What happens when a wisdom tooth is removed?

How should you get ready?

Book the appointment for a day you can afford to be quiet afterwards, and get the shopping done first, because you will not feel like going out. Soft food in the fridge, cold packs in the freezer, and pain relief in the cupboard before you go, not after.

• Eat a proper meal beforehand, unless you have been told not to.
• Tell us about every medicine you take, especially blood thinners, and about any condition that affects bleeding or healing. Do not stop a prescribed medicine on your own.
• Arrange a lift if an anaesthetist has been booked. After local anaesthetic alone, driving yourself is fine once you feel ready.
• Wear something comfortable, and bring headphones if music helps.
• Do not smoke on the day if you can help it. It makes losing the clot afterwards more likely.

Step by step: the appointment

1. Going over the plan

   Your dentist brings up the x-ray, shows you which teeth are coming out and how they are sitting, and goes through the risks again so you can ask anything before you are numb.

2. Numbing

   Numbing gel first, then the anaesthetic. For a lower wisdom tooth this numbs that side of your jaw, your lip and part of your tongue, which feels fat and unfamiliar. We test the area before starting, and top it up whenever you need it.

3. Reaching the tooth

   For a simple removal, nothing more is needed. For a surgical one, a small cut is made in the gum and eased back so the dentist can see the tooth. You feel it being moved, not cut.

4. Removing it

   The tooth is loosened and lifted out. Where it is buried or angled, a little bone is taken away and the tooth is divided so it comes out in pieces through a smaller opening. That is gentler on the jaw than forcing it whole.

5. Cleaning and closing

   The socket is rinsed and checked, and the gum is stitched if it was opened. Most stitches dissolve on their own.

6. Gauze and instructions

   You bite on gauze to settle the bleeding while we go through the aftercare with you. You get it in writing, along with a number to call if something worries you later.

What does it actually feel like?

Firm pressure, rocking and pushing, and a lot of noise close to your ear. The sounds are the part people are least prepared for, and they are far worse to imagine than to sit through. There is water and suction in your mouth throughout, and your jaw gets tired from being open.

What you should not feel is sharp pain. If you do, raise your hand. We stop and add more anaesthetic. Telling us early is better than gripping the chair.

How long does it take?

A simple extraction is quick. A buried lower tooth takes considerably longer, and four together longer again. We tell you how much time to allow when we book you in, once the x-ray has shown us what is there. What we will not do is rush a difficult tooth to fit a gap in the day.

What if you are anxious about it?

Wisdom teeth are the treatment people build up most in their heads, usually on stories from friends. Tell us at the booking, not on the day. We can agree a stop signal, explain each step before it happens, break four teeth into two appointments, and book you first thing so you are not sitting with it all day. Sedation can be arranged: a visiting registered specialist anaesthetist attends the clinic on days set aside for it, provides IV sedation or a general anaesthetic, and charges their own fee. It is booked in advance and we ask you to commit first. Our nervous patients page explains the rest of how we work.

What are the first few hours like?

You go home the same day. Your lip and tongue stay numb for a few hours, so no hot drinks and nothing to chew until the feeling is back. Bleeding oozing for a while is normal, and the gauze handles it. Take the first dose of pain relief before the numbness wears off rather than after, and get your head up on a pillow when you rest.

The days that follow are covered on our aftercare page, including how to protect the clot and what dry socket feels like. For which teeth are worth removing at all, see wisdom teeth removal, and the cost page explains the fees.