Wisdom Teeth: Stay or Go?
How we decide whether a wisdom tooth has to come out, what's behind the pain when one flares, what the appointment involves, and how to recover without complications.
Should My Wisdom Teeth Come Out, and What Would It Cost in Broughty Ferry?
Only when they're causing problems, or clearly about to. The typical reasons are recurring gum infections around a partly erupted tooth, decay that can't be properly filled, damage to the neighbouring molar, or a cyst showing on an X-ray. Wisdom teeth that are healthy, including ones still under the gum, are usually best left where they are. Here at Ferry Smile Studios, removing a wisdom tooth surgically costs £450. We have a 3D CT scanner on the premises for lower teeth lying close to the nerve, and for anyone who would rather not be aware of the procedure, IV sedation can be arranged.
Most Can Simply Be Left
Your wisdom teeth are the third molars, the final teeth to appear, usually somewhere from 17 to 25 years of age. In some mouths they erupt cleanly and work like any other back tooth. In others the jaw is too short, so they remain beneath the gum or emerge at an angle, a situation dentists describe as impacted.
An impacted tooth doesn't automatically need removing. UK guidance advises against extracting healthy, trouble-free wisdom teeth, buried or otherwise. Many people live their whole lives with impacted wisdom teeth and never have a moment's discomfort from them. Every operation carries some risk, and when the tooth isn't causing problems, there's no reason to accept that risk.
Our approach is to monitor them. At each dental examination we check how the teeth are positioned and take an X-ray from time to time, so that early decay or damage to the neighbouring tooth is picked up before it becomes painful.
When Taking It Out Is the Right Call
| Problem | Why it matters |
|---|---|
| Recurring pericoronitis | The gum covering a partly erupted tooth becomes infected repeatedly. Two or more episodes is a frequent reason to remove it |
| Decay in the wisdom tooth itself | So far back, a filling is often impractical and the tooth hard to keep clean |
| Harm to the second molar | Food packs between the two teeth and rots the back surface of the molar in front, the tooth you most want to protect |
| Gum disease and bone loss | Deep pockets alongside a wisdom tooth undermine the bone holding up its neighbour |
| A cyst or other change on X-ray | Sacs of fluid can form around buried teeth and slowly eat away bone |
| Damage to the cheek or gum | A top wisdom tooth that bites down on the gum covering a lower one, or rubs against the inside of the cheek |
We'll say which of these, if any, applies in your case, and whether leaving the tooth under observation is a sensible alternative. The decision is yours, and the fee is put in writing before anything is scheduled. 1
Wisdom Tooth Giving You Grief?
Book in, and we'll take an X-ray and talk you through the choices.
What's Behind the Pain
Pericoronitis is by far the most common reason a wisdom tooth hurts. A flap of gum sits partly over the tooth, food debris and bacteria gather underneath, and the gum swells up. The usual giveaways are a nasty taste, discomfort when swallowing, a jaw too stiff to open fully, or a face that is swollen on that side. Flare-ups tend to strike when you're exhausted, run down or fighting off a cold.
A first bout generally calms down with meticulous cleaning, including a soft brush reaching right to the back, plus warm salt-water rinses several times daily. We can irrigate beneath the flap, and where the swollen gum is being bitten by the upper wisdom tooth, smoothing or extracting that upper tooth frequently prevents a recurrence. Antibiotics are only worth prescribing once infection has begun spreading or you've developed a temperature. For repeated episodes, removing the lower tooth is the permanent solution.
The source can also be decay, whether in the wisdom tooth itself or its neighbour in front, and an X-ray will reveal it. If swelling makes breathing or swallowing difficult, or tracks towards the eye or down the neck, go to A&E.
Imaging Before Any Surgery
Ahead of any wisdom tooth removal we take an X-ray showing the entire tooth, its roots and the bone around them. In the lower jaw, a nerve passes through the bone directly below the wisdom tooth roots. It supplies sensation to the lower lip and chin and, via a branch close by, part of the tongue. For a good many teeth, a standard X-ray confirms there's ample clearance and nothing further is required.
Where the roots appear to lie near that nerve, a 3D CT scan is taken, £160, using the scanner here at the practice, so there's no trip elsewhere. 1 The scan reveals precisely how the roots and nerve relate to each other, which allows us to plan the safest route for removal and give you an honest estimate of your personal risk. Now and then it shows that an alternative technique, such as removing just the crown and leaving the roots in place, is the safer option. The scan itself is described in our CT scan guide.
The Procedure Itself
Local anaesthetic numbs the area completely, so what you'll feel is pressure and pushing, nothing sharp. A wisdom tooth that has erupted fully can usually be removed much as any other tooth would be. A buried or partly erupted tooth calls for surgery: a small flap of gum is raised, a little bone around the tooth may be taken away, and the tooth is often sectioned into pieces so that each comes out with less force. Dissolving stitches close the gum afterwards. Most removals take somewhere between 20 minutes and an hour.
Should the X-ray or scan indicate a tooth is going to be unusually challenging, we'll tell you before anything is booked, and where the oral surgery team at Dundee Dental Hospital would be the safer option, a referral is made.
Sedation If You're Anxious
Many people would rather not be fully conscious while a wisdom tooth is removed, and asking for that is entirely reasonable. IV sedation is delivered through a fine cannula in a vein, in addition to the normal local anaesthetic. You can still hear and respond to us, but you feel relaxed and sleepy, and most people remember very little of the appointment afterwards.
A session costs £500, and every extra 30 minutes adds £250. 1 A responsible adult must collect you and remain with you until bedtime, and driving, operating machinery and signing anything important are off limits for 24 hours. How to prepare is set out in our IV sedation guide.
Recovering Well
Within three to five days most people feel themselves again. The first couple of days are the roughest, with swelling usually at its worst on day two or three.
- Keep firm pressure on the gauze for 20 minutes so it stays put. If oozing starts again later, repeat with a fresh piece
- Begin painkillers before the numbness wears off and keep taking them at the intervals on the packet for the first day or two
- For the first 24 hours, steer clear of hot drinks, alcohol, smoking, vaping, straws and vigorous rinsing, all of which can shift the clot
- Stick to soft, lukewarm food, and chew away from the socket
- Starting the next day, rinse gently with warm salt water after eating, and brush your remaining teeth normally
- Holding a cold pack against the cheek over the first 24 hours keeps swelling in check
- Leave the gym alone for a few days, and prop your head up slightly when you sleep
If the pain worsens on day three or four rather than easing, often accompanied by a foul taste, the clot may have been lost, a condition called dry socket. Give us a call. A soothing dressing in the socket brings rapid relief.
The Fees
| Treatment | Fee |
|---|---|
| New patient examination including X-rays | £70 |
| 3D CT scan, where roots lie close to the nerve | £160 |
| Emergency appointment the same day for a flare-up | £70 |
| Simple extraction of an erupted tooth | £125 |
| Wisdom tooth or surgical extraction | £450 |
| IV sedation, each session | £500 |
Your written plan confirms the fee before treatment starts, and extractions and scans are 10% cheaper for dental plan members. 1 In pain right now? Ring 01382 477350. Same-day emergency appointments are held every weekday for registered and unregistered patients alike. Our full price list has every fee.
Questions
This guide is general information, not a diagnosis. A dentist needs to examine you to say what is right for your teeth.