Specialist Removal of Wisdom Teeth
Wisdom tooth removal is one of the most common oral surgical procedures, performed where the third molars are causing pain, infection, or risk to neighbouring structures.
While some wisdom teeth erupt normally, many are impacted or partially erupted, leading to recurrent problems that often require surgical removal.
Why Wisdom Teeth Cause Problems
Wisdom teeth are the last teeth to develop and often lack sufficient space to erupt fully.
This can result in:
- Impaction (trapped within bone or gum)
- Partial eruption with difficulty cleaning
- Pressure on neighbouring teeth
- Recurrent inflammation or infection
Common symptoms include:
- Pain at the back of the mouth
- Swelling or infection around the gum
- Difficulty opening the mouth
- Unpleasant taste or discharge
- Episodes of flare-up (pericoronitis)
Assessment and Planning
Careful planning is essential.
This includes:
- Clinical examination
- X-rays or 3D imaging where required
- Assessment of the tooth position relative to nerves and adjacent structures
This allows surgery to be tailored to the complexity and anatomical considerations of your case.What are wisdom teeth?
The Procedure
Wisdom tooth removal is a common surgical procedure performed under sterile conditions. The approach varies depending on the position of the tooth and your preferred level of sedation.
Anaesthetic options
Local anaesthetic
The area around the tooth is numbed using injections. You remain fully awake but should feel no pain—only pressure during the procedure. This is suitable for straightforward extractions and patients comfortable with being aware of the surgery.
IV sedation (Remimazolam)
Intravenous sedation using remimazolam provides a deeper level of relaxation. You remain responsive but typically feel drowsy and have little memory of the procedure. It has a rapid onset and recovery profile, making it an increasingly popular option for patients who are anxious but do not require a full general anaesthetic.
General anaesthetic
You are fully asleep for the procedure. This is usually reserved for more complex cases, multiple extractions, or patients who prefer complete unconsciousness. It is typically carried out in a hospital setting.
Surgical Procedure
The technique depends on the position of the tooth. Impacted teeth may require a small incision in the gum and, where necessary, division of the tooth to facilitate removal while minimising bone removal. The site is then irrigated and closed with sutures.
Risks and Complications
Wisdom tooth removal is generally safe, but as with any surgical procedure there are recognised risks:
- Pain and swelling — common in the first few days
- Bleeding — usually minor and short-lived
- Infection — may require antibiotics
- Dry socket (alveolar osteitis) — a painful condition where the blood clot is lost prematurely
- Nerve injury — temporary or, rarely, permanent altered sensation of the lower lip, chin, or tongue (more relevant for lower wisdom teeth)
- Sinus communication — occasionally with upper teeth, leading to a connection between mouth and sinus
- Jaw stiffness (trismus) — temporary limitation of mouth opening
The overall risk profile depends on the position of the tooth and the complexity of the surgery.
Regenerative Adjuncts: Platelet-Rich Fibrin (PRF)
Platelet-rich fibrin (PRF) is an autologous biomaterial derived from a small sample of the patient’s blood, processed chairside. It contains a high concentration of platelets, leukocytes, and growth factors within a fibrin matrix.
When placed into the extraction site, PRF may promote soft tissue and bone healing, improve early postoperative comfort, and is increasingly used as an adjunct to reduce the incidence of dry socket. While not mandatory, it represents a low-risk biological enhancement that may be offered in selected cases.
Recovery
Immediate recovery
- Mild to moderate discomfort once anaesthetic wears off
- Swelling typically peaks at 48–72 hours
- Limited mouth opening is common
- A soft diet is recommended for several days
First week
- Most patients return to normal daily activities within 2–5 days
- Sutures may dissolve or require removal depending on the technique
- Careful oral hygiene is essential to reduce infection risk
Full healing
- Soft tissue heals within 2–3 weeks
- Bone healing continues over several months
Aftercare advice
- Avoid smoking and vigorous rinsing for the first 48 hours
- Maintain good oral hygiene while avoiding the surgical site initially
- Use prescribed or recommended pain relief
- Follow all specific post-operative instructions provided
Consultation
A consultation allows assessment of your wisdom teeth and discussion of whether removal is indicated.
Book a Consultation
For assessment and removal of wisdom teeth in London, arrange a consultation to discuss your options.