly. A cyst occurs when fluid fills the sack that normally surrounds a developing wisdom tooth

During your assessment, the reasons for the extraction of your wisdom tooth will be discussed with you. If you are not happy that you understand why the wisdom teeth need to be removed then please contact us.

What will the local anaesthetic involve?

On your assessment it has been discussed to extract your tooth under local anaesthetic. This is an injection into the gum surrounding the wisdom tooth, similar to that you may have had at your dentist for a filling. The injection takes a couple of minutes to numb the area and means that you will feel no pain while the wisdom tooth is removed. The lower lip and tongue will stay numb for a few hours or even longer after the procedure as a result of the local anaesthetic. Please eat before the procedure as normal.

What will the procedure involve?

The procedure either involves simple removal of the tooth out of its socket or, sometimes, a cut in the gum over the tooth and removal of some bone surrounding the crown of the wisdom tooth. It may become necessary to cut the tooth into 2 or 3 pieces to remove it. Once the wisdom tooth has been removed the gum is put back into place with stitches. In the majority of cases these stitches are dissolvable and can take up to two weeks to dissolve.

How long does it take to remove a wisdom tooth?

This is a variable. Some wisdom teeth may take only a few minutes to remove. More difficult wisdom teeth can take up to 40 minutes to extract.

Are there any risks?

With dental extractions there is a risk of pain, bleeding, bruising, stiffness in opening the mouth, swelling and infection.

Is there much pain or swelling after the removal
of wisdom teeth?

It is likely that there will be some discomfort and swelling both on the inside and outside of your mouth after surgery. This is usually worse for the first three days but it may take up to two weeks before all the soreness goes. You may also find that your jaw is stiff and you may need to eat a soft diet for a week or so. It is likely you will need regular painkillers for 3-4 days after the procedure. It may also be necessary for you to have a course of antibiotics after the extraction. There may be some bruising of the skin of your face that can take up to a fortnight to fade away.

Numbness of the lip, chin, tongue

There are two main nerves which run through the lower jaw: one going to the tongue and one going to the lower lip, which lie near lower wisdom teeth and there is a risk these nerves can be damaged temporarily or permanently on having the lower wisdom teeth removed. The risk of permanent numbness to part of the lip and chin depends on the closeness of the wisdom tooth to the main nerve. Specifically with lower wisdom teeth there is a 1% risk of permanent numbness to the lip, chin and tongue.

This will be discussed again when you come in for your surgery. If you have any further questions or concerns regarding numbness, please ask. You will not routinely be given a review appointment so if the numbness continues for a week or more following surgery we would advise you to contact the oral and maxillofacial surgery department on the numbers given.

Who do I contact if I have concerns following
my procedure?

If you are worried and would like further advice, please do not hesitate to contact us. A doctor is available to deal with your concerns 24 hours a day.

During normal working hours, Monday to Friday 8am until 5pm please telephone the Maxillofacial clinic where your procedure was carried out:

For advice during evenings, weekends and on public holidays, our partner organisation, Queen Victoria Hospital, East Grinstead has a doctor available to assist with any concerns.

Please ensure you have your patient reference number to hand when you contact us.

During normal working hours, Monday to Friday 8am until 5pm please telephone the Maxillofacial clinic where your procedure was carried out:

For advice during evenings, weekends and on public holidays, our partner organisation, Queen Victoria Hospital, East Grinstead has a doctor available to assist with any concerns.

Please ensure you have your patient reference number to hand when you contact us.