Wisdom tooth extraction
Wisdom teeth don't always need to come out, but when they cause problems or are likely to, Dr. Azadi can assess them and, in many cases, remove them here in our office.
What are wisdom teeth?
Wisdom teeth are the third molars, the last teeth at the very back of the mouth. They usually appear between the late teens and mid-twenties. Some people have all four, some have fewer, and some have none.
When there is enough room, wisdom teeth can come in straight and be kept clean like any other tooth. Often there isn't enough room, and the tooth stays partly or fully trapped under the gum or bone. This is called an impacted wisdom tooth. Impacted teeth may grow in at an angle, push against the tooth in front, or only partly break through the gum.
Signs a wisdom tooth may be causing trouble
- Pain, tenderness or swelling at the back of the mouth
- A sore, swollen gum flap over a partly erupted tooth, sometimes with a bad taste (an infection called pericoronitis)
- Food getting trapped behind the last molar
- Swelling of the cheek or jaw, or difficulty opening your mouth fully
- Decay or gum problems in the wisdom tooth or the molar in front of it
Some wisdom teeth cause damage without any symptoms, which is why we check them on x-rays at your regular visits.
Do my wisdom teeth need to come out?
Not always. A wisdom tooth that has come in fully, is healthy, and can be cleaned properly may simply be monitored. Removal is usually recommended when a wisdom tooth:
- Keeps getting infected or causes repeated pain
- Has decay that can't reasonably be repaired
- Is damaging the tooth in front, or trapping food and plaque against it
- Is linked to gum disease, a cyst, or other changes seen on x-ray
- Is likely to cause problems later, based on its position
When removal is advised, it is often simpler in younger adults, before the roots are fully formed. We'll explain the reasons for our recommendation and the option of waiting, so you can decide.
Removal here, or with an oral surgeon
Many wisdom teeth can be removed in our office under local anaesthetic (freezing). Some cases are better handled by an oral and maxillofacial surgeon, for example a tooth that is deeply impacted, has roots very close to the nerve in the lower jaw, or when you would prefer to be asleep for the procedure. If that's the best choice for you, we'll refer you and send your x-rays along.
Who should book an assessment
- Teens and young adults whose wisdom teeth are coming in
- Anyone with pain, swelling or a sore gum flap at the back of the mouth
- Patients who have been told a wisdom tooth is impacted
- Anyone who hasn't had their wisdom teeth checked on an x-ray
You don't need a referral. You can book a wisdom tooth assessment with us directly.
What happens with a wisdom tooth extraction
- AssessmentWe examine the area and take a panoramic x-ray to see the position of each tooth and its roots. Occasionally a 3D scan is recommended when roots are close to the nerve.
- PlanningWe explain whether removal is recommended, the risks and alternatives, how many teeth to remove at once, and give you a written estimate. We can send a predetermination to your insurer first.
- The procedureThe area is thoroughly frozen. A tooth that hasn't fully come in may need a small opening in the gum, and sometimes the tooth is removed in sections. Stitches may be placed.
- Follow-upYou'll go home with written care instructions. We check healing at a follow-up visit if needed and are a phone call away if you have concerns.
Possible risks
- Pain, swelling, bruising and jaw stiffness for several days
- Bleeding, which usually settles within the first day
- Dry socket: a painful condition when the blood clot is lost from the socket, usually two to four days after the extraction. It is treatable, so call us if pain gets worse instead of better.
- Infection
- Numbness or tingling of the lip, chin or tongue when lower roots lie close to a nerve. This is usually temporary but can rarely be permanent. We'll tell you if your x-ray shows a higher risk.
- For upper wisdom teeth, a small opening into the sinus, which usually heals on its own
Aftercare
- Bite firmly on the gauze for 30 to 60 minutes. Some oozing for the rest of the day is normal.
- For the first 24 hours, don't rinse, spit forcefully, drink through a straw, smoke or vape. These can dislodge the blood clot.
- Use a cold pack on your cheek on and off for the first day to reduce swelling.
- Eat soft, cool foods at first and chew away from the area.
- From the next day, rinse gently with warm salt water after meals, and keep brushing your other teeth.
- Take pain relief as we advise. Most people feel much better within a few days to a week.
Call us if bleeding won't stop, if pain or swelling is getting worse after the third day, or if you develop a fever. See our extraction aftercare guide for more.
Common questions
Does wisdom tooth removal hurt?
The area is frozen, so you should feel pressure but not sharp pain during the procedure. Soreness afterwards is normal and is usually managed with the pain relief we recommend.
How long does recovery take?
Most people return to normal activities within a few days. Swelling usually peaks around the second or third day and then settles.
Can all four be removed at once?
Often, yes. It depends on how the teeth are positioned and what you are comfortable with. We'll plan this with you.
Is wisdom tooth removal covered by insurance?
Many dental plans cover extractions in part. We can send a predetermination so you know your share before treatment.
What if I leave my wisdom teeth in?
If they are healthy and can be cleaned, that may be fine. We'll keep an eye on them with x-rays at your regular check-ups.
Dr. Anahita Azadi Boroujeni, DDS, Dr. Cynthia Simon, DMD, and Dr. Kyra de Gouw, DMD, are general dentists registered with the Royal College of Dental Surgeons of Ontario. This page is general information. Your treatment is planned after an examination.