Wisdom teeth and surgical extraction: when and aftercare

In short: surgical extraction is for a tooth that hasn't fully come through (such as an impacted wisdom tooth) or is broken so badly that a simple extraction won't work. It's done under local anaesthetic, and the wound is often closed with stitches. The most important thing afterwards is to follow the instructions for the first two days so the wound heals without problems.

When is surgical extraction needed?

• An impacted wisdom tooth, or one coming in at an angle, causing pain or repeated gum inflammation over it.
• A wisdom tooth pushing the teeth in front, or causing decay in the tooth next to it.
• A tooth broken at gum level, or roots left behind.
• Orthodontic reasons: sometimes a tooth is removed to make space.

Not every wisdom tooth has to come out; if it has come through well, is clean and causes no problems, it can stay. A panoramic X-ray shows this.

The steps

1. Examination and X-rays (panoramic, sometimes a CBCT scan if the tooth is near the nerve).
2. Local anaesthetic until the area is completely numb.
3. A small opening in the gum, sometimes dividing the tooth so it comes out easily.
4. Cleaning and stitching the area if needed.

Aftercare

The first 24 hours

• Bite on the gauze for 30–45 minutes.
• Don't rinse, spit or use a straw — this protects the clot that seals the wound.
• Cold compresses on the cheek to reduce swelling.
• Soft, lukewarm or cold food (yoghurt, lukewarm soup, mashed potatoes), chewing on the other side.
• No smoking at all.

From the second day

• Gentle warm salt-water rinses after meals.
• Keep brushing normally, carefully around the wound.
• Take your medicines exactly as prescribed.

What's normal, and when to call your dentist

Normal: mild swelling for two or three days, pain controlled by painkillers, light bleeding on the first day.

Call your dentist if:

• bleeding continues despite pressing on the gauze;
• pain gets much worse on day three or four (this may be dry socket);
• you have a fever, swelling that grows after day three, or difficulty swallowing.

Rinsing, straws and smoking in the first 24 hours are among the most common reasons a wound heals slowly.

If a wisdom tooth hurts or the gum over it keeps getting inflamed, book an examination and X-ray at our 6th of October branch or El Saff branch. If the extracted tooth needs replacing, read about dental implants.